Effectiveness of an Extended Release Stimulant Medication in Treating Preschool Children With ADHD

NCT ID: NCT00712699

Last Updated: 2013-08-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-06-30

Study Completion Date

2010-08-31

Brief Summary

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This study will evaluate the safety and effectiveness of extended release mixed amphetamine salts in treating preschool children with attention deficit hyperactivity disorder.

Detailed Description

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Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder that affects between 4% and 12% of school-aged children. Children with ADHD often show symptoms of hyperactivity, inattention, inability to sit still, trouble listening, excessive talking, and aggression. ADHD is generally not diagnosed and treated in children less than 6 years old because some symptoms of ADHD are difficult to distinguish from normal behaviors of preschool-aged children. However, some preschool children who exhibit symptoms indicative of ADHD and who have been carefully diagnosed by a health professional may benefit from early treatment to lower risk for functional impairment later in childhood. Currently, environmental changes, parent effectiveness training, and behavior therapy are the commonly used treatments for preschoolers with ADHD symptoms, but not all preschoolers respond well to such behavioral interventions. These children may benefit from medication treatment; however, the safety and effectiveness of ADHD medications in treating preschool-aged children is not well known. Extended release mixed amphetamine salts (XR-MAS), a stimulant medication, is a commonly prescribed and approved medication for treating ADHD in children 6 years and older. Further study is needed to determine how XR-MAS affects preschool-aged children with ADHD symptoms. This study will compare the safety and effectiveness of XR-MAS versus placebo in treating preschool children with ADHD.

Participation in this study will last 6 weeks. All participants will first undergo rigorous psychiatric assessments to confirm their diagnosis of ADHD. Eligible participants will then be assigned randomly to receive treatment with either XR-MAS then placebo or placebo then XR-MAS. Participants will take their assigned XR-MAS or placebo medications for 3 weeks and then cross over to the other medication for an additional 3 weeks of treatment. Rating scale scores will be collected weekly from parents and teachers to assess symptom response and measures of safety.

Conditions

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Attention Deficit Disorder With Hyperactivity

Keywords

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Preschool Children ADHD Medication Controlled Study Placebo Mixed Amphetamine Salts

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Sequence 1: XR-MAS then placebo

Depending on whether 1) child has had previous medication trial or 2) is on psychotropic medication at time of screening, children will either enter the washout period of 3 days before extended release mixed amphetamine salts (XR-MAS) or placebo (PBO) is initiated or proceed directly to the active treatment sequence they were randomized to. Participants randomized to Sequence 1 first receive treatment with XR-MAR for 3 weeks and then placebo for 3 weeks. Flexible, forced dosing will start at 5 mg/day for the first week, increase to 10 mg/day for the second week and continue to 15 mg/day on the third week. No washout period otherwise occurs (XR-MAS is not clinically suspected to have lingering effects beyond initial dosing/day of administration), including the crossover week to PBO.

Group Type EXPERIMENTAL

Sequence 1: XR-MAS then placebo

Intervention Type DRUG

XR-MAS given in non-identifying 5 mg capsules with instructions to start 1 capsule (5 mg/d) for one week, then increase to 2 capsules (10 mg/d) for week two, and 3 caps (15 mg/d) for week 3 following flexible, forced titration based on response and tolerance.

Sequence 2 Placebo then XR-MAS

Intervention Type DRUG

PBO given in non-identifying 5 mg capsules with instructions to start 1 capsule (5 mg/d) for one week, then increase to 2 capsules (10 mg/d) for week two, and 3 caps (15 mg/d) for week 3 following flexible, forced titration based on response and tolerance.

Sequence 2 Placebo then XR-MAS

Depending on whether 1) child has had previous medication trial or 2) is on psychotropic medication at time of screening, children will either enter the washout period of 3 days before extended release mixed amphetamine salts (XR-MAS) or placebo (PBO) is initiated or proceed directly to the active treatment sequence they were randomized to. Participants randomized to Sequence 2 will first receive treatment with PBO for 3 weeks and then XR-MAS for 3 weeks. Flexible, forced dosing will start at 5 mg/day for the first week, increase to 10 mg/day for the second week and continue to 15 mg/day on the third week. No washout period (stimulants are not clinically suspected to have lingering effects beyond initial dosing/day of administration)otherwise occurs, including the crossover week to XR-MAS.

Group Type EXPERIMENTAL

Sequence 1: XR-MAS then placebo

Intervention Type DRUG

XR-MAS given in non-identifying 5 mg capsules with instructions to start 1 capsule (5 mg/d) for one week, then increase to 2 capsules (10 mg/d) for week two, and 3 caps (15 mg/d) for week 3 following flexible, forced titration based on response and tolerance.

Sequence 2 Placebo then XR-MAS

Intervention Type DRUG

PBO given in non-identifying 5 mg capsules with instructions to start 1 capsule (5 mg/d) for one week, then increase to 2 capsules (10 mg/d) for week two, and 3 caps (15 mg/d) for week 3 following flexible, forced titration based on response and tolerance.

Interventions

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Sequence 1: XR-MAS then placebo

XR-MAS given in non-identifying 5 mg capsules with instructions to start 1 capsule (5 mg/d) for one week, then increase to 2 capsules (10 mg/d) for week two, and 3 caps (15 mg/d) for week 3 following flexible, forced titration based on response and tolerance.

Intervention Type DRUG

Sequence 2 Placebo then XR-MAS

PBO given in non-identifying 5 mg capsules with instructions to start 1 capsule (5 mg/d) for one week, then increase to 2 capsules (10 mg/d) for week two, and 3 caps (15 mg/d) for week 3 following flexible, forced titration based on response and tolerance.

Intervention Type DRUG

Other Intervention Names

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Adderall XR IND# 58,037

Eligibility Criteria

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Inclusion Criteria

* Living at home for at least 6 months with parent or caregiver
* Enrolled in a structured school setting at least 2 half days a week with a minimum of 7 peers
* Full Scale Intelligence Quotient (FSIQ) of 70 or greater OR 72 or greater if bilingual
* Best estimate diagnosis based on clinical interview, Diagnostic Interview Schedule for Children, Child Behavior Checklist, and rating scales scores
* Symptoms present for at least 9 months
* Meets severity criteria for Clinical Global Impression-Severity with score of greater than or equal to 4 and Clinical Global Assessment Scale score of greater than or equal to 55
* Parent/caregiver can commit to 6 weekly sessions, including initial screening exams
* If on current psychotropic medication, will undergo a washout period of at least 3 days before study entry
* Not currently receiving psychotherapy or started psychotherapy within 30 days of study entry

Exclusion Criteria

* Previous nonresponse to mixed amphetamine salts (defined as 2 weeks of persistent symptoms in spite of doses greater than or equal to 15 mg per day)
* Diagnosis of language-based or cognitive delay of more than 2 standard deviations below same-aged peers or diagnosis of mental retardation
* Pervasive developmental disorder or autism
* Significant developmental disorder (e.g., blindness, deafness, cerebral palsy, epilepsy, psychosis)
* Taking another psychotropic medication that cannot be discontinued
* Serious psychiatric disorder (e.g., bipolar, suicidality, tic disorder)
* Actively taking medication for certain medical conditions (e.g., hypertension, structural cardiac condition, glaucoma, hyperthyroidism)
* Allergy to mixed amphetamine salts
* History of physical, sexual, or emotional abuse that is clinically significant
Minimum Eligible Age

36 Months

Maximum Eligible Age

66 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Baystate Medical Center

OTHER

Sponsor Role lead

Responsible Party

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john fanton

Primary Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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John H. Fanton, MD

Role: PRINCIPAL_INVESTIGATOR

Baystate Medical Center

Countries

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United States

Other Identifiers

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F32MH078388

Identifier Type: NIH

Identifier Source: secondary_id

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DDTR BK-TKFND

Identifier Type: -

Identifier Source: secondary_id

F32MH078388

Identifier Type: NIH

Identifier Source: org_study_id

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