Posted on Authorea 3 Aug 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159646774.49107232 | This a preprint and has not been peer reviewed. Data may be preliminary. adem,lc feeg,saigwt mt ys() lhuhSTadAtninDfii/Hyperactivity -Deficit/ and SCT slowness, Although mental as such (1). symptoms eyes of empty range with a staring energy, by characterized of disorder lack daydreams, a is disorder; (SCT) Tempo Cognitive Sluggish ADHD. hyperactivity symptoms subthreshold SCT and decreasing SCT in with effects attention-deficit/ INTRODUCTION case more a much in had to that compared experienced tempo; we (SCT), Tempo nitive cognitive Message: Clinical from Key benefit sluggish more much treatment atomoxetine; had methylphenidate; case methylphenidate. The to compared ADHD. Keywords: symptoms subthreshold SCT and of clinical terms (SCT) thank several in Tempo to atomoxetine his like Cognitive years, would half Sluggish also a with We and department. four the as Abstract: in such colleagues time other long colleagues. of a those some for to followed by been performed psychometric has were his performing patient examinations and the playroom the Since in patient tests. the observing for department Psychiatry Adolescent Acknowledgements: TAHILLIO ID: Turkey Akın – Psychiatry Adolescent and Author: Child of Corresponding Department Medicine, of Faculty University Ege SLUGGISH TAHILLIO IMPROVING Akın IN RE- EFFECTIVE CASE A MORE METHYLPHENIDATE: PORT TO COMPARED BE SYMPTOMS TEMPO MIGHT to COGNITIVE compared ATOMOXETINE symptoms SCT of Title: terms in atomoxetine from benefit Tempo more Cognitive much Sluggish with had case case a The methylphenidate. of ADHD. process treatment subthreshold pharmacological and and (SCT) procedure diagnostic differential the report We Abstract 2020 3, August 1 Tahıllıo˘gluAkın A Report Methylphenidate: Case to Compared Sluggish Symptoms Improving Tempo in Cognitive Effective More Be Might Atomoxetine g nvriyMdclFclyHospital Faculty Medical University Ege https://orcid.org/0000-0002-3952-3672 erpr h ieeta igotcpoeueadpamclgcltetetpoeso case a of process treatment pharmacological and procedure diagnostic differential the report We GLU ˘ 1 L e-mail: GLU ˘ n Ey¨up Ercan and 1 yu ar ERCAN Ey¨up Sabri , ealtakt h eaou n h scooit fEeUiest hl and Child University Ege of psychologists the and pedagogue the to thank all We lhuhteei opoe vdnergrigpamcteayo lgihCog- Sluggish of pharmacotherapy regarding evidence proven no is there Although [email protected] 1 1 1 hn ubr 953935 ORCID +905538993050 number: Phone Posted on Authorea 3 Aug 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159646774.49107232 | This a preprint and has not been peer reviewed. Data may be preliminary. aigSae–I,AH-SI)(7 8 ee1 n ons hra yeatvt/musvt scores hyperactivity/ whereas points, 7 and (ADHD 14 were Disorders 18) Behavioral Disruptive (17, ADHD-RS-IV) for and IV, Scale parent subthreshold of – Evaluation K-SADS-PL, scores Scale and the Inattention to Rating Screening detected. According Version Based were parents. criteria Lifetime DSM-IV the diagnostic and teacher-rated psychopathology, and ADHD -Present case meeting his the Children not accompany to symptoms School-Age may inattentive applied for was that Schizophrenia 16) (15, and identify (TRF) (K-SADS-PL) 27. Disorders Form to was Survey Report Affective Teacher’s interview teacher Attention of for (CBCL) the semi-structured (SCT-TRF) List Schedule Child by items A Check SCT-scanning filled Barkley Behavior 4 score Child 14). teacher-rated the of BCAS from (13, (SCT-CBCL) from points The items 5 points SCT-scanning parents. and 4 plan 13), the 30 parent-rated (12, by strategy from received filled points treatment he 6 BCAS) a got did - old, He by Scale academically 4-months followed Screening but and was SCT daydream, 7-years case (Barkley eyes, was the empty used he period, with he When this that time During medication. stated long without teacher lessons. a interventions his there his behavioral at also of including in something and reports functionality, problems at observation revealed daily have look case The his not the slowly, affect impulsivity. of very would and examination that move psychiatric hyperactivity deficit he Clinical to of attention . old, 19). signs of of years is presence signs no seven point any the enough was were cut-off for without not he (the examined write were scale When be there and this to average. that from order read class in points to the 10) 4 learned of (9, got (CDI) he level to the He Inventory related the school, in Depression had findings at primary Children epilepsy was the clinical there the he of achievement filled additional that to academic favor (ASD), no adaptation learned his However, in disorder his was and observation. findings delay, After spectrum It playroom no a observed. were alone. in investigate were there toilet pedagogue ASD to a that the order by too absent- and to In observed slow-moving, being before go was called, of him to examination. was complaints able for (EEG) name application being with electroencephalography his when neurological not clinic someone a and outpatient at darkness, been our looking of to not fear referred peers, mindedness, their first to was compared with boy stagnant along 6-month-old improvement 5-year-and been The has the there investigate extent determine to what to aimed HISTORY and to CASE we symptoms and reasons, ADHD symptoms subthreshold these SCT process. and For in treatment SCT shaping improvements pharmacological of with patients. are terms case a there in of a in clinicians if in of kind for symptoms procedure crucial process this SCT very diagnostic treatment affects about is there differential psychopharmacologic protocol symptoms, approaches addition, SCT treatment and In treatment intense ADHD process and their noticeable. standard ADHD, diagnostic is the subthreshold treatment differential how with SCT case Exploring the with on SCT. on SCT studies with reports of in individuals lack improvements case (8). the symptoms demonstrate no scrutinized, SCT to are are on atomoxetine observed effect study data that was minimal existing first suggested improvement has When study the but academic placebo-controlled symptoms was and double-blind ADHD it another atomoxetine, over scores hand, control because symptom of provides other SCT treatment important the that of is On showed not weeks used, study medication. do was 16 This SCT atomoxetine of of which result symptoms in (5). study, Sluggish/sleepy improving a a that with as of methylphenidate out decreased with results association points association The also not no have (7). study has symptoms nonresponse current SCT/Daydreamy therapy whereas A There methylphenidate, methylphenidate to 6). (4). respond that studies (5, methylphenidate limited load indicating that in symptom detected symptoms findings was SCT SCT It literature core SCT improve scarce. pure also not very with does are is patients it SCT although of of problems, proportion modalities attention the treatment improves with possible that individuals on stated (3). of literature was 40% 59% The it was whereas study, ADHD SCT; another have with In to diagnosed (2). found not well were but as ADHD separate with ADHD a individuals had between overlap is of SCT the SCT 39% highlight that ADHD. researches Many supports and ADHD. evidence SCT from current differentiating entity increasing diagnostic together, independent presented and often are (ADHD) Disorder 2 Posted on Authorea 3 Aug 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159646774.49107232 | This a preprint and has not been peer reviewed. Data may be preliminary. nit ypossc sntbigal og otetie ln n h ero akesi condition a of dimension, is signs symptom darkness internalizing additional an of no as fear were SCT the there accompany and However, can alone of Depression expected. oppositional toilet presence of is patient. the the presence and the to follow-up, the literature diagnose go clinical suggest to the of to to disorder with beginning able found as consistent the was being is evidence at depression) not no that especially anxiety, as disruptive case, But, such our (i.e. symptoms disorder. (i.e. In disorders anxiety conduct disorders 23). externalizing or – internalizing with disorder 21 association with defiant (2, less associated ADHD in to more is opposed SCT whereas that disorders), out behavioral point data SCT literature with Many Case the in Process Ethical Diagnostic by Differential the approved of was 20-2T/7). study informed no: case were (decision This K-SADS-PL University parents comorbidityDISCUSSION them. Ege his diagnostic 1). from of and obtained Researches – additional were case Medical (Figure No consents of The point inform Committee practice. written 1 symptoms. SCT- the and first was inattentive by parent-rated study Eventually, the score filled subthreshold case scores scale after except respectively. BCAS SCT-TRF years detected, points, The teacher-rated 3 was 16 and approximately eyes. and problems blank 0, re-administered points inattention with was was 20 staring moderate score to and scale that decreased called, absent-mindedness, teacher CBCL determined was as the such name was and symptoms his It SCT family when in time improvements compared used. noticeable reaction symptoms the were SCT was long from there in methylphenidate improvement obtained and significant notes disappeared, when more He observation almost a months the significantly. period was as two and decreased there the dizziness After examinations complaints that and to mg/day. Clinical indicated dizziness headache family 36 and followed total. a his to and in disappeared, and had reduced months mg/day headaches teacher he slightly 7 43 dose, that was for up of this atomoxetine reported atomoxetine dose at increased of patient used a drug was dose the at the dosage the and fixed using reason, drug family was of this the The atomoxetine For and of dose. effects. mg/day dosage this side The 10 at months was months. two atomoxetine 3 switched for and of within discontinued mg/day dose was 43 48 treatment starting to methylphenidate points). The and old, 8 7-months 12 and atomoxetine. and 0 between points), to 9-years between 8 was (scoring and (scoring patient Form 0 Survey the between Report When Attention (scoring Teacher’s List of Child Check items Behavior Barkley Child 4 subscale the BCAS: SCT-related Hyperactivity/impulsivity of SCT-TRF: HI: points), items 4 points), 27 Dis- SCT-related 27 Behavior SCT-CBCL: and and points), Disruptive 0 0 for between Scale between (scoring scales Evaluation (scoring from subscale and scores Inattention Screening and (IN: Based history orders DSM-IV treatment ADHD-RS-IV: pharmacological legend: patient’s Figure the of Graphs 1: – Figure here) 1. the about – regarding from 1 Figure graphs – reports in the Figure Indeed, shown and (Insert are table symptoms. pharmacotherapy scales SCT The the on from condition. effective obtained this sufficiently scores confirmed examinations be parents psychiatric and not use, clinical teacher methylphenidate could declined, parent-rated the of treatment from completely months this points 27 almost that After 4 symptoms got determined parent- scale. inattentive symptoms, He SCT-TRF period, moderate this respectively. teacher-rated SCT this the points, Within from During months, although points 25 mg/day. severity. 6 and 6 30 and similar 26 to next scale were at up SCT-CBCL scores the remained increased BCAS was slow-moving Within teacher-rated case methylphenidate and diminish. and the of rated not mg/day. eyes that dose did empty 15 the determined symptoms with process, to was SCT particular staring the it increased Release but daydreaming, months, Immediate was problems, as two symptoms, attention methylphenidate such ADHD After moderate of subthreshold of mg/day. his dose terms 10 treat in The to of drug order score dose the IQ In from a performance he 108. benefited a that at of 88, established started score was of was IQ it score total test, (IQ) Methylphenidate Quotient the a Intelligence to 20) and verbal According (19, 128, a (WISC-R) of case. with Version the capacity Revised of intelligence - capacity normal Children intelligence had for the Scale evaluate Intelligence to Weschler applied The was respectively. 0, and 1 were 3 Posted on Authorea 3 Aug 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159646774.49107232 | This a preprint and has not been peer reviewed. Data may be preliminary. ntae tmxtn n 6weso ramn eeamnsee.Sgicn eutosi ohADHD both in reductions were Significant only” administered. ”Dyslexia is were and study treatment placebo- only” Wietecha’s of double-blind higher this ”ADHD weeks have teachers. In 16 ”ADHD+Dyslexia”, to and medication. and with the parents found with atomoxetine diagnosed SCT, on SCT was initiated groups in based of he improvement three scores terms showing months, study, literature SCT in 7 controlled the in methylphenidate in for decline from study atomoxetine of first enough daydreaming the Using rates benefit in higher not atomoxetine. improvement and did to acceleration significant case switched no the was that was medication determined there was studies, However, it two Since these methylphenidate. in with treatment. methylphenidate noted medicated movement, despite not slow was when symptoms of do what signs especially the symptoms to in improvement appearance, appearance significant contrary no sleepy SCT-sluggish/sleepy had case in and methylphenidate that our with study, treatment absent-mindedness, out this associated methylphenidate to not points Similar on are the (7). study symptoms effects that nonresponse SCT-daydreaming negative Another claimed whereas had also methylphenidate, study to ADHD (28). respond The with area school. children methylphenidate, school at of in use only the symptoms the improvements after SCT have school to improvements of at were found and presence there signs home were suggested the at scores study in both SCT-Sluggish improvements up-to-date SCT-Daydreams symptomatology of and and An SCT SCT-Total rates significant of higher case. by scores been the exhibit reported have the of to there in scores symptoms continued side, SCT deficit flip he attention total the that moderate in On observed of reduction values. was small threshold It above a scored teacher. only and was the methylphenidate there and of discontinuation months, parents and 27 the onset about the symptoms lasted Between insufficient to which or (27). positively treatment, manifestations the Specified) responded atypical Otherwise fulfill demonstrating symptoms (ADHD-Not not adults ADHD ADHD in did of subthreshold treatment remain patient that atomoxetine to symptoms suggests of the ADHD weeks trial Although subthreshold following six clinical his years. the allow symptoms. open-label to three In want SCT An approximately not as for did untreated. application. we treatment well accurately, first drug ADHD as of the receiving symptoms criteria been after diagnostic ADHD has years subthreshold he two had and about began, He for treatment drug medication the without process, followed was case SCT The with diagnoses and Case depression characteristics, the or SCT in ADHD had having Process 44-54% Treatment ADHD not that phenotype with independent found patients an of study present 27-35% One SCT (26). diagnosis, with ADHD. ADHD children the both of of had interviews, to presentation 28-46% SCT clinical according inattentive Moreover, with K-SADS-PL of no patients functionality. and symptoms had of daily criteria and subthreshold his diagnostic affect score had DSM-5 not IQ patient on do estimated conducted that normal examinations symptoms a psychiatric inattention had capacity has patient intelligence case the The the that measure finding to and two can wanted WISC-R, these insufficiency. SCT we distinguish mental applying levels in to purpose, case, high observed important possible this is the had a slowness” For it of with cases disability, speed ASD intellectual associated structures. these ”processing with with be psychopathological the of individuals cases may different in Since one-third psychopathologies frequently adolescent in that two observed symptoms. in examined be found these their also higher of first ASD between any significantly diagnosis coexistence overlap was with of The or be ASD adults SCT lack similarity young to (25). and support the symptoms in found ASD However, that SCT study were between fields of up-to-date case. symptoms relationship empathy around An the SCT The especially and in and ASD. (24). called, communication investigated study considering was was social current from name not diagnosis away language, a his would ASD us when in alone possible kept look case a ”anergia” has immediately the Hence, of not of did presence age. findings patient the of the anergia, years that 6 ”anergia” as noted The the also accepted with depression. was was case. confounded major It the be it with of perhaps if case depression may the Even the findings explain These diagnose adequately energy. clinically depression. low to of had evidence and symptom enough slowly moving not was was case there However, too. 4 Posted on Authorea 3 Aug 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159646774.49107232 | This a preprint and has not been peer reviewed. Data may be preliminary. rgnldatpeaain eiwadeiig ...cnrbtdt h rcse fconceptualization, of processes the to contributed supervision. E.S.E. and REFERENCES editing & editing. review and validation, investigation, review methodology, preparation, draft original Contributions: Author be Statement: Availability should Data results These methylphenidate. interest. decreased to of patients. have more compared symptoms Interest: with SCT atomoxetine of needed drugs, Conflict of are both use trials in controlled the SCT randomized symptoms in to and ADHD attention rates faster replicated, subthreshold moderate response as of and high signs well more the no as improved much for were have drugs used there other Both were any Although are observed. have ADHD, severely cases deficits. not for were of did symptoms used SCT number who commonly whose higher case, and valid are a a which are in with atomoxetine, findings time and trials the sufficient methylphenidate clinical since both and SCT conclusion, replicated with In cases be all should for findings generalized The to be needed. alone. cannot easier case results it one the making obtained for limitations; be process, the could pharmacotherapy for case effectiveness. the As treatment the monitored of of also results symptoms the scales SCT clinician’s out the These to of find supportive related informants. been teacher information have the multiple way, treatment scales and these this from appropriate parents and other In periodically, more the SCT of develop both to examination. diagnosis, related and absence psychiatric scales SCT and analyze the the confirm clearer fill better treatment to to addition, of to asked order report were In course in clinicians case Furthermore, the help SCT. in our basis. might regarding case view, strategies study this case-by-case of of The a results publication point valuable. methylphenidate the on no of this more made symptoms effects ADHD From is the threshold SCT comparing there including and compared. on comorbidities but observing either and simultaneously together trials, that by involved atomoxetine field observed clinical are this and been in in drugs has data treatment first it both the the SCT far, investigating where provides literature So for literature the SCT. used in the with study is in patient first atomoxetine a the of is or This line process methylphenidate treatment In limitations. atomoxetine. and and (5). with strengths diagnosis improvement treatment some differential shown atomoxetine has have report with case case symptoms our Our ADHD these of between in symptoms determined improvements was SCT correlation study, of positive this terms A with in groups. symptoms three all SCT in and detected were symptoms SCT and Weeh ,Wlim ,Sawt ,Sawt ,Hoe R ia B unD cunt .(2013) K. 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Ol¸ce˘gi El (WISC-R) ¨ Posted on Authorea 3 Aug 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159646774.49107232 | This a preprint and has not been peer reviewed. Data may be preliminary. FrtS u ,AsvA 22)A pnLblTilo ehlhndt raigSugs Cogni- Sluggish Treating Methylphenidate of Trial Open-Label An (2020) A. Aysev H, (2010) Gul J. S, Biederman Fırat C, Williams 28. N, Gebhard N, Chu R, Doyle C, Petty P, Hammerness C, cognitive Surman sluggish of 27. differentiation Clinical (2018). ex- P. An S. Becker, tempo: & L., cognitive G. Burns, Sluggish S´aez, B., M., (2020) Servera, SW. 26. White NN, Capriola-Hall GL, Simmons AM, Brewe 25. hlrn htAetePeitr fTetetRsos tHm n col te iod 2020 Disord. Atten J School? and Home at 10.1177/1087054720902846. ADHD Response 12-Year-Old doi: Treatment to of 17:1087054720902846. 6- Predictors Feb the Among Are Symptoms What Impulsivity Hyperactivity/ Children: and Inattention, Tempo, hype- CNS tive attention-deficit study. 6-week onset 10.1111/j.1755-5949.2009.00124.x. open-label late doi: prospective Spring;16(1):6-12. and/or 2010 a subthreshold Ther. (ADHD-NOS): with Neurosci specified adults otherwise of disorder-not treatment ractivity the in Atomoxetine 127, Psychology, Abnormal of Journal abn0000375 children. doi: doi:10.1037/ in 818–829. 7:1362361319900422. disorder Feb attention-deficit/hyperactivity 2020 and tempo Autism. autism. with adults for correlates 10.1177/1362361319900422. clinical of amination 10.1177/1362361318811329. 7 Posted on Authorea 3 Aug 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159646774.49107232 | This a preprint and has not been peer reviewed. Data may be preliminary. 8