Methylphenidate Improves Emotional Lability Among Children With ADHD

Delayed-release/extended-release methylphenidate improves emotional lability among children with attention-deficit/hyperactivity disorder (ADHD), according to new research published in the Journal of Attention Disorders.

Previous research indicates that children with ADHD who display emotional lability are more likely to have ADHD symptoms as adults and are at an increased risk for certain comorbidities, such as oppositional defiant and substance use disorders. However, relatively little is known about how stimulant medications used to treat ADHD may affect emotional lability.

To this aim, researchers conducted a post-hoc analysis of 2 randomized, double-blind, phase 3 trials that evaluated delayed-release/extended-release methylphenidate treatment among children with ADHD aged 6 to 12 years. Diagnoses of ADHD were validated using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Additionally, the researchers measured children’s emotional lability using the Conners’ Global Index – Parent (CGI-P) emotional lability subscale for up to 6 weeks following delayed-release/extended-release methylphenidate treatment.

The researchers included a total of 278 children with ADHD for analysis, 145 of whom were randomized to delayed-release/extended-release methylphenidate and 133 received a placebo. On average, participants were approximately 9 years of age and 68% to 70% of children were boys (depending on the original phase 3 trials).

Delayed-release/extended-release methylphenidate treatment was associated with significant improvements in emotional lability at weeks 1, 2, 3, 4, 5, and 6 (all P <.001), relative to baseline emotional lability scores. At baseline, the mean (SD) CGI-P emotional lability scores were 5.3 (2.53) for the placebo group and 5.5 (2.66) for the delayed-release/extended-release methylphenidate group. By week 3, the emotional lability scores were significantly lower among children who received delayed-release/extended-release methylphenidate (least squares mean=3.11; SE, 0.261) compared with those who received placebo (least squares mean=4.08; SE, 0.251; P =.0053).

These findings indicate that delayed-release/extended-release methylphenidate has the potential to reduce emotional lability among children with ADHD. The researchers concluded, “While the benefit of [delayed-release/extended-release methylphenidate] treatment on [emotional lability] was clearly outlined in this analysis, the beneficial effect compared with other stimulants remains to be tested.”

The primary study limitation is the lack of comparisons to other stimulant ADHD medications. Additionally, the use of the CGI-P emotional lability subscale limits accessibility due to copyright.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of author disclosures.

This article originally appeared on Psychiatry Advisor