James M Swanson1, Lily Hechtman. 1. Professor of Pediatrics, UCI Child Development Center, Centerpointe Plaza, 19722 MacArthur Blvd., University of California at Irvine, Irvine, California 92612, (949) 824-1822 (Phone), (949) 824-1811 (Fax), jmswanso@uci.edu (Email).
Abstract
INTRODUCTION: Over 30% of children with ADHD treated with a rigorous multimodal intervention in the MTA study did not reach full functional remission. New long-acting drugs have been developed with this treatment goal in mind. METHODS: Presentations at the 2004 Annual Meeting of the Canadian Academy of Child and Adolescent Psychiatry discussed the development of long-acting drugs for ADHD and clinical studies of their efficacy; these presentations are summarized below. RESULTS: Concerta(R) OROS-MPH releases methylphenidate (MPH) in an initial bolus, followed by increasing concentrations throughout the day. This pattern of drug delivery overcomes the development of acute tolerance; classroom analog studies have shown that ADHD symptoms and academic productivity are thereby maintained for 12 hours. A larger open-label study showed that efficacy was maintained through the 12-month study period. An 8-week open-label trial found that OROS-MPH produced significantly higher remission rates than immediate-release MPH (44% vs 16%; p = 0.0002), as well as significantly higher Clinical Global Impression and parent satisfaction scores. Adderall XR(R), an extended-release formulation of mixed amphetamine salts, has recently been withdrawn from the market. CONCLUSIONS: Long-acting stimulant formulations have dramatically changed the landscape of ADHD practice.
INTRODUCTION: Over 30% of children with ADHD treated with a rigorous multimodal intervention in the MTA study did not reach full functional remission. New long-acting drugs have been developed with this treatment goal in mind. METHODS: Presentations at the 2004 Annual Meeting of the Canadian Academy of Child and Adolescent Psychiatry discussed the development of long-acting drugs for ADHD and clinical studies of their efficacy; these presentations are summarized below. RESULTS: Concerta(R) OROS-MPH releases methylphenidate (MPH) in an initial bolus, followed by increasing concentrations throughout the day. This pattern of drug delivery overcomes the development of acute tolerance; classroom analog studies have shown that ADHD symptoms and academic productivity are thereby maintained for 12 hours. A larger open-label study showed that efficacy was maintained through the 12-month study period. An 8-week open-label trial found that OROS-MPH produced significantly higher remission rates than immediate-release MPH (44% vs 16%; p = 0.0002), as well as significantly higher Clinical Global Impression and parent satisfaction scores. Adderall XR(R), an extended-release formulation of mixed amphetamine salts, has recently been withdrawn from the market. CONCLUSIONS: Long-acting stimulant formulations have dramatically changed the landscape of ADHD practice.
Authors: J M Swanson; H C Kraemer; S P Hinshaw; L E Arnold; C K Conners; H B Abikoff; W Clevenger; M Davies; G R Elliott; L L Greenhill; L Hechtman; B Hoza; P S Jensen; J S March; J H Newcorn; E B Owens; W E Pelham; E Schiller; J B Severe; S Simpson; B Vitiello; K Wells; T Wigal; M Wu Journal: J Am Acad Child Adolesc Psychiatry Date: 2001-02 Impact factor: 8.829
Authors: Andrew M Garratt; Oyvind A Bjertnaes; Olaf Holmboe; Ketil Hanssen-Bauer Journal: Child Adolesc Psychiatry Ment Health Date: 2011-05-21 Impact factor: 3.033
Authors: Martin A Katzman; Greg Mattingly; Larry J Klassen; Marc J Cataldo; Graeme A E Donnelly Journal: J Clin Psychopharmacol Date: 2020 Nov/Dec Impact factor: 3.118