Journal of the American Academy of Child & Adolescent Psychiatry
ARTICLESImpact of Methylphenidate Delivery Profiles on Driving Performance of Adolescents With Attention-Deficit/Hyperactivity Disorder: A Pilot Study
Section snippets
Subjects
Seven male drivers with ADHD, with a mean age of 17.2 ± 1.2 years and 15.8 ± 12.4 months of driving experience, participated in this repeated-measure crossover study (Table 1); one subject (subject 2) dropped out of the study due to the unexpected death of a close friend. Thus, six subjects completed the study. Subjects were recruited through high school nurses and a newspaper advertisement. Inclusion criteria were diagnosis of current ADHD as determined by parent-report questionnaire and
RESULTS
As shown in Figure 1, IDS worsened in the evening for the MPH t.i.d. condition but remained stable for the once-daily OROS MPH condition. ANOVA revealed a significant medication effect (F = 9.3, df = 1, p = .004) and a trend for an interaction (F = 2.2, df = 3, p = .10) but no time effect (F = 1.8, df = 2, p = .17). The mean ± SD IDSs under the OROS MPH q.d. versus MPH t.i.d. conditions were 2 p.m., −0.55 ± 2.3 versus −0.54 ± 3.3 (p = 1.0); 5 p.m., −2.2 ± 0.4 versus −1.04 ± 2.2 (p = .2); 8
DISCUSSION
When adolescent drivers with ADHD were treated with OROS MPH q.d., they demonstrated less variability and performed significantly better throughout the day on objective measures of driving performance than when treated with MPH t.i.d. There were statistically significant differences at 8 p.m. (12 hours postdose), with participants demonstrating significant decay in driving performance while receiving MPH t.i.d.
When participants received OROS MPH q.d., they were significantly less likely to
REFERENCES (33)
- et al.
The adolescent outcome of hyperactive children diagnosed by research criteria, I: an 8-year prospective follow-up study
J Am Acad Child Adolesc Psychiatry
(1990) - et al.
Driving difficulties among male adolescents
J Adolesc Health
(2001) - et al.
Safety belt nonuse by internal medicine patients: a missed opportunity in clinical preventive medicine
Am J Med
(1995) - et al.
Psychosocial and medical histories of stimulant-treated children
J Am Acad Child Adolesc Psychiatry
(1988) - et al.
Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments
Comp Psychiatry
(1996) - et al.
Inattentive and hyperactive behaviors and driving offenses in adolescence
J Am Acad Child Adolesc Psychiatry
(1997) - et al.
NIMH Diagnostic Interview Schedule for Children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses
J Am Acad Child Adolesc Psychiatry
(2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)
(1994)Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment
(1998)- et al.
Driving-related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: a 3- to 5-year follow-up survey
Pediatrics
(1993)
Driving in young adults with attention deficit hyperactivity disorder: knowledge, performance, adverse outcomes, and the role of executive functioning
J Int Neuropsychol Soc
Motor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactivity disorder
Pediatrics
Specific driving impairments with progressive age
Adv Med Psychother Psychodiag
Seniors compensatory driving strategy may increase driving risk
J Am Geriatr Soc
Driving decrements in type I diabetes during moderate hypoglycemia
Diabetes
Effect of stimulant medication on driving performance of young adults with attention-deficit hyperactivity disorder: a preliminary double-blind placebo-controlled trial
J Nerv Ment Dis
Cited by (96)
ADHD and accidents over the life span – A systematic review
2021, Neuroscience and Biobehavioral ReviewsMotor vehicle driving in high incidence psychiatric disability: Comparison of drivers with ADHD, depression, and no known psychopathology
2015, Journal of Psychiatric ResearchInfluence of stimulant and non-stimulant drug treatment on driving performance in patients with attention deficit hyperactivity disorder: A systematic review
2014, European NeuropsychopharmacologyCitation Excerpt :Nevertheless, in the study of Cox et al. (2008) MPH-OROS, but not MAS-XR, improved driving performance of ADHD patients and in the study of Verster et al. (2008) the statistically significant difference in the standard deviation of lateral position (SDLP) weaving between placebo and MPH-IR was 2.3 cm in a car driving at 95 km/h, that could be considered clinically irrelevant and the SDLP (mean: 21.1 cm with placebo) can be considered within normal range (Verster and Roth, 2011). Six studies were completely funded by a pharmaceutical company (Cox et al., 2004a, 2006, 2004b, 2012; Kay et al., 2009; Biederman et al., 2012a), one study was partially funded by a pharmaceutical company (Barkley et al., 2007), and one study was an investigator-initiated sponsored trial (Sobanski et al., 2013). With one exception (Barkley et al., 2007), all of these industry-sponsored studies reported a positive result for the drug that the sponsoring company produced.
ADHD and relative risk of accidents in road traffic: A meta-analysis
2014, Accident Analysis and PreventionCitation Excerpt :The most frequent medications tested are stimulants ((OROS) methylphenidate, mixed amphetamine salts, lisdexamfetamine dimesylate), but also non-stimulants (atomoxetine) have been tested. Several studies have used randomized, single- or double-blind, placebo-controlled research designs only including ADHD-drivers with a within-subjects crossover design or waiting-list subjects as controls (Cox et al., 2004, 2006, 2012; Barkley et al., 2005; Kay et al., 2009; Biederman et al., 2012). Significant effects of stimulants on behavior which have been reported are less variability and better driving performance (Cox et al., 2004), lesser impulsiveness, lesser variability of steering, improved turn signaling (Barkley et al., 2005), better driving performance, fewer instances of speeding, less erratic speed control, more time executing left turns, less inappropriate use of brakes (Cox et al., 2006), improved, overall driving performance (Kay et al., 2009), and faster reaction time, fewer “accidents”, lower rate of “collisions” (Biederman et al., 2012).
This study was funded by a grant from McNeil Consumer & Specialty Pharmaceuticals.