The Effect of Combined Iron and Methylphenidate Use in Iron Deficient Attention deficit Hyperactivity Disorder (ADHD) Children of Bangladesh.

Iron acts as a risk factor and psychostimulant modulator in treatment of attention deficit hyperactivity disorder (ADHD) with Iron deficiency anemia (IDA). So, the aim of the study to see the comparative efficacy of combined use of methylphenidate with iron and methylphenidate alone among severe ADHD children with IDA. This randomized controlled trial conducted in the OPD, Pediatric Neurology, National Installation of Neurosciences & Hospital (NINS), Dhaka, Bangladesh; 50 children of severe ADHD with iron deficiency were enrolled. Participants were randomized into Group A (25 cases) given a combination of Methylphenidate and iron and Group B (25 cases) given Methylphenidate alone for 3 months. Conner's rating scale, CBC and serum ferritin was evaluated after one and three months, severity was compared between treatment groups. All the hematological parameters including serum ferritin were improved from baseline. As ferritin concentration increased, the severity of T scores of ADHD index were decreased at 1 month (p=0.047) and 3 months (p=0.026) after intervention, Treatment response were found earlier in Group A (13.39±6.90 days) than in Group B (18.48±8.69). Combined therapy of methylphenidate and iron was more effective than methylphenidate alone for treating the iron deficient child with ADHD.