Research helps end guesswork in prescribing ADHD drug

May 3, 2010, Cincinnati Children's Hospital Medical Center

Children with ADHD who carry a specific type of dopamine receptor gene respond better to the drug methylphenidate (MPH) than those without the genotype, according to new research from Cincinnati Children's Hospital Medical Center.

The findings come from the first-ever placebo-controlled pharmacogenetic drug trial for Attention Deficit/Hyperactivity Disorder in school age to evaluate variants of the DRD4 dopamine receptor gene using teacher ratings of children's symptoms.

The research makes progress toward ending the guesswork now involved in prescribing effective ADHD medications that deliver the greatest symptom improvement and fewest side effects, according Tanya Froehlich, M.D., a physician and researcher in the division of Developmental and Behavioral Pediatrics at Cincinnati Children's.

"We don't have a good way of predicting who will experience great improvement in ADHD symptoms with a particular medication, so we use a trial-and-error approach. Unfortunately, as a result finding an effective treatment can take a long time," Froehlich said. "With more information about genes that may be involved in ADHD medication response, we might be able to predict treatment course, tailor our approach to each child, and improve symptom response while decreasing health care costs."

The study was presented May 1 at the annual meeting of the Pediatric Academic Societies in Vancouver, Canada.

Dr. Froehlich and her colleagues tested 89 children between the ages of 7 and 11 who were not already taking stimulant medications for their ADHD. The researchers analyzed DNA from saliva samples to see if the children carried the 7-repeat version of the DRD4 gene, an increasing target of ADHD gene-based studies that has been linked to increased risk for the condition.

Children in the double-blind four-week trial were given one week each of placebo and three different doses of MPH for their ADHD. Parents and teachers assessed and scored the children's behavioral symptoms based on the Vanderbilt ADHD Parent and Teacher Rating Scales. In children with at least one copy of the 7-repeat DRD4 gene who took MPH, teachers reported greater improvement in symptoms with increasing doses compared to children who did not have any copies of the 7-repeat gene.

Going forward, Dr. Froehlich said researchers will be studying additional gene variants and their relationship to ADHD medication response. This includes that encode MPH drug targets, such as the dopamine transporter, as well as enzymes that help the body metabolize the drug. MPH (which goes by several brand names, including Ritalin and Concerta) is a stimulant frequently used to treat .

Related Stories

Recommended for you

Reducing sessions of trauma-focused psychotherapy does not affect effectiveness

January 17, 2018
Posttraumatic Stress Disorder (PTSD) patients treated with as few as five sessions of trauma-focused psychotherapy find it equally effective as receiving 12 sessions.

How past intentions influence generosity toward the future

January 17, 2018
Over time, it really is the thought that counts – provided we know what that thought was, suggests new research from Duke University's Fuqua School of Business.

Baby brains help infants figure it out before they try it out

January 17, 2018
Babies often amaze their parents when they seemingly learn new skills overnight—how to walk, for example. But their brains were probably prepping for those tasks long before their first steps occurred, according to researchers.

Tracking the impact of early abuse and neglect

January 17, 2018
Children who experience abuse and neglect early in life are more likely to have problems in social relationships and underachieve academically as adults.

Study: No evidence to support link between violent video games and behaviour

January 16, 2018
Researchers at the University of York have found no evidence to support the theory that video games make players more violent.

Can psychedelic drugs 'reconnect' depressed patients with their emotions?

January 15, 2018
Imperial research suggests psilocybin can help relieve the symptoms of depression, without the 'dulling' of emotions linked with antidepressants.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.