background Treatment of children with attention deficit hyperactivity disorder (adhd) with methylphenidate is sometimes preceded by a double-blind trial. Although this is common practice in the Netherlands, a systematical description and discussion in the Dutch language is lacking.
aims To critically discuss advantages and limitations of a double blind trial in comparison to open treatment with methylphenidate.
methods The practice of a double blind trial for clinical use is described, and discussed against the background of a review of the literature. Additionally the practice is illustrated with two case histories.
results Research shows that a double blind trial can enhance parental satisfaction with the pharmacological treatment of their child. The clinical experience of the authors learns that the working alliance with the family is positively influenced.
conclusions A double blind placebo-controlled trial is a valuable tool for the clinician treating adhd. The lack of consensus regarding methodology in n=1 trials and the lack of unequivocal measures to assess adhd treatment, prohibit the use of a universal standard to evaluate the results.