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. 2018 May 10;2018(5):CD012069. doi: 10.1002/14651858.CD012069.pub2

Barrickman 1995.

Methods Double‐blind, cross‐over study comparing methylphenidate and bupropion
Participants Number of participants screened: not stated
Number of participants included: 18 patients
Number of participants followed up: 15
Number of withdrawals: 3
 Diagnosis of ADHD: DSM‐III‐R (subtype: not stated)
 Age: 11.8 (SD 3.3), range 7‐16
IQ: full scale WISC‐R score 106 (SD 10), range 84‐123
Sex: 12 males, 3 females
Methylphenidate‐naïve: 5 (33.33%)
Ethnicity: white
Country: USA
Comorbidity: conduct disorder (n = 2), oppositional defiant disorder (n = 2), developmental learning disorder (n = 5)
Comedication: none. Before washout methylphenidate (n = 9), methylphenidate + imipramine (n = 1)
Sociodemographics: not stated
Inclusion criteria:
  1. ADHD diagnosis according to DSM‐III‐R

  2. Aged 7‐17 years


Exclusion criteria:
  1. IQ < 70

  2. Any other major Axis I, II or III diagnoses

  3. Seizure disorders (bupropion contraindication) or history of seizures, eating disorders (predisposed to bupropion seizures), current use of an MAOI

Interventions Participants were randomly assigned to 1 of 2 possible drug condition orders, methylphenidate or bupropion.
Mean methylphenidate dosage: 31 (n = 11) mg/day (20‐60 mg/day) or 0.7 (n = 0.2) mg/kg/day (0.4‐1.3 mg/kg/day)
Administration schedule: morning, noon, and 4 pm if needed
Duration of intervention: 6 weeks
Washout prior to study initiation: 14 days
Medication‐free period between intervention: 14 days
Titration period: methylphenidate was administered in a dose of 0.4 mg/kg per day during the first week and the to the maximum effective dose during the next 2 weeks. Dosage was fixed for the final 3 weeks
Treatment compliance: not stated
Outcomes Non‐serious adverse events:
 Adverse effects checklist monitored by a physician by the end of each week.
 Physical examination
 Children's Depression Inventory (CDI), rated each week by physician.
 Revised Children's Manifest Anxiety Scale (R‐CMAS), rated each week by physician
Notes Sample calculation: yes
 Ethics approval: not stated
 Funding: not stated
 Vested interest/authors' affiliations: not stated
 Key conclusions of the study authors: bupropion and methylphenidate were both effective and did not differ in their overall efficacy as treatment for ADHD. Thus, results of nearly all of the rating scales trended in favour of methylphenidate. There is a possibility that this insignificant difference might be a function of the relatively small dose of bupropion used in this study
 Supplemental information requested through personal email correspondence with the authors in June 2014. No reply