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A Study of Combination Therapy in Children With ADHD

Primary Purpose

ADHD, Attention Deficit Hyperactivity Disorder, Attention Deficit Disorder With Hyperactivity

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Methylphenidate ER
Cyproheptadine
Sponsored by
Douglas Sears
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for ADHD focused on measuring Methamphetamine, Methylphenidate, ADHD

Eligibility Criteria

6 Years - 12 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The subject and subject's parents speak English
  • Child or adolescent patients, male or female outpatients, who are at least 6 years of age, but must not yet have reached their 13th birthday prior to Visit 1, when informed consent is obtained
  • Patients must meet Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) diagnostic criteria for ADHD (any subtype) and score at least 1.5 standard deviations above the age norm for their diagnostic subtype using published norms for the Swanson, Nolan and Pelham Questionnaire: Attention-Deficit/Hyperactivity Disorder Subscale (SNAP-IV ADHD Subscale) score at both Visit 1 and 2
  • Laboratory results, including serum chemistries, hematology, and urinalysis, must show no clinically significant abnormalities (clinically significant is defined as laboratory values requiring acute medical intervention, indicating a serious medical illness, or requiring further medical evaluation in the judgment of the investigator)
  • Patients and parents have been judged by the investigator to be reliable to keep appointments for clinic visits and all tests, including venipuncture, and examinations required by the protocol.
  • Patient has not been on stimulants for at least 2 weeks.

Exclusion Criteria:

  • Patients who have a documented history of Bipolar I or II disorder, or any history of psychosis. Diabetic patients or patients on chronic steroids.
  • Patients with a history of any seizure disorder (other than febrile seizures) or patients who have taken (or are currently taking) anticonvulsants for seizure control are not eligible to participate
  • Patients at serious suicidal risk as defined by 1) suicidal ideation as endorsed on items 4 and 5 of the C-SSRS within the past year, 2) suicidal behaviors detected by the C-SSRS during the past two years; or 3) psychiatric interview and examination
  • Patients with significant cardiovascular disease or other conditions that could be aggravated by an increased heart rate or increased blood pressure
  • Patients who have any medical condition that would increase sympathetic nervous system activity markedly (for example, catecholamine-secreting neural tumor), or who are taking a medication on a daily basis (for example, albuterol, inhalation aerosols, pseudoephedrine), that has sympathomimetic activity. Such medications can be taken on an as-needed basis
  • Presence of contraindications for methylphenidate or cyproheptadine hydrochloride
  • Patients who have had prior serious adverse reaction to stimulants.
  • Parental or (immediate) family history of substance abuse

Sites / Locations

  • SMRI (Schuster Medical Research Institute)

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Active Comparator

Active Comparator

Arm Label

Control

Methylphenidate ER, cyproheptadine 2.5mg

Methylphenidate ER, cyproheptadine 5mg

Arm Description

Methylphenidate ER QD placebo BID

Methylphenidate ER QD cyproheptadine hydrochloride 2.5mg BID

Methylphenidate ER QD cyproheptadine hydrochloride 5.0mg BID

Outcomes

Primary Outcome Measures

Appetite - Appetite and Dietary Assessment Tool (ADAT) developed by Burrowes et al (1996)

Secondary Outcome Measures

Swanson, Nolan & Pelham Rating Scale - Revised (SNAP-IV): ADHD Combined Score
The items from the DSM-IV (1994) criteria for Attention-Deficit/Hyperactivity Disorder (ADHD) are included for the two subsets of symptoms: inattention (items #1-#9) and hyperactivity/ impulsivity (items #11-#19).
Weight
Appetite - VAS - Visual Analogue Scale
Clinical Global Impressions - Improvement(CGI-I): ADHD Score
Clinical Global Impressions - Severity(CGI-S): ADHD Score
Clinical Global Impressions - Effectiveness(CGI-E): ADHD Score
Appetite - Appetite and Dietary Assessment Tool (ADAT) developed by Burrowes et al (1996)

Full Information

First Posted
September 9, 2013
Last Updated
April 8, 2015
Sponsor
Douglas Sears
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1. Study Identification

Unique Protocol Identification Number
NCT01940978
Brief Title
A Study of Combination Therapy in Children With ADHD
Official Title
A Double-Blind Placebo-Controlled Study of Combination Therapy in Children With ADHD
Study Type
Interventional

2. Study Status

Record Verification Date
April 2015
Overall Recruitment Status
Completed
Study Start Date
March 2014 (undefined)
Primary Completion Date
March 2015 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Douglas Sears

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Lack of appetite and weight loss are a common side effect of ADHD therapy with amphetamines such as methylphenidate. Lack of sufficient food intake has been shown to have negative effects on weight and height as well as learning and memory. There is no current treatment to prevent this loss of appetite except discontinuation or reduction of the methylphenidate. Discontinuation or reduction of the drug can cause the return of ADHD symptoms. The purpose of this study is to compare the effects, good and/or bad, of two doses of a drug, cyproheptadine, vs placebo to find out if cyproheptadine prevents the appetite suppression associated with methylphenidate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
ADHD, Attention Deficit Hyperactivity Disorder, Attention Deficit Disorder With Hyperactivity, Mental Disorders Diagnosed in Childhood, Attention Deficit and Disruptive Behavior Disorders
Keywords
Methamphetamine, Methylphenidate, ADHD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
99 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Control
Arm Type
Placebo Comparator
Arm Description
Methylphenidate ER QD placebo BID
Arm Title
Methylphenidate ER, cyproheptadine 2.5mg
Arm Type
Active Comparator
Arm Description
Methylphenidate ER QD cyproheptadine hydrochloride 2.5mg BID
Arm Title
Methylphenidate ER, cyproheptadine 5mg
Arm Type
Active Comparator
Arm Description
Methylphenidate ER QD cyproheptadine hydrochloride 5.0mg BID
Intervention Type
Drug
Intervention Name(s)
Methylphenidate ER
Other Intervention Name(s)
Concerta
Intervention Description
Watson generic, starting dose 18mg QD
Intervention Type
Drug
Intervention Name(s)
Cyproheptadine
Other Intervention Name(s)
Periactin
Intervention Description
cyproheptadine hydrochloride
Primary Outcome Measure Information:
Title
Appetite - Appetite and Dietary Assessment Tool (ADAT) developed by Burrowes et al (1996)
Time Frame
0, 12 weeks
Secondary Outcome Measure Information:
Title
Swanson, Nolan & Pelham Rating Scale - Revised (SNAP-IV): ADHD Combined Score
Description
The items from the DSM-IV (1994) criteria for Attention-Deficit/Hyperactivity Disorder (ADHD) are included for the two subsets of symptoms: inattention (items #1-#9) and hyperactivity/ impulsivity (items #11-#19).
Time Frame
0,1,5,9,12 weeks
Title
Weight
Time Frame
0,1,5,9,12 Weeks
Title
Appetite - VAS - Visual Analogue Scale
Time Frame
0,1,5,9,12
Title
Clinical Global Impressions - Improvement(CGI-I): ADHD Score
Time Frame
1,5,9,12 weeks
Title
Clinical Global Impressions - Severity(CGI-S): ADHD Score
Time Frame
0,1,5,9,12
Title
Clinical Global Impressions - Effectiveness(CGI-E): ADHD Score
Time Frame
1,5,9,12
Title
Appetite - Appetite and Dietary Assessment Tool (ADAT) developed by Burrowes et al (1996)
Time Frame
1,5,9 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject and subject's parents speak English Child or adolescent patients, male or female outpatients, who are at least 6 years of age, but must not yet have reached their 13th birthday prior to Visit 1, when informed consent is obtained Patients must meet Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) diagnostic criteria for ADHD (any subtype) and score at least 1.5 standard deviations above the age norm for their diagnostic subtype using published norms for the Swanson, Nolan and Pelham Questionnaire: Attention-Deficit/Hyperactivity Disorder Subscale (SNAP-IV ADHD Subscale) score at both Visit 1 and 2 Laboratory results, including serum chemistries, hematology, and urinalysis, must show no clinically significant abnormalities (clinically significant is defined as laboratory values requiring acute medical intervention, indicating a serious medical illness, or requiring further medical evaluation in the judgment of the investigator) Patients and parents have been judged by the investigator to be reliable to keep appointments for clinic visits and all tests, including venipuncture, and examinations required by the protocol. Patient has not been on stimulants for at least 2 weeks. Exclusion Criteria: Patients who have a documented history of Bipolar I or II disorder, or any history of psychosis. Diabetic patients or patients on chronic steroids. Patients with a history of any seizure disorder (other than febrile seizures) or patients who have taken (or are currently taking) anticonvulsants for seizure control are not eligible to participate Patients at serious suicidal risk as defined by 1) suicidal ideation as endorsed on items 4 and 5 of the C-SSRS within the past year, 2) suicidal behaviors detected by the C-SSRS during the past two years; or 3) psychiatric interview and examination Patients with significant cardiovascular disease or other conditions that could be aggravated by an increased heart rate or increased blood pressure Patients who have any medical condition that would increase sympathetic nervous system activity markedly (for example, catecholamine-secreting neural tumor), or who are taking a medication on a daily basis (for example, albuterol, inhalation aerosols, pseudoephedrine), that has sympathomimetic activity. Such medications can be taken on an as-needed basis Presence of contraindications for methylphenidate or cyproheptadine hydrochloride Patients who have had prior serious adverse reaction to stimulants. Parental or (immediate) family history of substance abuse
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jose M Schuster, MD
Organizational Affiliation
SMRI
Official's Role
Principal Investigator
Facility Information:
Facility Name
SMRI (Schuster Medical Research Institute)
City
Van Nuys
State/Province
California
ZIP/Postal Code
91403
Country
United States

12. IPD Sharing Statement

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A Study of Combination Therapy in Children With ADHD

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