Brown 1988.

Study characteristics
Methods	8‐week, double‐blind, randomised, cross‐over trial with 4 interventions: Placebo 0.15 mg/kg MPH 0.30 mg/kg MPH 0.5 mg/kg MPH
Participants	Number of participants screened: not stated Number of participants included: 11 (all boys) Number of participants followed up: 11 Number of withdrawals: 0 Diagnosis of ADHD: DSM‐III (subtype not stated) Age: mean 13 years, 7 months (range 12 years and 10 months‐14 years and 10 months) IQ: full‐scale mean 92.91 (range 86‐104) MPH‐naive: not stated, but none of the participants had been treated with stimulants during the year preceding the trial Ethnicity: African American (100%) Country: USA Setting: outpatient clinic Comorbidity: CD, socialised aggressive (45%) Comedication: no Other sociodemographics: none Inclusion criteria Sexual rating of ≥ 3 according to Tanner’s classification of stages of development, to ensure post‐pubertal status ADD according to DSM‐III Score of ≥ 15 on the Abbreviated CTRS Exclusion criteria Mental disability or gross neurological disorders
Interventions	Participants were randomly assigned to possible drug condition orders: Interventions (mean dosage) Placebo MPH low (0.15 mg/kg) MPH medium (0.30 mg/kg) MPH high (0.5 mg/kg) Mean MPH dosage: MPH low (4.38 mg), medium (12.55 mg), high (21.28 mg) Administration schedule: twice daily; morning and noon Duration of each medication condition: 2 weeks Washout before trial initiation: none (but no stimulant treatment for the past year) Titration period: none Treatment compliance: compliance was determined to be satisfactory
Outcomes	ADHD symptoms At the end of each 2‐week trial, parents and teachers completed the following rating scales CPRS ‐ Revised Abbreviated Conners' Parent Hyperactivity Index Abbreviated Conners' Teacher Hyperactivity Index ADD/H Comprehensive Teacher Rating Scale Non‐serious AEs Side Effects Rating Scale (includes questions about sleep disturbances, dysphoria, decreased appetite, physiological complaints such as headaches and generalised anxiety), parent‐rated (assessing the preceding week) Cardiovascular measures (heart rate, resting SBP and DBP measures for BP) assessed ≥ 1 h after administration of MPH or placebo. Apical pulse rates taken for 1 full minute Weight (during every clinic visit)
Notes	Sample calculation: no Ethics approval: yes; Institutional Review Board (IRB) at Emory University Key conclusion of trial authors Significant drug effects were found for most measures. In general, higher doses resulted in the most beneficial response in behavioural, academic and laboratory measures of attention and impulsivity. However, a significant linear increase occurred in DBP. Results suggest that MPH is an effective adjunct to the treatment of ADD in adolescents Comment from trial authors We do not know whether our findings can be generalised in non‐black populations Exclusion of MPH non‐responders/children who have previously experienced AEs while taking MPH before randomisation: no Withdrawals due to AEs: no Funding source: Biomedical Research Support Grant Program, Division of Research Resources, NIH and Emory University Research Email correspondence with trial authors: October 2013. We received from trial authors additional information about ethics approval, planned outcomes and participants followed up. Unfortunately, it was not possible for trial authors to provide other data that we needed because the trial was conducted many years ago, and trial authors no longer had the data
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Drug order was randomly assigned across participants; no further description
Allocation concealment (selection bias)	Low risk	All medication was prepared in identical capsules by hospital pharmacists. Medication was dispensed in dated envelopes
Blinding of participants and personnel (performance bias) All outcomes	Low risk	All medication was prepared in identical capsules by hospital pharmacists. Medication was dispensed in dated envelopes. Double‐blind
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Double‐blind
Incomplete outcome data (attrition bias) All outcomes	Low risk	No withdrawals Selection bias (e.g. titration after randomisation → exclusion): no
Selective reporting (reporting bias)	Low risk	Researchers administered all measures that were proposed and reported these data in the published report