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Methylphenidate vs Dextroamphetamine vs Caffeine in Minimal Brain Dysfunction:  Controlled Comparison by Placebo Washout Design With Bayes' Analysis

L. Eugene Arnold, MD; James Christopher, MD; Robert Huestis, MD; Donald J. Smeltzer, MA
Arch Gen Psychiatry. 1978;35(4):463-473. doi:10.1001/archpsyc.1978.01770280073008.
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• Double-blind crossover comparison of methylphenidate hydrochloride, dextroamphetamine sulfate, and caffeine after placebo washout in 29 children with minimal brain dysfunction (MBD) showed on six ratings that methylphenidate and dextroamphetamine were significantly (P <.05 to P <.001) better than placebo and caffeine, but not significantly (P <.05) different from each other. Placebo, caffeine, and ratings before drug did not differ significantly. Of 26 drug responders, 12 responded best to dextroamphetamine, ten to methylphenidate, and one to caffeine. The latter child showed no improvement at all with either prescription stimulant. Methylphenidate and dextroamphetamine were each efficacious for six children who did not respond to the other stimulant. All three drugs showed significant (P <.05) weight loss and cardiovascular side effects, the latter possibly spurious. Dextroamphetamine showed a significant (P <.05) decrease from placebo in "tummyaches."


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