Bupropion versus methylphenidate in the treatment of children with attention-deficit/hyperactivity disorder: randomized double-blind study

Objective To compare the safety and efficacy of bupropion with methylphenidate in children and adolescents with attention‐deficit/hyperactivity disorder (ADHD). Methods In a 6‐week randomized double‐blind study, 44 patients with a DSM‐IV‐TR diagnosis of ADHD were randomly assigned to receive bupropion 100–150 mg/day (100 mg/day for <30 kg and 150 mg/day for >30 kg) or methylphenidate 20–30 mg/day. Symptoms were assessed using Teacher and Parent Attention‐Deficit/Hyperactivity Disorder Rating Scale‐IV (ADHD‐RS‐IV) at baseline and weeks 3 and 6. Results Forty patients had at least one post‐baseline measurement, and 38 patients completed the trial. No significant difference was found between the two groups on the Parent and Teacher ADHD‐RS‐IV scores ([ F (1, 38) = 0.266, p = 0.609] and [ F (1, 38) = 0.001, p = 0.972], respectively). By week 6, 18 patients (90%) in each group achieved response on the Parent scale (Fisher's exact test p ‐value = 1.0). With the Teacher ADHD‐RS‐IV used, eight (40%) patients in the bupropion group and 12 (60%) patients in the methylphenidate group achieved response by week 6 ( χ 2 (1) = 1.600, p = 0.206). Headache was observed more frequently in the methylphenidate group. Frequency of other side effects was not significantly different between the two groups. Conclusions Bupropion has a comparable safety and efficacy profile with methylphenidate in children and adolescents with ADHD. Copyright © 2012 John Wiley & Sons, Ltd.