Does increasing methylphenidate dose aid symptom control in ADHD?
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Most children with attention deficit/ hyperactivity disorder (ADHD) who are started on methylphenidate will respond favorably to a dose increase if the initial dose does not sufficiently reduce symptoms. Once titrated to an effective maintenance dose, frequent follow-up is necessary to monitor for side effects and recurring symptoms. The dose of methylphenidate can then be increased further for better symptom control, which may be warranted in most cases. In some children, methylphenidate may not achieve response even at high doses or may cause intolerable side effects. For these children, start a different stimulant medication (strength of recommendation: B, based on extrapolation of 1 randomized controlled trial).
Journal of Family Practice, 52(5) 2003: 400+.