Methylphenidate Ameliorates Depressive Comorbidity in ADHD Children without any Modification on Differences in Serum Melatonin Concentration between ADHD Subtypes

International Journal of Molecular Sciences

Isabel Cubero-Millán²  Antonio Molina-Carballo²  Irene Machado-Casas²  Luisa Fernández-López²  Sylvia Martínez-Serrano²  Pilar Tortosa-Pinto²  Aida Ruiz-López²  Juan-de-Dios Luna-del-Castillo¹  José Uberos² 

[1] Biostatistical Department, School of Medicine, Granada University, 18140 Granada, Spain; E-Mail:;Neuropediatric, Neuropsicology and Early intervention Unit; Pediatric Service, Clinico San Cecilio Hospital, 18012 Granada, Spain; E-Mails:

关键词: children;    ADHD;    ADHD subtypes;    comorbidities;    depressive symptoms;    CDI;    prolonged release methylphenidate;    melatonin;    6-sulphatoxy-melatonin;   

DOI  :  10.3390/ijms150917115

来源: mdpi

【 摘 要 】

The vast majority of Attention-deficit/hyperactivity disorder (ADHD) patients have other associated pathologies, with depressive symptoms as one of the most prevalent. Among the mediators that may participate in ADHD, melatonin is thought to regulate circadian rhythms, neurological function and stress response. To determine (1) the serum baseline daily variations and nocturnal excretion of melatonin in ADHD subtypes and (2) the effect of chronic administration of methylphenidate, as well as the effects on symptomatology, 136 children with ADHD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: DSM-IV-TR criteria) were divided into subgroups using the “Children’s Depression Inventory” (CDI). Blood samples were drawn at 20:00 and 09:00 h, and urine was collected between 21:00 and 09:00 h, at inclusion and after 4.61 ± 2.29 months of treatment. Melatonin and its urine metabolite were measured by radioimmunoassay RIA. Factorial analysis was performed using STATA 12.0. Melatonin was higher predominantly in hyperactive-impulsive/conduct disordered children (PHI/CD) of the ADHD subtype, without the influence of comorbid depressive symptoms. Methylphenidate ameliorated this comorbidity without induction of any changes in the serum melatonin profile, but treatment with it was associated with a decrease in 6-s-melatonin excretion in both ADHD subtypes. Conclusions: In untreated children, partial homeostatic restoration of disrupted neuroendocrine equilibrium most likely led to an increased serum melatonin in PHI/CD children. A differential cerebral melatonin metabolization after methylphenidate may underlie some of the clinical benefit.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.