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Journal ArticleDOI

Mathematical models of complex dose‐response relationships: Implications for experimental design in psychopharmacologic research

TLDR
A mathematical model is developed to account for the complex relationship between drug dose and clinical response in psychopharmacologic research which indicates that random assignment to two fixed doses is more powerful and less sensitive to heterogeneity than assignment to clinically determined doses.
Abstract
We develop a mathematical model to account for the complex relationship between drug dose and clinical response in psychopharmacologic research. The model specifies relationships among drug dose, drug bioavailability, pharmacokinetic factors, course moderators, clinical response and the heterogeneity of the disorder, and allows for the derivation of results that have implications for experimental design in psychopharmacologic research. These results form the basis for computer simulations which indicate that random assignment to two fixed doses is more powerful and less sensitive to heterogeneity than assignment to clinically determined doses. Fixed dose designs, however, tend to overestimate the magnitude of drug bioavailability-clinical response relationships. Clinically determined dose designs are useful in some experimental situations; their effectiveness is enhanced by systematically reducing the clinically determined dose. Larger dose reductions improve the ability to detect bioavailability-clinical response relationships.

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Citations
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Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature.

TL;DR: It is suggested that stimulant therapy in childhood is associated with a reduction in the risk for subsequent drug and alcohol use disorders.
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Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study.

TL;DR: By their young adult years, ADHD youth were at high risk for a wide range of adverse psychiatric outcomes including markedly elevated rates of antisocial, addictive, mood and anxiety disorders.
Journal ArticleDOI

A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders

TL;DR: Previous retrospective results indicating that children with ADHD are at high risk of developing a wide range of impairments affecting multiple domains of psychopathology such as cognition, interpersonal, school, and family functioning are confirmed.
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How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD

TL;DR: In this paper, the authors examined the age-dependent persistence of attention-deficit hyperactivity disorder (ADHD) in boys transitioning from adolescence into early adulthood attending to different definitions of persistence.
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A Double-blind, Crossover Comparison of Methylphenidate and Placebo in Adults With Childhood-Onset Attention-Deficit Hyperactivity Disorder

TL;DR: Robust doses of methylphenidate are effective in the treatment of adult ADHD, independent of gender, psychiatric comorbidity with anxiety or moderate depression, or family history of psychiatric disorders.
References
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Book

Statistical Principles in Experimental Design

TL;DR: In this article, the authors introduce the principles of estimation and inference: means and variance, means and variations, and means and variance of estimators and inferors, and the analysis of factorial experiments having repeated measures on the same element.
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Statistical Principles in Experimental Design

TL;DR: This chapter discusses design and analysis of single-Factor Experiments: Completely Randomized Design and Factorial Experiments in which Some of the Interactions are Confounded.
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The robust beauty of improper linear models in decision making.

TL;DR: In this article, Dawes presented evidence that even such improper linear models are superior to clinical intuition when predicting a numerical criterion from numerical predictors, and showed that unit (i.e., equal) weighting is quite robust for making such predictions.
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The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients.

TL;DR: Important additive effects between various social influences and pharmacological treatments have been revealed which make it possible to predict relapse patterns in schizophrenia with considerable precision.
Journal ArticleDOI

Family factors in schizophrenic relapse. Replication in California of British research on expressed emotion.

TL;DR: Cross-cultural results concerning the prophylactic effects of medication suggest that clinicians should look to the emotional atmosphere in the home for explanations of medication failures.
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