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Ritalin Tests for Preschoolers

Eliot Marshall's News Focus article “Planned Ritalin trial for tots heads into uncharted waters” (17 Nov., p. [1280][1]) describes a clinical trial that begins in December 2000, the Preschool ADHD Treatment Study, that will assess the efficacy and safety of methylphenidate (Ritalin) on children 3 to 6 years old. Although the article provides a good description of the background of the study and its overall design, it contains an inaccurate statement regarding methylphenidate dosing used in the initial stages of the study that could cause concern on the part of families who might participate. Marshall mentions that “only very low doses of [methylphenidate] will be used in the initial stage—so low that a planning memo calls the level ‘homeopathic.’” This statement is incorrect, for it suggests that all the dose levels would “have no effect.” As strongly recommended by the National Institute of Mental Health's Data Safety and Monitoring Board, only one of the four methylphenidate doses used in the initial stage will be very low—so low that the authors of two previous studies would consider it “homeopathic.” This will allow us to test whether this single very low dose might work better in a preschool child.

 [1]: /lookup/doi/10.1126/science.290.5495.1280