Attention deficit/hyperactivity disorder and methylphenidate

Rapport, Mark D.; Moffitt, Catherine

doi:10.1016/s0272-7358(02)00129-0

Cited by 108 publications

(17 citation statements)

References 55 publications

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“…Fluctuations in blood pressure and pulse rate typically seen with stimulant therapy 29 occurred in subjects throughout this study. Across all MTS treatment groups, 13 subjects had increases in systolic blood pressure (≥20 mm Hg), 63 subjects had increases in diastolic blood pressure (≥10 mm Hg), and 12 subjects had increases in pulse rate (≥110 bpm).…”

Section: Resultsmentioning

confidence: 80%

Switching from oral extended-release methylphenidate to the methylphenidate transdermal system: continued attention-deficit/hyperactivity disorder symptom control and tolerability after abrupt conversion

Arnold

Bozzolo

Hodgkins

et al. 2009

Current Medical Research and Opinion

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Objective To evaluate symptom control and tolerability after abrupt conversion from oral extended-release methylphenidate (ER-MPH) to methylphenidate transdermal system (MTS) via a dose-transition schedule in children with attention-deficit/hyperactivity disorder (ADHD). Methods In a 4-week, prospective, multisite, open-label study, 171 children (164 intent-to-treat) with diagnosed ADHD aged 6–12 years abruptly switched from a stable dose of oral ER-MPH to MTS in nominal dosages of 10, 15, 20, and 30 mg using a predefined dose-transition schedule. After the first week on the scheduled dose, the dose was titrated to optimal effect. The primary effectiveness outcome was the change from baseline (while taking ER-MPH) to week 4 in ADHD-Rating Scale-IV (ADHD-RS-IV) total scores. Adverse events (AEs) were assessed throughout the study. Results Most subjects (58%) remained on the initial MTS dose defined by the dose-transition schedule; 38% increased and 4% decreased their MTS dose for optimization. MTS dose optimization resulted in significantly better ADHD-RS-IV total (mean ± SD) scores at week 4 than at baseline (9.9±7.47 vs 14.1±7.48; p<0.0001). The most commonly reported AEs included headache, decreased appetite, insomnia, and upper abdominal pain. Four subjects (2.3%) discontinued because of application site reactions and 3 discontinued because of other AEs. Conclusions Abrupt conversion from a stable dose of oral ER-MPH to MTS was accomplished using a predefined dose-transition schedule without loss of symptom control; however, careful titration to optimal dose is recommended. Most AEs were mild to moderate and, with the exception of application site reactions, were similar to AEs typically observed with oral MPH. Limitations of this study included its open-label sequential design without placebo, which could result in spurious attribution of improvement to the study treatment and precluded superiority determinations of MTS over baseline ER-MPH treatment. The apparent superiority of MTS was likely due to more careful titration and clinical monitoring rather than the product itself. NCT NCT00151983

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Section: Resultsmentioning

confidence: 80%

Switching from oral extended-release methylphenidate to the methylphenidate transdermal system: continued attention-deficit/hyperactivity disorder symptom control and tolerability after abrupt conversion

Arnold

Bozzolo

Hodgkins

et al. 2009

Current Medical Research and Opinion

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“…While many adverse events are often transient and dose-dependent 46 , effects such as appetite loss may persist for years 47 . Adverse events may also be genotype-specific, with, for example, CYP2D6 poor metabolizers at greater risk with atomoxetine 48 .…”

Section: Presentmentioning

confidence: 99%

Attention-Deficit Hyperactivity Disorder and Pharmacotherapy—Past, Present, and Future: A Review of the Changing Landscape of Drug Therapy

Connolly

Glessner

Kao

et al. 2015

Ther Innov Regul Sci

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Attention deficit hyperactivity disorder (ADHD) is the most common neurobiological disorder in children, with a prevalence of ~6-7% 1,2 that has remained stable for decades 2 . The social and economic burden associated with patients 3 , families, and broader systems (healthcare/educational) is substantial, with the annual economic impact of ADHD exceed $30 billion in the US alone 4 . Efficacy of pharmacotherapy in treating ADHD symptoms has generally been considerable with at least ¾ of individuals benefitting from pharmacotherapy, typically in the form of stimulants 5 . In this review, we begin by briefly reviewing the history of pharmacotherapy in relation to ADHD, before focusing (primarily) on the state-of-the-field on themes such as biophysiology, pharmacokinetics, and pharmacogenomics. We conclude with a summary of emerging clinical and research studies, particularly the potential role for precision therapy in matching ADHD patients and drug types. KeywordsADHD; pharmacotherapy; pharmacology; drug; medication; adverse events PASTThe most common and effective medications are methylphenidates and amphetamines. Atomoxetine and the a-adrenergic agonists are also widely-used, while tricyclics such as modafinil and Wellbutrin are less common and typically less effective 6 .First synthesized in 1887, amphetamine (alpha-methylphenethylamine) was not studied clinically until 1927, initially as an artificial replacement for epinephrine 7 . For several years,

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“…of quantifiable side effects associated with MPH therapy for children with ADHD has suggested that effects on height and weight are mostly transient, dose-dependent and easily rectifiable with dosage adjustments. Moreover, these side effects are considered minor from a clinical perspective considering the overall improvement in behaviour and cognitive functioning observed in most children [83]. Indeed, assessment of treatment effects with OROS MPH on growth in an open-label study found that, in general, children with ADHD gained both height and weight over time [29, 115].…”

Section: Concerns Of Long-term Stimulant Treatmentmentioning

confidence: 99%

“…In children, effects on heart rate and blood pressure have been shown to be mostly transient, dose-dependent and easily rectified with dosage adjustments, and are therefore, considered minor [83]. Stimulant and non-stimulant medications used in adults with ADHD have been associated with minor, but statistically significant, changes in heart rate and blood pressure, although such changes have frequently been observed in those receiving placebo [117].…”

Section: Concerns Of Long-term Stimulant Treatmentmentioning

confidence: 99%

Treating attention-deficit/hyperactivity disorder beyond symptom control alone in children and adolescents: a review of the potential benefits of long-acting stimulants

Buitelaar

Medori²

2009

Eur Child Adolesc Psychiatry

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Attention-deficit/hyperactivity disorder (ADHD), one of the most common neuropsychiatric conditions of childhood, often has a chronic course and persists into adulthood in many individuals. ADHD may have a clinically important impact on health-related quality of life in children, a significant impact on parents’ emotional health and interfere with family activities/cohesion. To date, the main targets of ADHD treatment have focused on reducing the severity of symptoms during the school day and improving academic performance. However, the treatment of ADHD should reach beyond symptom control to address the issues of social competencies and improvement of health-related quality of life from the perspectives of individuals with ADHD and their families, to support them in reaching their full developmental potential. Methylphenidate (MPH) is recognised as the first-line choice of pharmacotherapy for ADHD in children and adolescents. This paper focuses on the importance and benefits to child development of ADHD symptom control beyond the school day only, i.e. extending into late afternoon and evening and uses the example of an extended-release MPH formulation (OROS® MPH) to demonstrate the potential benefits of active full day coverage (12 h) with a single daily dose. Concerns of long-term stimulant treatment are also discussed.

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Attention deficit/hyperactivity disorder and methylphenidate

Cited by 108 publications

References 55 publications

Switching from oral extended-release methylphenidate to the methylphenidate transdermal system: continued attention-deficit/hyperactivity disorder symptom control and tolerability after abrupt conversion

Switching from oral extended-release methylphenidate to the methylphenidate transdermal system: continued attention-deficit/hyperactivity disorder symptom control and tolerability after abrupt conversion

Attention-Deficit Hyperactivity Disorder and Pharmacotherapy—Past, Present, and Future: A Review of the Changing Landscape of Drug Therapy

Treating attention-deficit/hyperactivity disorder beyond symptom control alone in children and adolescents: a review of the potential benefits of long-acting stimulants

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