title: Blood pressure changes associated with medication treatment of adults with attention-deficit/hyperactivity disorder. The Association of 25-Hydroxyvitamin D3 and D2 with Behavioural Problems in Childhood Vitamin D in Pregnancy and Attention Deficit Hyperactivity Disorder-like Symptoms in Childhood A large, double-blind, randomized clinical trial of methylphenidate in the treatment of adults with attention-deficit/hyperactivity disorder Academic Achievement in Adults with a History of Childhood Attention-Deficit/Hyperactivity Disorder: A Population-Based Prospective Study Effect of vitamin D supplementation as adjunctive therapy to methylphenidate on ADHD symptoms: A randomized, double blind, placebo-controlled trial Effect of vitamin D treatment in children with attention-deficit hyperactivity disorder
abstract: OBJECTIVE To evaluate the effects of medications used in the treatment of adults with attention-deficit/hyperactivity disorder ( ADHD ) on blood pressure and pulse . METHOD Subjects were those with DSM-III-R-/DSM-IV-diagnosed ADHD enrolled in placebo-controlled studies of 5 different medications for ADHD . Cardiovascular data from these studies of both stimulants ( methylpheni date , amphetamine compounds , pemoline ) and nonstimulants ( bupropion , desipramine ) were reanalyzed for baseline-to-endpoint active-treatment or placebo effects on blood pressure and heart rate . RESULTS There were 125 subjects with a mean + /- SD age of 39 + /- 9 years . In general , active drug treatment for ADHD compared to baseline was associated with several statistically significant changes in systolic blood pressure ( bupropion : + 5.9 mm Hg , p < .05 by paired t test ; amphetamine : + 5.4 mm Hg , p < .05 ) , diastolic blood pressure ( desipramine : + 7.1 mm Hg , p < .05 ) , and heart rate ( bupropion : + 6.9 mm Hg , p < .05 ; amphetamine : + 7.3 mm Hg , p < .05 ; methylpheni date : + 4.5 mm Hg , p < .05 ) . New-onset cases of systolic or diastolic hypertension ( blood pressure > or = 140/90 ) were recorded in 8 % ( 7/89 ) of placebo-treated subjects and 10 % ( 9/89 ) of subjects receiving active medication , regardless of the class ( stimulant , nonstimulant ) . CONCLUSION Both stimulant and nonstimulant catecholaminergic medications used in adults with ADHD are associated with minor , but statistically significant , changes in heart rate and blood pressure that were often observed in those receiving placebo . Given the minor pressor and chronotropic effect of these medications , adults with ADHD should have their blood pressure and heart rate checked at baseline and periodically during treatment Background Higher serum concentrations of 25-hydroxyvitamin D ( 25(OH)D ) , an indicator of vitamin D synthesis and intake , have been associated with better mental health and cognitive function . Concentrations of 1,25-dihydroxyvitamin D3 ( the active vitamin D3 metabolite ) have been associated with openness and extrovert behaviour , but 25(OH)D concentrations have not been associated with behavioural problems in humans . Methods We investigated the prospect i ve association between the different forms of 25(OH)D - 25(OH)D3 and 25(OH)D2–  and childhood behavioural problems in Avon Longitudinal Study of Parents and Children ( ALSPAC ) .  Serum 25(OH)D3 and 25(OH)D2 concentrations were assessed at mean age 9.9 years . Incident behavioural problems were assessed with Strengths and Difficulties Question naire ( SDQ ; emotional symptoms , conduct problems , hyperactivity-inattention problems , peer relationship problems and pro-social behaviour subscales and total difficulties score ) at mean age 11.7 . Sample sizes varied between 2413 - 2666 depending on the outcome . Results Higher 25(OH)D3 concentrations were weakly associated with lower risk of prosocial problems ( fully adjusted odds ratio : OR ( 95 % confidence interval : CI ) 0.85 ( 0.74 , 0.98 ) ) . Serum 25(OH)D3 or 25(OH)D2 concentrations were not associated with other subscales of SDQ or total difficulties score after adjusting for concfounders and other measured analytes related to vitamin D. Conclusions Our findings do not support the hypothesis that 25-hydroxyvitamin D status in childhood has important influences on behavioural traits in humans Background : Vitamin D status during prenatal brain development may influence risk of  attention deficit and hyperactivity disorder ( ADHD ) symptoms in childhood . However , there are no prospect i ve studies addressing this hypothesis . We aim ed to examine whether maternal vitamin D status in pregnancy is associated with risk of  ADHD-like symptoms in offspring . Methods : We conducted a prospect i ve study analyzing data from 1,650 mother – child pairs from five birth cohorts embedded in the INMA Project ( Spain , 1997–2008 ) . Maternal vitamin D status in pregnancy was estimated by measuring plasma concentration of 25-hydroxyvitamin D3 [ 25(OH)D3 ] at 13 weeks of gestation . Children were assessed by teachers for ADHD-like symptoms at ages 4–5 years using the Diagnostic and Statistical Manual of Mental Disorders ADHD form list . Results : After adjustment , the number of total ADHD-like symptoms in children decreased by 11 % per 10 ng/ml increment of maternal 25(OH)D3 concentration ( incidence rate ratio [ IRR ] = 0.89 ; 95 % confidence interval [ CI ] = 0.80 , 0.98 ) . Similarly , the number of symptoms in the ADHD subscales decreased in relation to higher maternal 25(OH)D3 concentration ( IRR per 10 ng/ml increment = 0.89 ; 95 % CI = 0.79 , 0.99 for the inattention scale ; and IRR = 0.88 ; 95 % CI = 0.78 , 0.99 for the hyperactivity – impulsivity scale ) . Using diagnostic criteria , we found an association of increasing maternal 25(OH)D3 with a lower risk of ADHD DSM-IV ( relative risk ratio per 10 ng/ml increment = 0.87 ; 95 % CI = 0.72 , 1.06 ) and ICD-10 hyperkinetic disorder ( relative risk ratio = 0.72 ; 95 % CI = 0.49 , 1.04 ) in children . Conclusion : Higher maternal circulating levels of 25(OH)D3 in pregnancy are associated with lower risk of developing ADHD-like symptoms in childhood BACKGROUND The few controlled studies of methylpheni date ( MPH ) in adults with attention deficit/hyperactivity disorder ( ADHD ) have reported equivocal results . A previous , pilot study by our group suggested that these results were due to inadequate dosing . METHOD We conducted a r and omized , 6-week , placebo-controlled , parallel study of MPH in 146 adult patients with DSM-IV ADHD using st and ardized instruments for diagnosis , separate assessment s of ADHD , depressive and anxiety symptoms , and a robust average oral daily dose of 1.1 mg/kg/day . RESULTS We found a marked therapeutic response for the MPH treatment of ADHD symptoms that exceeded the placebo response ( 76 % vs. 19 % ) . Treatment was safe and well tolerated . Response to MPH was independent of socioeconomic status , gender , and lifetime history of psychiatric comorbidity . CONCLUSIONS These results confirm that robust doses of MPH are effective in the treatment of adult ADHD Objective : Previous research on the developmental course of attention-deficit/hyperactivity disorder ( ADHD ) is limited by biased clinic-referred sample s and other method ological problems . Thus , questions about adult academic outcomes associated with childhood ADHD remain unanswered . Thus , the objective of this study was to describe academic outcomes in adulthood among incident cases of research -identified childhood ADHD versus non-ADHD referents from a population -based birth cohort . Method : Young adults with research -identified childhood ADHD ( N = 232 ; mean age 27.0 yr ; 72.0 % men ) and referents ( N = 335 ; mean age 28.6 yr ; 62.7 % men ) from a 1976 to 1982 birth cohort ( N = 5699 ) were invited to participate in a followup study and were administered an academic achievement battery consisting of the basic reading component of the Woodcock-Johnson III Tests of Achievement ( WJ-III ) and the arithmetic subtest of the Wide Range Achievement Test — Third Edition ( WRAT-3 ) . Outcomes were compared between the 2 groups using linear regression models , adjusted for age , sex , and comorbid learning disability status . Results : Childhood ADHD cases scored from 3 to 5 grade equivalents lower on all academic tests compared with referents , with mean ( SD ) st and ard scores of 95.7 ( 8.4 ) versus 101.8 ( 8.1 ) in basic reading ; 95.0 ( 9.3 ) versus 101.9 ( 8.5 ) in letterword identification ; 98.2 ( 8.6 ) versus 103.2 ( 9.2 ) in passage comprehension ; 95.7 ( 9.1 ) versus 100.9 ( 9.0 ) in word attack ; and 87.8 ( 12.9 ) versus 98.0 ( 12.0 ) in arithmetic . Conclusion : This is the first prospect i ve , population -based study of adult academic outcomes of childhood ADHD . Our data provide evidence that childhood onset ADHD is associated with long-term underachievement in reading and math that may negatively impact ultimate educational attainment and occupational functioning in adulthood Objectives : Previous studies have shown that serum levels of vitamin D were lower in attention deficit hyperactivity disorder ( ADHD ) children compared to healthy controls . The aim of the study was to determine the effect of vitamin D supplementation as adjunctive therapy to methylpheni date on symptoms of children with ADHD . Methods : Sixty-two children aged 5–12 years with a diagnosis of ADHD based on DSM-IV criteria were r and omly assigned into two groups to receive either 2000IU vitamin D or placebo in addition to methylpheni date for 8 weeks . Symptoms severity was assessed by Conner 's Parent Rating Scale-Revised[S ] ( CPRS ) , ADHD rating scale-IV ( ADHD-RS ) , and Weekly Parent Ratings of Evening and Morning Behavior ( WPREMB ) at weeks 0 , 4 , and 8 . Serum levels of 25(OH)D were measured at baseline and after 8 weeks . Anthropometric variables , dietary intake , physical activity , sun exposure , and side effects were assessed . Results : Fifty-four participants completed the trial . After 8 weeks of supplementation , serum levels of 25(OH)D significantly increased in the vitamin D group . ADHD symptoms decreased significantly in both groups ( P < 0.05 ) . Evening symptoms and total score of WPREMB scale were significantly different at weeks 4 and 8 between the two groups ( P = 0.013 , 0.016 , respectively ) , but no differences were found in symptoms by CPRS and ADHD-RS scales . Discussion : Vitamin D supplementation as adjunctive therapy to methylpheni date improved ADHD evening symptoms . Future research is needed to clarify vitamin D effects as monotherapy in ADHD and its mechanism . The trial was registered in www.i rct .ir is ( I RCT 201404222394N10 ) Background In this research the symptom improvement of attention-deficit hyperactivity disorder ( ADHD ) of children was assessed by oral vitamin D administration  in Tabriz , Iran . Methods In this double-blind , r and omized clinical trials , 96 children ( 2–18 years ) were enrolled to placebo and vitamin D groups . Children took vitamin D pearl ( 50,000 IU/week ) or placebo for 6 weeks . Children , who had the change in methylpheni date dosage and received any anticonvulsants and corticosteroids were excluded from the research . ADHD symptoms were diagnosed by Conners parent rating scale ( CPRS ) test at baseline and after intervention . ADHD Conners divided into inattention ( IA ) , hyperactivity/impulsivity ( H/I ) and combination type ( C ) subscales .  Vitamin D serum level was assessed at baseline and after 8 weeks in both groups . Results The differences between CPRS and its subscales were not significant at baseline ( P > 0.05 ) . The Conners IA score was decreased in vitamin D group ( P < 0.05 ; adjusted with age and baseline values ) . ADHD Conners and all subscale scores reduced remarkably after intervention in patients with insufficient level of vitamin D compared to placebo ( P < 0.05 ) . Conclusions Oral vitamin D  improved ADHD symptoms with a particular effect on inattention symptoms . In addition , symptoms related to all subscales were improved remarkably in patients with insufficient level of vitamin D. Vitamin D treatment in children with ADHD could be considered due to the exp and benefit of vitamin D in body
target: Vitamin D supplementation demonstrated a small but statistically significant improvement in ADHD total scores , inattention scores , hyperactivity scores , and behavior scores .
  There was no statistically significant improvement in oppositional scores .
  Reported adverse events in the vitamin D group were mild and not significantly different from the control group .
  Vitamin D supplementation increased serum vitamin D levels and the ratio of patients with sufficient vitamin D levels .
  Conclusions : Vitamin D supplementation as adjunctive therapy to methylpheni date appeared to reduce ADHD symptoms without serious adverse events , associated with improved vitamin D status .
background: Objective : A systematic review and meta- analysis of r and omized controlled trials ( RCTs ) were conducted to assess the benefits and harms of vitamin D supplementation for attention-deficit/hyperactivity disorder ( ADHD ) patients .