Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial

Laurence L. Greenhill, James M. Swanson, Benedetto Vitiello, Mark Davies, Walter Clevenger, Min Wu, L. Eugene Arnold, Howard B. Abikoff, Oscar G. Bukstein, C. Keith Conners, Glen R. Elliott, Lily Hechtman, Stephen P. Hinshaw, Betsy Hoza, Peter S. Jensen, Helena C. Kraemer, John S. March, Jeffrey H. Newcorn, Joanne B. Severe, Karen WellsTimothy Wigal

Research output: Contribution to journalArticlepeer-review

197 Scopus citations


Objective: Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention- Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial identified the best MPH dose for each child with attention-deficit/hyperactivity disorder (ADHD). Method: Children with ADHD assigned to MTA medication treatment groups (n = 289) underwent a controlled 28-day titration protocol that administered different MPH doses (placebo, low, middle, and high) on successive days. Results: A repeated-measures analysis of variance revealed main effects for MPH dose with greater effects on teacher ratings of impairment and deportment (F3 = 100.6, n = 223, p = .0001; effect sizes 0.8-1.3) than on parent ratings of similar endpoints (F3 = 55.61, n = 253, p = .00001; effect sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid diagnosis, site, or treatment group. Conclusions: The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily dose limit of 35 mg of MPH for children weighing less than 25 kg. It replicated previously reported MPH response rates (77%), distribution of best doses (10-50 mg/day) across subjects, effect sizes on impairment and deportment, as well as dose-related adverse events.

Original languageEnglish (US)
Pages (from-to)180-187
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number2
StatePublished - 2001


  • Attention-deficit/hyperactivity disorder
  • Deportment
  • Impairment
  • Methylphenidate

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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