Prog. Neuro-Psychophormocol. 6 Biol. Psychiat. 1984, Vol. 8, pp. 661664 Printed in Great Britain. All rights reserved 027a5846/84 $0.00 + .50 Copyright 0 1984 Pergamon Press Ltd. zyxwvut EFFICACY OF ACTH 4-S ANALOG, METHYLPHENIDATE, AND PLACEBO ON ATTENTION DEFICIT DISORDER WITH HYPERKINESIS HENDRIK J. BUTTER, ls4 YVON LAPIERRE 1'2'5' PHILIP FIRESTONE, 3 and ARTHUR BL&,3 Departnmnts of 1 Psychiatry, 2 Pharmacolo y, and 'Psychology, University of Ottawa, Ottawa, Ontario; & Centre hospitalier Pierre-Janet,Hull, Quebec; and 3 Royal Ottawa Hospital, Ottawa, Ontario, Canada. (Final form, July 1984) Abstract Butter, Hendrik J., Yvon Lapierre, Philip Firestone and Arthur Blank: Efficacy of ACTH 4-9 analog, methylphenidateand placebo on attention deficit disorder with hyperkinesis. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1984, 8 (4-6): 661664. 1. The present study compared the efficacy of ACTH 4-9 analog, methylphenidate,and placebo on attention deficit disorder with 30 (HK) children with attention deficit disorder and psychometric measurements. 2. HK children were randomly placed into three groups, according to body weight, and treat- ed with placebo, methylphenidate,and adrenocorticotropic hormone fractions (ACTH 4-9 analog). 3. The results revealed that HK children on methylphenidatemanifested a significantly greater vasoM)tor reactivity, behavioral improvement,and learning receptivity than HK children taking ACTH 4-9 analog and/or placebo. 4. Future research implicationswith ACTH 4-9 and HK children are discussed. Keywords: ACTH 4-9 analog, Fiethylphenidate, Attention Deficit Disorder Abbreviations: Adrenocorticotropic hormone (ACTH); Hyperkinesis (HK); Conners's Short Form Rating Scale (CSS); Matching Familiar Figure Test (MFF); armory for Design MFD). Introduction It is becoming increasinglyapparent that short-chain polypeptides such as rrelanocyte stimulating hornone and analogues adrenocorticotropic hormone (ACTH) fractions (ACTH 4-9) influence both behavior and the electrophysiologicalactivity of the brain.1 Itire precisely, ACTE 4-9 analog studiesl-4 have reported enhancement of short-term visual memory, attention, self-rated competence, and observer-rated sociability. These behavioral and neurophysiolo- gical findings indicated that ACTH and its fractional analogues have direct, extra-adrenal effects on central nervous system functioning. Attention deficit disorder with hyperkinesis (HK) is now quite well recognised as a clini- cal syndroam in children who manifest difficulties in attention, mermry, and rmtivation,with or without hyperactivity.3 Studies6-8 investigating the management of the disorder have reported that methylphenidate reduces distractibility and impulsivity and improves selective attention in both hams and school environments. Consequently,rnethylphenidate has become the usual chemotherapeutic strategy for children with this syndrome. 661