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Journal of Pediatric Psychology Advance Access published online on May 22, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp044
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Predicting Methylphenidate Response in Long-Term Survivors of Childhood Cancer: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial

Heather M. Conklin, PhD1, Susan Helton, EdS1, Jason Ashford, MS1, Raymond K. Mulhern, PhD*, Wilburn E. Reddick, PhD2, Ronald Brown, PhD3, Melanie Bonner, PhD4, Bruce W. Jasper, PhD1, Shengjie Wu, MS5, Xiaoping Xiong, PhD5 and Raja B. Khan, MD6

1Division of Behavioral Medicine, 2Division of Translational Imaging Research, St. Jude Children's Research Hospital, 3Department of Public Health, Temple University, 4Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 5Department of Biostatistics, St. Jude Children's Research Hospital and 6Department of Neurology, University of Tennessee

All correspondence concerning this article should be addressed to Heather M. Conklin, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 740, Memphis, TN 38105, USA. Email: heather.conklin{at}stjude.org


  Abstract

Objective To investigate the methylphenidate (MPH) response rate among childhood survivors of acute lymphoblastic leukemia (ALL) and brain tumors (BTs) and to identify predictors of positive MPH response. Methods Cancer survivors (N = 106; BT = 51 and ALL = 55) identified as having attention deficits and learning problems participated in a 3-week, double-blind, crossover trial consisting of placebo, low-dose MPH (0.3 mg/kg), and moderate-dose MPH (0.6 mg/kg). Weekly teacher and parent reports on the Conners’ Rating Scales were gathered. Results Following moderate MPH dose, 45.28% of the sample was classified as responders. Findings revealed that more problems endorsed prior to the medication trial on parent and teacher ratings were predictive of positive medication response (p < .05). Conclusions MPH significantly reduces attention problems in a subset of childhood cancer survivors. Parent and teacher ratings may assist in identifying children most likely to respond to MPH so prescribing may be optimally targeted.

Key words: brain tumor; leukemia; stimulant medication; methylphenidate..

*Deceased.

Received November 7, 2008; revision received April 22, 2009; accepted April 22, 2009


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