Acute blood pressure change with methylphenidate is associated with improvement in attention performance in children with ADHD

Prog Neuropsychopharmacol Biol Psychiatry. 2020 Jan 10;96:109732. doi: 10.1016/j.pnpbp.2019.109732. Epub 2019 Aug 12.

Abstract

This exploratory study aims to determine whether the change in systolic blood pressure (sBP) after acute methylphenidate (MPH) administration (ΔBPMPH) is associated with the neurocognitive response to MPH in the Conners Continuous Performance Test (CPT) in 513 children with ADHD (aged 6 to 12 years old). We noted that higher increases in sBP were associated with larger improvement in CPT performance with MPH. In the univariate regression model, the ΔBPMPH accounted for an additional 2% of the variance in the change in CPT-Overall Index (OI) after controlling for covariates (p < .001). Linear regression analysis also indicated that ΔBPMPH significantly contributed to predict a change in omission errors, reaction time, and reaction time variability (p < .001, p < .01, p = .001, respectively), but not in commission errors or detectability index (d`). Participants with a clinically meaningful sBP increase of at least 5 mmHg (n = 191) improved by 4.8 points on the CPT-OI score (p < .001), compared to an improvement of only 0.6 points for participants whose sBP declined by at least 5 mmHg (n = 121). In conclusion, larger sBP increases after MPH administration were associated with greater enhancement in CPT performance. These results could be useful in informing MPH dosing in clinical practice.

Keywords: Attention; Blood pressure; CPT; Methylphenidate; Stimulants.

Publication types

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

MeSH terms

  • Attention / drug effects*
  • Attention / physiology
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / physiopathology
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Blood Pressure / drug effects*
  • Blood Pressure / physiology
  • Central Nervous System Stimulants / pharmacology
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Methylphenidate / pharmacology
  • Methylphenidate / therapeutic use*
  • Neuropsychological Tests*
  • Psychomotor Performance / drug effects
  • Psychomotor Performance / physiology

Substances

  • Central Nervous System Stimulants
  • Methylphenidate