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Archivos de Pediatría del Uruguay

versión On-line ISSN 1688-1249


SPERANZA, Noelia et al. Uso de metilfenidato en niños y adolescentes usuarios de servicios de asistencia pública de Montevideo. Arch. Pediatr. Urug. [online]. 2008, vol.79, n.4, pp.277-283. ISSN 1688-1249.

Introduction: methylphenidate is used in the treatment of the attention deficit hyperactivity disorder (ADHD), the most common behavioral disorder in children. Centro Hospitalario Pereira Rossell (CHPR) and Hospital Vilardebó (HV) pharmacies are responsibles of dispensation of methylphenidate to the users of services of Administración de Servicios de Salud del Estado (ASSE). Dispensation has increased two folders between 2001 and 2006. International advertistments about severe adverse reactions have alredy appeared. Objective: to describe methylphenidate use in a children population users of public health system of Montevideo. Methodology: children between 6 and 14 years old who obtain methylphenidate from Centro Hospitalario Pereira Rossell (CHPR) and Hospital Vilardebó (HV) pharmacies bewteen september and december 2006 were identified and included in the study. Sample was calculated taking into account number of children assisted by ASSE in Montevideo and estimated frequency of ADHD (5%). Sample size calculated was 114 (IC95%; imprecision 3%). Telephone interviews were done to children’s parents and/or tutors to ask about: indication, prescription, adverse reactions, and therapeutics benefits. Quality of prescription was evaluated using the American Academy of Pediatrics recommendations published in 2001. Results: 124 interviews were done. Mean age was 10 years old; 77% were male. 93,5% (n=116) met criteria of DSM IV for ADHD diagnosis. Mean dose was 12,9 mg. 64,5% of children received methylphenidate once daily , 27,4% twice daily, 5,6% three times daily and one child four times daily. 85,5% received methylphenidate before go to school. 84,6% of parents referred therapeutics benefits, 56% of these ones were receiving another psychotropic medication. 59,7% refered one or more posible adverse reactions. More frequents adverse reactions weree headache (29%), anorexia (25%) and abdominal pain (24,2%). Discussion: although limitation in the use of interview to evaluate indication, no problems were identified. Dose range agreed with the recommended. It is interesting to note that most of patients reached therapeutic benefits using low doses and once daily. These findings could be explained by use of methylphenidate in relationship with school time or combinated use of others psychotropic medications. Possible adverse reactions detected were a frequent problem. Prescriptor’s and health user’s eduaction is essential to achieve an adequate use and monitorization of methylphenidate


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