Effects of Atomoxetine and Methylphenidate on Sleep in Children With ADHD

Sangal, R. Bart; Owens, Judith; Allen, Albert J.; Sutton, Virginia K.; Schuh, Kory; Kelsey, Douglas K.

doi:10.1093/sleep/29.12.1573

Cited by 170 publications

(129 citation statements)

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“…Some studies suggest that methylphenidate, a common pharmacotherapy for ADHD, may exacerbate these sleep problems (Corkum et al, 2008;Galland et al, 2010;Ironside et al, 2010;Sangal et al, 2006;Schwartz et al, 2004). We show here that in healthy adult mice, methylphenidate alone can alter both sleep and circadian rhythmicity.…”

Section: Discussionsupporting

confidence: 49%

“…The change in phase angle is also consistent with findings from placebocontrolled and baseline-comparison human studies examining the effects of methylphenidate on various sleep and circadian markers. Longer sleep latency and decreased total sleep time were observed in people given methylphenidate (Boonstra et al, 2007;Corkum et al, 2008;Galland et al, 2010;Sangal et al, 2006;Schwartz et al, 2004). A phase delay in circadian locomotor rhythms has also been noted (Ironside et al, 2010).…”

Section: Discussionmentioning

confidence: 91%

“…While methylphenidate is quite effective at managing the inattention, impulsiveness, and hyperactivity associated with ADHD, it may not help the co-morbid sleep problems, and in fact methylphenidate may exacerbate these symptoms. In children, placebo-controlled studies have demonstrated that methylphenidate leads to longer sleep latency, lower sleep efficiency, decreased total sleep time (Corkum et al, 2008;Galland et al, 2010;Sangal et al, 2006;Schwartz et al, 2004), increased motor activity at sleep onset, decreased circadian amplitude, and phase delayed daily rhythms (Ironside et al, 2010). Many of these symptoms are consistent with either a phase delayed circadian clock or a circadian clock with a lengthened period.…”

Section: Introductionmentioning

confidence: 99%

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Methylphenidate Modifies the Motion of the Circadian Clock

Antle

Diepen

Deboer

et al. 2012

Neuropsychopharmacol

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People with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, and these are frequently exacerbated by the methylphenidate they take to manage their ADHD symptoms. Many of the changes to sleep are consistent with a change in the underlying circadian clock. The present study was designed to determine if methylphenidate alone could alter properties of the circadian clock. Young male mice were examined in light-dark cycles and in constant darkness and recordings were performed on behavioral activity, sleep, and electrical activity in the suprachiasmatic nucleus (SCN) of freely moving mice. Methylphenidate in the drinking water (0.08%) significantly increased activity in the mid-to-late night, and led to a delay in the onset of activity and sleep relative to the light-dark cycle. While locomotor levels returned to baseline after treatment ended, the phase angle of entrainment required at least a week to return to baseline levels. In constant darkness, the free-running period of both wheel-running and general locomotor rhythms was lengthened by methylphenidate. When the treatment ended, the free-running period either remained stable or only partially reverted to baseline levels. Methylphenidate also altered the electrical firing rate rhythms in the SCN. It induced a delay in the trough of the rhythm, an increment in rhythm amplitude, and a reduction in rhythm variability. These observations suggest that methylphenidate alters the underlying circadian clock. The observed changes are consistent with clock alterations that would promote sleep-onset insomnia.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Methylphenidate Modifies the Motion of the Circadian Clock

Antle

Diepen

Deboer

et al. 2012

Neuropsychopharmacol

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“…If the SLEEP, ATTENTION, AND EXECUTIVE FUNCTIONING number of counts exceeds the threshold, the epoch is scored as wake; if the number is equal or below the threshold, the epoch is scored as sleep. Threshold was set at medium (40 activity counts), which has been used in previous studies experimenting with the same device and similar population (e.g., Sangal et al, 2006). An event marker button was used to indicate bedtime and rising time.…”

Section: Methodsmentioning

confidence: 99%

Sleep, Attention, and Executive Functioning in Children with Attention-Deficit/Hyperactivity Disorder

Moreau

Rouleau

Morin

2013

Archives of Clinical Neuropsychology

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“…[9][10][11][12][13] Some of the randomized controlled comparison studies for efficacy and safety of these two agents found MPH was superior while some others did not find any difference between two agents. 9,10,12,14,15 The metaanalyses of those studies also show similar contradictions. [16][17][18][19] Therefore, there is still a need for the studies comparing MPH and ATX which are two agents frequently used in the treatment of ADHD.…”

mentioning

confidence: 73%

Atomoxetine Versus Oros Methylphenidate in Attention Deficit Hyperactivity Disorder: A Six-Month Follow Up Study for Efficacy and Adverse Effects

Çetin¹,

Torun²,

Taner³

2015

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Attention deficit hyperactivity disorder (ADHD) is one of the most frequently seen neuropsychiatric disorders in childhood. The aim of this study is to compare the efficacy and the adverse effects of two FDA-approved agents, atomoxetine (ATX) and osmotic release oral system methylphenidate (OROS-MPH), in the treatment of ADHD. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This research was designed as a randomized, open label, prospective and follow-up study. The study was performed by 120 cases between ages 7-16 years who were diagnosed as ADHD for the first time and given prescription. The cases were divided into two by randomization. One group was given ATX (n=59) while the other was given OROS-MPH (n=61) were evaluated prospectively by clinical examination and Conner's Comprehensive Behavior Rating Scale-Teacher (CRS-T) at the 2 nd , 4 th , and 6 th months. Efficacy of treatment was regarded as a 40% reduction in CRS-T scores when compared to baseline values, and the adverse effects were questioned in every follow up visit. R Re es su ul lt ts s: : The efficacy was 55.7% in CRS-T hyperactivity score, 63.9% in the attention deficit score, and 55.7% in the behavior problems score in OROS-MPH group. Those values were 47.5%, 69.5% and 57.6% respectively in ATX group. Adverse effects were seen in 27.1% (n=16) of the patients in the ATX group, and in 31.1% (n=19) of the patients in the OROS-MPH group. Two groups were not found significantly different for the frequency of adverse effects as well as the efficacy of the medication, at the follow-up evaluations which were performed at 2 nd , 4 th and 6 th months. C Co on nc cl lu us si io on n: : In this study, ATX and OROS-MPH were compared for their efficacy and adverse effects for the treatment of ADHD, and two agents were found similar for their efficacies and adverse effect profiles. ATX and OROS-MPH have similar efficacies in the treatment of ADHD and adverse effect profiles are similar. K Ke ey y W Wo or rd ds s: : Attention deficit disorder with hyperactivity; atomoxetine; methylphenidate; adverse effects; efficiency Ö ÖZ ZE ET T A Am ma aç ç: : Dikkat eksikliği hiperaktivite bozukluğu (DEHB), çocukluk çağında en sık görülen nörop-sikiyatrik hastalıklardan biridir. Bu çalışmada, DEHB tedavisinde kullanılan FDA onaylı iki ajan olan atomoksetin (ATX) ile osmotik salınımlı metilfenidat (OROS-MPH)'ın etkinlik ve yan etki profillerinin karşılaştırılması amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu araştırma randomize, açık uçlu ve prospektif bir izlem çalışması olarak dizayn edildi. Çalışma, DEHB tanısı konulan ve ilk kez ilaç tedavisi başlanan, yaşları 7-16 yıl arasındaki 120 hasta ile yapıldı. Hastalar, randomizasyonla ikiye ayrıldı. ATX (n=59) ve OROS-MPH (n=61) kullanan hastalar 2., 4. ve 6.aylarda Conner's Öğretmen Derecelendirme Ölçeği (CÖDÖ) ve klinik muayene ile değerlendirildi. Başlangıca göre 6. ayda CÖDÖ puanlarında %40 azalma etkinlik olarak kabul edildi ve...

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Effects of Atomoxetine and Methylphenidate on Sleep in Children With ADHD

Abstract: Patients receiving twice-daily atomoxetine had shorter sleep-onset latencies, relative to thrice-daily methylphenidate, based on objective actigraphy and polysomnography data. Although both medications decreased nighttime awakenings, the decrease was greater for methylphenidate.

Cited by 170 publications

References 0 publications

Methylphenidate Modifies the Motion of the Circadian Clock

Methylphenidate Modifies the Motion of the Circadian Clock

Sleep, Attention, and Executive Functioning in Children with Attention-Deficit/Hyperactivity Disorder

Atomoxetine Versus Oros Methylphenidate in Attention Deficit Hyperactivity Disorder: A Six-Month Follow Up Study for Efficacy and Adverse Effects

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