Methylphenidate vs Dextroamphetamine vs Caffeine in Minimal Brain Dysfunction: Controlled Comparison by Placebo Washout Design With Bayes' Analysis

doi:10.1001/archpsyc.1978.01770280073008

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Vol. 35 No. 4, April 1978

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Methylphenidate vs Dextroamphetamine vs Caffeine in Minimal Brain Dysfunction

Controlled Comparison by Placebo Washout Design With Bayes' Analysis

L. Eugene Arnold, MD; James Christopher, MD; Robert Huestis, MD; Donald J. Smeltzer, MA

Arch Gen Psychiatry. 1978;35(4):463-473.

Abstract

• Double-blind crossover comparison of methylphenidatehydrochloride, dextroamphetamine sulfate, and caffeine afterplacebo washout in 29 children with minimal brain dysfunction(MBD) showed on six ratings that methylphenidate and dextroamphetaminewere significantly (P <.05 to P <.001) better than placeboand caffeine, but not significantly (P <.05) different fromeach other. Placebo, caffeine, and ratings before drug did notdiffer significantly. Of 26 drug responders, 12 responded bestto dextroamphetamine, ten to methylphenidate, and one to caffeine.The latter child showed no improvement at all with either prescriptionstimulant. Methylphenidate and dextroamphetamine were each efficaciousfor six children who did not respond to the other stimulant.All three drugs showed significant (P <.05) weight loss andcardiovascular side effects, the latter possibly spurious. Dextroamphetamineshowed a significant (P <.05) decrease from placebo in "tummyaches."

Author Affiliations

From the Division of Child Psychiatry, Ohio State University.

Footnotes

Accepted for publication March 31, 1977.

Reprint requests to Division of Child Psychiatry, Departmentof Psychiatry, Ohio State University, 473 W 12th Ave, Columbus,OH 43210 (Dr Arnold).

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