Sunohara 1999.

Study characteristics
Methods	Cross‐over trial with 3 arms: LD‐MPH HD‐MPH placebo Phases: 3
Participants	Number of participants screened: not stated Number of participants included: 20 (16 boys, 4 girls) Number of participants followed up: 20 Number of withdrawals: 0 Diagnosis of ADHD: DSM‐III‐R (subtype not stated) Age: mean 10.5 years (range 10‐12) IQ: < 80 MPH‐naive: none Ethnicity: not stated Country: Canada Setting: outpatient clinic Comorbidity: ODD (n = 4), learning disability (n = 8) Comedication: not stated Other sociodemographics: none Inclusion criteria Children 10‐12 years of age meeting DSM‐II‐R criteria for ADHD recruited from Child Development Centre at Hospital for Sick Children, Canada Exclusion criteria CD, externalising disorder, anxiety IQ < 80
Interventions	Participants were randomly assigned to LD‐MPH (mean 0.28 mg/kg) and HD‐MPH (mean 0.56 mg/kg) and placebo in the morning and afternoon Duration of each medication condition: 2 days Washout before trial initiation: no Titration period: no Treatment compliance: not stated
Outcomes	Non‐serious AEs Reported as adverse effects. There were 0 adverse effects at the higher dose for all children
Notes	Sample calculation: not stated Ethics approval: no information Key conclusion of trial authors No adverse effects of the higher dose were reported for any children Exclusion of MPH non‐responders/children who have previously experienced AEs while taking MPH before randomisation: unclear Any withdrawals due to AEs: no Funding source: RESTRACOM graduate studentship for The Hospital for Sick Children Research Institute and Novartis Pharmaceuticals Email correspondence with trial authors: April 2014. Wrote to trial authors to ask for additional data but have not received a reply
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not stated
Allocation concealment (selection bias)	Unclear risk	Not stated
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not stated
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not stated
Incomplete outcome data (attrition bias) All outcomes	Low risk	All participants were followed up Selection bias (e.g. titration after randomisation → exclusion of MPH non‐responders or placebo responders): no
Selective reporting (reporting bias)	Unclear risk	No protocol identified