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Old 10-17-18, 10:29 AM
PI-ADHD 29 PI-ADHD 29 is offline
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Low dose methylphenidate is better for inattentive?

I've found an article of Barkley in pubmed.https://www.ncbi.nlm.nih.gov/pubmed/2011430. According to the article hyperactive type adhd children respond better than inattentive adhd children to mph treatment.
And also according to the article inattentive children respond best at low dose medication.
I've tried both 5 mg and 30 mg of ritalin. And i couldn't see any difference between them. Both doses' effect (focus, motivation) continued only 15-20 minutes(because i've developed tolerance just in two weeks).
Has anyone else ever tried low and high doses and if you what's your experience and idea?
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Old 10-17-18, 11:34 AM
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Re: Low dose methylphenidate is better for inattentive?

Yea but this confused me,

Quote:
Abstract
The response of 23 children with attention deficit disorder (ADD) with hyperactivity (+H) and 17 children with ADD without hyperactivity (-H) to three doses of methylphenidate (5, 10, and 15 mg twice a day) was evaluated in a triple-blind, placebo-controlled cross-over design using parent and teacher ratings of behavior, laboratory tests of ADD symptoms, and behavioral observations during academic performance. Results indicated that the children with ADD+H were rated as having more pervasive behavioral problems at home and more pervasive and severe conduct problems at school than the children with ADD-H. Laboratory tests found the children with ADD+H to be impaired in behavioral inhibition and vigilance whereas children with ADD-H were more impaired in the consistent retrieval of verbally learned material Drug effects were noted on the parent and teacher ratings and on most laboratory measures, with all three doses typically producing significant changes but rarely differing among themselves in effectiveness. The groups were not found to differ significantly on any measures in their response to methylphenidate. However, more children with ADD-H were clinically judged as having either no clinical response (24%) or responding best to the low dose (35%) of medication. In contrast, most ADD+H (95%) children were judged to be positive responders and most were recommended to receive the moderate to high dose (71%).
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Old 10-17-18, 12:13 PM
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Re: Low dose methylphenidate is better for inattentive?

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Originally Posted by sarahsweets View Post
Yea but this confused me,
I couldn't understand why did it confuse you. What do you mean?
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Old 10-17-18, 01:29 PM
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Re: Low dose methylphenidate is better for inattentive?

If I'm reading the abstract correctly (haven't read the full paper yet)...

Among people diagnosed at that time with ADD-H, 76% of them had a positive clinical response to methylphenidate (vs. 95% in the ADD+H group), and 41% of them (that's the 76% who responded to methylphenidate minus the 35% who did better at lower doses) responded better to a moderate-high dose of meds (vs. 71% of the ADD+H) group.

So overall -- again, assuming I'm interpreting the abstract correctly -- it looks like the portions of the ADD-H group who:
  • Didn't respond to methylphenidate was 24%
  • Responded best to a low dose of methylphenidate was 35%
  • Responded best to a moderate or high dose of methylphenidate was 41%

This suggests that on average, the ADD-H group needs lower doses of methylphenidate than the ADD+H group, but that even among the ADD-H group, a plurality responded better to a moderate/higher dose of methylphenidate.


My personal experience with methylphenidate has been mixed, but generally I have responded better to higher doses. However, the therapeutic effects also seem to wane with time for me.

Last edited by namazu; 10-17-18 at 09:06 PM.. Reason: typo
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Old 10-17-18, 04:59 PM
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Re: Low dose methylphenidate is better for inattentive?

I guess I'm in the 41%. there is a big difference between 10 and 30 mg for me.
I had no idea that there was any variation between attentive vs inattentive in meds.
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Old 10-17-18, 09:12 PM
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Re: Low dose methylphenidate is better for inattentive?

Quote:
Originally Posted by stef View Post
I guess I'm in the 41%. there is a big difference between 10 and 30 mg for me.
I had no idea that there was any variation between attentive vs inattentive in meds.
I think (but would need to look it up to be sure) that there have been mixed results, with some studies finding no real differences in response to medications by subtype.

Part of that may be that the studies are small or the outcome measures are not sensitive to small differences. Part of that may be that some studies didn't do a thorough comparison of differents meds or doses. Part of that may be due to how the subtypes are classified -- do they include "subthreshold combined types" (people with some hyperactive-impulsive symptoms but not enough for combined presentation) among their "inattentives", or only people without any real hyperactive-impulsive symptoms? Part of that may be that there are other factors -- say, metabolism or other aspects of neurology or body chemistry -- that make more of a difference than subtype/presentation in terms of response to medications.
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