Efficacy of olanzapine versus methylphenidate treatment for childhood hyperkinetic syndrome

Xueru HAO; Wenbo CUI

ABSTRACT

BACKGROUND:

Attention deficit and hyperkinetic disorder (ADHD) isfrequently treated with psychostimulant medications, which had beenshown to improve both cognitive and behavioral outcomes for most chil dren.

OBJECTIVE:

To compare the efficacy and adverse effects of olanzapinevs methylphenidate treatment in childhood hyperkinetic syndrome.

DESIGN:

Clinical comparative study.

SETTING:

Department of Psychiatry, Beijing Huilongguan Hospital; De partment of Mental Psychiatry, Shangdong Mouping People's Hospital. PARTICIPANT S Sixty children with hyperkinetic syndrome from theclinics of the Department of Psychiatry,Beijing Huilongguan Hospital andthe Department of Mental Psychiatry of Shandong Mouping People's Hos pital between March 2002 and April 2004 were enrolled into this prospec tive study after obtaining the consents from their guardians.The patientswere randomly divided into 2 group the olanzapine group (n=30) and themethylphenidate group (n=30).

METHODS:

In the olanzapine group olanzapine 2.5-7.5 mg per day wasgiven as a single dose in every evening.In the methylphenidate groupmethylphenidate 5-15 mg per day was given in divided dose in everymorning and evening.The dosage ofolanzapine and methylphenidatewere adjusted according to age, body mass and patient's clinical condi tions. And the period of treatment for either drug was 12 weeks. Conners teachers scale was used before and at the end of the 12 weektreatment(①hyperkinetic index consisted of 10 items②hyperkinetic behavior factorconsisted of 7 items. Each item was rated “none=0, a little=1, quite alot=2, and very much=3 ). Side effect scale was used to evaluate the hy perkinetic symptom and adverse reactions which consisted of behavior toxicity, abnormal laboratory tests , symptoms of the nervous system, au tonomic nervous system, cardiovascular system and skin etc with. 0=none; 1 =suspicious or very mild, 2=mild, 3 =moderate, 4=severe. The highestscore was 22,and the lowest was 0 with a score over 2 being positivefinding). MAIN OUTCOME

MEASURES:

Hyperkinetic syndrom score and ad verse reaction score at the end of the 12 weeks treatment.

RESULTS:

All 60 children completed the study and their results wereentered into the data analysis① At the end of the 12th week treat ment, the total hyperkinetic index score and total behavior score in boththe olanzapine group and the methylphenidategroup were significantly lower than those before the treatment as shown in Table 1 (t=8.16-15.26, P ＜ 0.05-0.01 )]; The total hyperkinetic behavior score in the olanzap inegroup was significantly lower than that in the methylphenidategroup (t=2.69, P ＜ 0.05 ). ② The adverse reaction score of patients inthe olanzapine group and the methylphenidategroup was 10.3±4.5and 10.9±3.8 respectively ,with no significant difference(P ＞ 0.05)between the two groups.

CONCLUSION:

Olanzapine produced similar effect as methylphenidatein the treatment of the hyperkinetic symptoms and attention deficits with a better efficacy in treating the behavior disorder than methylphenidate.