Clinical gains from including both dextroamphetamine and methylphenidate in stimulant trials

J Child Adolesc Psychopharmacol. 2013 Nov;23(9):597-604. doi: 10.1089/cap.2012.0085. Epub 2013 May 9.


Objective: The purpose of this study was to investigate clinical gains from including both dextroamphetamine and methylphenidate in stimulant trials.

Method: Thirty-six medication-naïve children ages 9-14 years diagnosed with attention-deficit/hyperactivity disorder (ADHD) were enrolled for 6 weeks in a crossover trial, with 2 weeks of methylphenidate, dextroamphetamine, and placebo, in a randomly assigned, counterbalanced sequence. Outcome measures constituted a computer-based continuous performance test combined with a motion tracking system (Qb Test) and an ADHD questionnaire rated by parents and teachers.

Results: Group analyses found significant treatment effects of similar size for the two stimulants on both outcome measures. Single-subject analyses revealed that each stimulant produced a favourable response in 26 children; however, an individual child frequently responded qualitatively or quantitatively differently to the two stimulants. By including both stimulants in the trial, the number of favorable responders increased from 26 (72%) to 33 (92%). In children with favorable responses of unequal strength to the two stimulants, a shift from inferior drug to best drug was associated with a 64% mean increase in the overall response strength score, as measured by the ADHD questionnaire.

Conclusions: The likelihood of a favorable response and optimal response strength is increased by including both stimulants in the stimulant trial. The study was first registered in clinical trials 28 September 2010. Clinical Identifier: NCT01220440.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / physiopathology
  • Central Nervous System Stimulants / administration & dosage
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Cross-Over Studies
  • Dextroamphetamine / administration & dosage
  • Dextroamphetamine / therapeutic use*
  • Diagnosis, Computer-Assisted
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Methylphenidate / administration & dosage
  • Methylphenidate / therapeutic use*
  • Parents
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome


  • Central Nervous System Stimulants
  • Methylphenidate
  • Dextroamphetamine

Associated data