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Symptom control in children and adolescents with attention-deficit/hyperactivity disorder on switching from immediate-release MPH to OROS® MPH

Results of a 3-week open-label study

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Abstract

Aim

The aim of this study was to assess the impact of switching from immediate-release (IR) methylphenidate (MPH) to OROS® MPH (CONCERTA®), a once-daily long-acting MPH formulation, in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

Methods

Subjects with ADHD aged 6–16 (n=105),who were stably maintained on their current IR MPH regimen (10–60 mg/day), were switched to 18, 36 or 54mg OROS® MPH once daily for 21 days, depending on pre-study daily MPH dose.ADHD symptoms were assessed by parents, teachers and investigators.

Results

By Day 21, parent/caregiver IOWA Conners ratings had decreased from baseline by 2.7 points to 5.2 (I/O), and by 1.8 points to 5.0 (O/D). Teacher IOWA Conners ratings were maintained. Decreases in IOWA Conners ratings are indicative of ADHD symptom improvement. Approximately 75% of parents and investigators rated therapy as good or excellent. OROS® MPH therapy was well tolerated.

Conclusions

Switching from IR MPH to OROS® MPH maintained and may have improved symptom control in children and adolescents with ADHD, during the course of this study. The changes in parent/caregiver IOWA Conners ratings suggest that OROS® MPH improves symptom control in the after-school period. This is consistent with the 12-h duration of action previously demonstrated for OROS® MPH.

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References

  1. AACAP (2002) Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. J Am Acad Child Adolesc Psychiatry 41(2 Suppl):26S–49S

    PubMed  Google Scholar 

  2. Atkins MS, Pelham WE, Licht MH (1989) The differential validity of teacher ratings of inattention/overactivity and aggression. J Abnorm Child Psychol 17(4):423–435

    Article  PubMed  Google Scholar 

  3. Greenhill LL, Swanson JM, Vitiello B, Davies M, Clevenger W, Wu M, Arnold LE, Abikoff HB, Bukstein OG, Conners CK, Elliott GR, Hechtman L, Hinshaw SP, Hoza B, Jensen PS, Kraemer HC, March JS, Newcorn JH, Severe JB, Wells K, Wigal T (2001) Impairment and deportment responses to different methylphenidate doses in children with ADHD: the MTA titration trial. J Am Acad Child Adolesc Psychiatry 40(2):180–187

    Article  PubMed  Google Scholar 

  4. Klassen A, Miller A, Raina P, Lee SK, Olsen L (1999) Attention-deficit hyperactivity disorder in children and youth: a quantitative systematic review of the efficacy of different management strategies. Can J Psychiatry 44(10):1007–1016

    PubMed  Google Scholar 

  5. Kutcher S, Aman M, Brooks SJ, Buitelaar J, van Daalen E, Fegert J, Findling RL, Fisman S, Greenhill LL, Huss M, Kusumakar V, Pine D, Taylor E, Tyano S (2004) International consensus statement on attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs): clinical implications and treatment practice suggestions. Eur Neuropsychopharmacol 14(1):11–28

    Article  PubMed  Google Scholar 

  6. Loney J, Milich R (1982) Hyperactivity, inattention, and aggression in clinical practice. In: Wolraich M, Routh DK (eds) Advances in Development and Behavioral Pediatrics. JAI Press. Greenwich, CT, pp 113–147

  7. Miller A, Lee SK, Raina P (1999) Assessment of Attention Deficit/Hyperactivity Disorder: A Canadian Perspective—Technology Overview. In: Shukla KV, Otten N (eds) Canadian Coordinating Office for Health Technology Assessment

  8. Pelham WE, Gnagy EM, Burrows-Maclean L, Williams A, Fabiano GA, Morrisey SM, Chronis AM, Forehand GL, Nguyen CA, Hoffman MT, Lock TM, Fielbelkorn K, Coles EK, Panahon CJ, Steiner RL, Meichenbaum DL, Onyango AN, Morse GD (2001) Once-a-day Concerta methylphenidate versus threetimes-daily methylphenidate in laboratory and natural settings. Pediatrics 107(6):E105

    Article  PubMed  Google Scholar 

  9. Pelham WE, Gnagy EM, Chronis AM, Burrows-MacLean L, Fabiano GA, Onyango AN, Meichenbaum DL, Williams A, Aronoff HR, Steiner RL (1999) A comparison of morning-only and morning/late afternoon Adderall to morning-only, twice-daily, and three times-daily methylphenidate in children with attention-deficit/hyperactivity disorder. Pediatrics 104(6):1300–1311

    Article  PubMed  Google Scholar 

  10. Pelham WE, Milich R, Murphy DA, Murphy HA (1989) Normative data on the IOWA Conners Teacher Rating Scale. J Clin Child Psychol 18:259–262

    Google Scholar 

  11. Schachter HM, Pham B, King J, Langford S, Moher D (2001) How efficacious and safe is short-acting methylphenidate for the treatment of attention-deficit disorder in children and adolescents? A meta-analysis. CMAJ 165(11):1475–1488

    PubMed  Google Scholar 

  12. Stein MA, Greenhill LL (2002) Oncedaily Concerta (MPH) for adolescents and adult with ADHD. Int J Neuropsychopharmacol 5(Suppl 1):S162

    Google Scholar 

  13. Swanson J (2003) Compliance with stimulants for attention-deficit/hyperactivity disorder: issues and approaches for improvement. CNS Drugs 17(2):117–131

    PubMed  Google Scholar 

  14. Swanson J, Greenhill L, Pelham W, Wilens T, Wolraich M, Abikoff H, Atkins M, August G, Biederman J, Bukstein O, Conners CK, Efron L, Fiebelkorn K, Fried J, Hoffman M, Lambrecht L, Lerner M, Leventhal B, McBurnett K, Morse E, Palumbo D, Pfiffner L, Stein MA, Wigal S, Winans E (2000) Initiating CONCERTA (OROS methylphenidate HCI) qd in children with attention-deficit hyperactivity disorder. J Clin Res 3:59–76

    Google Scholar 

  15. Swanson JM, Lerner MA, Gupta S, Shoulson I, Wigal S (2003) Development of a new once-a-day formulation of methylphenidate for the treatment of ADHD. Arch Gen Psychiatry 60(2):204–211

    Article  PubMed  Google Scholar 

  16. Wilens T, Pelham W, Stein MA, Conners CK, Abikoff H, Atkins M, August G, Greenhill L, McBurnett K, Palumbo D, Swanson J, Wolraich M (2003) ADHD treatment with once-daily OROS® methylphenidate: interim 12-month results from long-term open-label study. J Am Acad Child Adolesc Psychiatry 42(4):424–433

    PubMed  Google Scholar 

  17. Wilens TE (2002) Treatment of ADHD with once-daily OROS methylphenidate: results from a long-term open-label study. Presented at 155th Annual Meeting of the American Psychiatric Association, Philadelphia, PA, May 18–22:2002

  18. Wolraich ML, Greenhill LL, Pelham W, Swanson J, Wilens T, Palumbo D, Atkins M, McBurnett K, Bukstein O, August G (2001) Randomized, controlled trial of OROS methylphenidate once a day in children with attention-deficit/hyperactivity disorder. Pediatrics 108(4):883–892

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Kinder- und Jugendpsychiatrie, Hans-Sachs-Strasse 6, 35033, Marburg, Germany

    H. Remschmidt

  2. Royal Hospital for Sick Children, 3 Rillbank Terrace, Edinburgh EH9 1LL, UK

    P. Hoare

  3. Kinder- und Jugendpsychiatrie der Universität Leipzig, Dritte Etage, Riemannstrasse 32–34, 04107, Leipzig, Germany

    C. Ettrich

  4. Kinder- und Jugendpsychiatrie der Georg-August Universität, Von-Siebold-Strasse 5, 37075, Göttingen, Germany

    A. Rothenberger

  5. Maudsley Hospital, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK

    P. Santosh

  6. Klinik für Kinder- und Jugendpsychiatrie am Zentralinstitut für seelische Gesundheit, 122120, 68159, Mannheim, Germany

    M. Schmidt

  7. Orchard House, Sussex Weald and Downs NHS Trust, 9 College Lane, Chichester PO19 4PQ, UK

    Q. Spender

  8. Leicestershire and Rutland Healthcare Trust, Bridge Park Plaza, Thurmaston, Leicester LE4 8PQ, UK

    R. Tamhne

  9. Ashurst Hospital, Department of Psychiatry, Lyndhurst, Southampton SO40 7AR, UK

    M. Thompson

  10. The Pear Tree Centre Child and Family Therapy Service, Smallwood House, Church Green West, Redditch, Worcestershire B97 4BD, UK

    C. Tinline

  11. Privatpraxis, Frohsinnstrasse 26, 63739, Aschaffenburg, Germany

    G. E. Trott

  12. Janssen-Cilag GmbH, Raiffeisenstrasse 8, 41470, Neuss, Germany

    R. Medori

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  1. H. Remschmidt
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  2. P. Hoare
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  3. C. Ettrich
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  4. A. Rothenberger
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  5. P. Santosh
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  6. M. Schmidt
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  7. Q. Spender
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  8. R. Tamhne
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  9. M. Thompson
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  10. C. Tinline
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  11. G. E. Trott
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  12. R. Medori
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Correspondence to H. Remschmidt.

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Remschmidt, H., Hoare, P., Ettrich, C. et al. Symptom control in children and adolescents with attention-deficit/hyperactivity disorder on switching from immediate-release MPH to OROS® MPH. Europ.Child & Adolescent Psych 14, 297–304 (2005). https://doi.org/10.1007/s00787-005-0467-6

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  • DOI: https://doi.org/10.1007/s00787-005-0467-6

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