Health Care Costs of Adults Treated for Attention-Deficit/Hyperactivity Disorder Who Received Alternative Drug Therapies

Wu, Eric Q.; Birnbaum, Howard G.; Zhang, Huabin F.; Ivanova, Jasmina I.; Yang, Elaine; Mallet, David

doi:10.18553/jmcp.2007.13.7.561

Cited by 16 publications

(11 citation statements)

References 33 publications

(54 reference statements)

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“…Another limitation in the present study was the 3-month exposure period selected to replicate the El-Zein et al12 protocol. Typically, individuals with ADHD are exposed to stimulant drugs for longer periods 38. Thus, assessment of cytogenetic endpoints after longer exposure periods would provide data to further evaluate the potential for therapeutic doses of MPH to induce cytogenetic damage in patients with ADHD.…”

Section: Discussionmentioning

confidence: 99%

Methylphenidate and Amphetamine Do Not Induce Cytogenetic Damage in Lymphocytes of Children With ADHD

Witt

Shelby

Itchon-Ramos

et al. 2008

Journal of the American Academy of Child & Adolescent Psych

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Objective-In response to previously published findings of methylphenidate-induced chromosomal changes in children, this study was designed to determine whether methylphenidateor amphetamine-based drugs induce chromosomal damage (structural aberrations, micronuclei, and sister chromatid exchanges) in peripheral blood lymphocytes of children with attention-deficit/ hyperactivity disorder after 3 months of continuous treatment.Method-Stimulant drug-naïve subjects, 6 to 12 years of age, in good overall health, and judged to be appropriate candidates for stimulant therapy based on rigorously diagnosed ADHD using DSM-IV criteria, were randomized into two open-label treatment groups (methylphenidate or mixed amphetamine salts). Each subject provided a blood sample before initiation of treatment and after 3 months of treatment. Pretreatment and posttreatment frequencies of chromosomal aberrations, micronuclei, and sister chromatid exchanges were determined for each subject.Results-Sixty-three subjects enrolled in the study; 47 subjects completed the full 3 months of treatment, 25 in the methylphenidate group and 22 in the amphetamine group. No significant treatment-related increases were observed in any of the three measures of cytogenetic damage in the 47 subjects who completed treatment or the 16 subjects who did not. Conclusions-Earlier findings of methylphenidate-induced chromosomal changes in childrenwere not replicated in this study. These results add to the accumulating evidence that therapeutic levels of methylphenidate do not induce cytogenetic damage in humans. Furthermore, our results indicate that amphetamine-based products do not pose a risk for cytogenetic damage in children. Although the use of these products has been associated with a number of manageable adverse effects (appetite suppression, insomnia, nervousness, headache, and dry mouth) and concern has been raised over potential adverse cardiovascular effects, their overall safety profiles are good. [7][8][9][10][11] However, the safety of MPH was abruptly challenged in 2005 by a report of increased frequencies of sister chromatid exchanges (SCE; indicative of DNA damage), structural chromosomal aberrations (CA), and micronuclei (MN; biomarkers of numerical and structural chromosomal changes) in lymphocytes of 12 pediatric patients with ADHD after 3 months of MPH-based drug therapy. 12 That study raised concern among members of the medical community and families of children with ADHD receiving MPH-based therapy because increased frequencies of CAs and micronuclei in peripheral blood lymphocytes are associated with an increased risk of cancer. 13,14 However, questions were raised regarding the study design and some of the reported findings, including the small sample size (12 children), a lack of critical details on blood sample processing and slide scoring, and the complete absence of SCE recorded in 6 of the 11 children analyzed for this endpoint. 15 The absence of SCE was especially troubling because such an observation has never been repor...

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Section: Discussionmentioning

confidence: 99%

Methylphenidate and Amphetamine Do Not Induce Cytogenetic Damage in Lymphocytes of Children With ADHD

Witt

Shelby

Itchon-Ramos

et al. 2008

Journal of the American Academy of Child & Adolescent Psych

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“…This retrospective database is fully de-identified and Health Insurance Portability and Accountability Act (HIPAA) compliant. The data for this study comprised medical, inpatient, and pharmacy claims with dates of service from January 1, 2001 through June 30,2006.…”

Section: Methodsmentioning

confidence: 99%

“…Consistent with prior research, costs were measured as the allowed payments by the health plan to the provider 30 . As such, deductible, co-insurance, and other cost sharing are not included in the measure of costs, allowing for more consistent comparisons across patients, data sources and geographic areas.…”

Section: Methodsmentioning

confidence: 99%

Healthcare costs in postmenopausal women with hormone-positive metastatic breast cancer

Lage

Borker

Barber

et al. 2010

Journal of Medical Economics

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“…1 In 6m onths of followup, the median duration of therapy with OROS-MPH was 99 days versus 128 days for MAS-XR and 86 days for atomoxetine. The unadjusted median total all-cause medical cost ($1,062) for the cohort of OROS-MPH patients (n=1,452) was 1.7% less than the total all-cause medical cost ($1,080) for MAS-XR patients (n =1,554), and 16.4% less than $1,271 for atomoxetine (n=1,563).…”

Section: Add or Adhd Or What Exactly?-gigo Part II And Other Lessons mentioning

confidence: 97%

ADD or ADHD or What Exactly?--GIGO Part II and Other Lessons in Research with Administrative Claims

Curtiss¹,

Fairman²

2007

JMCP

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Health Care Costs of Adults Treated for Attention-Deficit/Hyperactivity Disorder Who Received Alternative Drug Therapies

Cited by 16 publications

References 33 publications

Methylphenidate and Amphetamine Do Not Induce Cytogenetic Damage in Lymphocytes of Children With ADHD

Methylphenidate and Amphetamine Do Not Induce Cytogenetic Damage in Lymphocytes of Children With ADHD

Healthcare costs in postmenopausal women with hormone-positive metastatic breast cancer

ADD or ADHD or What Exactly?--GIGO Part II and Other Lessons in Research with Administrative Claims

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