A Randomized, Placebo-Controlled Trial of Three Fixed Dosages of Prolonged-Release OROS Methylphenidate in Adults with Attention-Deficit/Hyperactivity Disorder

Medori, Rossella; Ramos-Quiroga, Josep Antoni; Casas, Miguel; Kooij, J. J. Sandra; Niemelä, Asko; Trott, Götz‐Erik; Lee, Emma; Buitelaar, Jan K.

doi:10.1016/j.biopsych.2007.11.008

Cited by 169 publications

(199 citation statements)

References 24 publications

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“…The AISRS score improvement findings observed in this study with OROS methylphenidate doses ranging from 18 to 72 mg/d are similar to reductions in rating scales in previously published OROS methylphenidate studies performed in adults with ADHD. 13,15,44 Subjects treated with OROS methylphenidate also reported greater improvement in the BRIEF-A GEC score and in AIM-A quality-of-life scores of "living with ADHD," "general well-being," "performance and daily functioning," "impact of symptoms on bother/concern," and "impact of symptoms on daily interference" compared with placebo-treated subjects. Interestingly, the only AIM-A quality-of-life scale in which the OROS methylphenidate and placebo groups did not differ was that of "relationships/ communication."…”

mentioning

confidence: 95%

“…[13][14][15] These studies either randomized subjects to assigned OROS methylphenidate dosages or used a dose-titration strategy aimed at 30% reduction in ADHD symptoms, which, while decreasing ADHD symptom level, may still result in suboptimal clinical treatment benefit. 16,17 By design, these studies did not explore the possibility that allowing additional OROS methylphenidate dose adjustment(s) might produce further improvement, remission of symptoms, or better tolerability.…”

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confidence: 99%

“…[13][14][15]42,43 As seen in Figure 2, in the current study, there was a progressive decline in mean AISRS scores over the 6 weeks of treatment, with approximately one-half (62/143) of OROS methylphenidate-treated subjects receiving 72 mg/d and 20% each receiving 36 mg/d or 54 mg/d at the end point-with these later dosage groups (ie, 36 and 54 mg/d) having the greatest decrease from baseline to end point in their AISRS scores. This improvement over time as well as the waxing and waning of symptoms and responses suggests that clinicians may consider allowing a period of time, weeks or longer, between OROS methylphenidate dosage adjustments with continuous monitoring such that the benefits of a particular dose have sufficient time to emerge.…”

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confidence: 99%

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Randomized, 6-Week, Placebo-Controlled Study of Treatment for Adult Attention-Deficit/Hyperactivity Disorder

Goodman

Starr

Wen

et al. 2016

J. Clin. Psychiatry

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Objective: To evaluate the efficacy and safety of individualized dosing within the approved dose range for osmotic-release oral system (OROS) methylphenidate hydrochloride in adults with attention-deficit/hyperactivity disorder (ADHD). Methods: A double-blind, 6-week trial was conducted between July 2009 and February 2010 at 35 US sites. Adults with ADHD (DSM-IV diagnostic criteria) and a screening ADHD Investigator Symptom Rating Scale (AISRS) score > 24 were randomly assigned to OROS methylphenidate 18 mg or matching placebo. Treatment dose could be increased at 18 mg increments, up to 72 mg/d, until an optimal dose was achieved. AISRS score changes from baseline to end point (primary outcome) were analyzed using analysis of covariance. Results: At baseline, the intent-to-treat population of 169 OROS methylphenidate and 172 placebo subjects (mean age = 35.8 years) had mean (standard deviation [SD]) AISRS scores of 37.8 (6.94) and 37.0 (7.51), respectively. OROS methylphenidate-treated subjects exhibited a significantly greater mean (SD) AISRS score improvement than placebo subjects (-17.1 [12.44] vs -11.7 [13.30]; P < .001). In general, OROS methylphenidate-treated subjects experienced greater improvements than placebo subjects in secondary measures of symptom frequency, cognitive function, work productivity, and quality-of-life. Little effect of OROS methylphenidate was observed in exploratory sleep assessments. The adverse event pattern was similar to previous reports of stimulants in adults with ADHD. Conclusions: OROS methylphenidate treatment with individualized doses titrated to achieve symptom remission demonstrated greater ADHD symptom reduction than placebo treatment. These data support the overall efficacy of OROS methylphenidate treatment in the management of adults with ADHD and provide new possibilities for additional intervention. Trial Registration: ClinicalTrials.gov identifier: NCT00937040

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Randomized, 6-Week, Placebo-Controlled Study of Treatment for Adult Attention-Deficit/Hyperactivity Disorder

Goodman

Starr

Wen

et al. 2016

J. Clin. Psychiatry

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“…The transporter is the direct target of stimulant-based medication effective in treating ADHD symptoms (Medori et al, 2008;Faraone et al, 2004). The polymorphism identified as a risk factor for ADHD is a variable number of tandem repeat (VNTR) in the 3 0 -untranslated region (UTR) of the gene.…”

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confidence: 99%

Multicenter Analysis of the SLC6A3/DAT1 VNTR Haplotype in Persistent ADHD Suggests Differential Involvement of the Gene in Childhood and Persistent ADHD

Franke

Vásquez

Johansson

et al. 2009

Neuropsychopharmacol

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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders with a worldwide prevalence around 4-5% in children and 1-4% in adults. Although ADHD is highly heritable and familial risk may contribute most strongly to the persistent form of the disorder, there are few studies on the genetics of ADHD in adults. In this paper, we present the first results of the International Multicentre Persistent ADHD Genetics CollaboraTion (IMpACT) that has been set up with the goal of performing research into the genetics of persistent ADHD. In this study, we carried out a combined analysis as well as a meta-analysis of the association of the SLC6A3/DAT1 gene with persistent ADHD in 1440 patients and 1769 controls from IMpACT and an earlier report. DAT1, encoding the dopamine transporter, is one of the most frequently studied genes in ADHD, though results have been inconsistent. A variable number tandem repeat polymorphism (VNTR) in the 3 0 -untranslated region (UTR) of the gene and, more recently, a haplotype of this VNTR with another VNTR in intron 8 have been the target of most studies. Although the 10/10 genotype of the 3 0 -UTR VNTR and the 10-6 haplotype of the two VNTRs are thought to be risk factors for ADHD in children, we found the 9/9 genotype and the 9-6 haplotype associated with persistent ADHD. In conclusion, a differential association of DAT1 with ADHD in children and in adults might help explain the inconsistencies observed in earlier association studies. However, the data might also imply that DAT1 has a modulatory rather than causative role in ADHD.

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“…Bir başka araştırmada ise, hastalar tarafından belirtilen verilere bakılarak, metilfenidatın dozla ilişkili olmaksızın ilaç kullanan grubun %11,8'inde ağız kuruluğuna yol açtığı, kontrol grubu için ise bu değerin %2,1 olduğu bildirilmiştir (34).…”

Section: Dikkat Eksikliği Ve Hiperaktivite Bozukluğu Tedavisinde Kullunclassified

Oral and Dental Health Problems of Children with Attention Deficit/Hyperactivity Disorders, and Solution Proposals

Yetiş¹,

Kırzıoğlu²

2017

jpr

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GirişDikkat eksikliği ve hiperaktivite bozukluğu (DEHB), Amerikan Psikiyatri Derneği tarafından; çocukluk çağında, yaşa uygun olmayan seviyede dikkatsizlik, hiperaktivitedürtüsellik veya bunların kombinasyonu şeklinde kendini gösteren psikiyatrik bir bozukluk olarak tanımlanmaktadır (1).Çocuk ve ergenlerin yaklaşık %5-10'unu etkileyen, en yaygın görülen çocukluk çağı-başlangıçlı davranış bozukluğu (2) olan DEHB'nin, ülkemizde ve dünyada çocuk ve ergen psikiyatrisi polikliniklerine başvuran hastalarda en sık konulan tanılar arasında yer aldığı bildirilmektedir (3-5). Erkeklerde kızlara göre 8 kat daha fazla görülmekte olup (6), erkeklerde 6-9 yaş aralığında, kızlarda ise ergenlik döneminde prevalansının en yüksek seviyeye ulaştığı bildirilmiştir (7). ÖzABS TRACT Dikkat eksikliği ve hiperaktivite bozukluğu (DEHB), yaşa uygun olmayan seviyede dikkatsizlik, hiperaktivite-dürtüsellik veya bunların kombinasyonu şeklinde kendini gösteren en yaygın görülen çocukluk çağı-başlangıçlı davranış bozukluğudur. DEHB etiyolojisinde genetik ve çevresel faktörlerin rolü bulunmaktadır. Hastalığın kendisinden kaynaklı davranışsal problemler ve ilaç yan etkileri nedeniyle eklenen sorunlar, DEHB'li çocukların ağız ve diş sağlığı açısından risk grubunda yer almasına ve çocuk diş hekimliğinde özel ilgi gereksinimi olan hasta grubuna dahil olmalarına neden olmaktadır. Tedavisinde kullanılan ilaçların ağız kuruluğuna neden olabildiği belirtilmiştir. DEHB olan çocukların düşük oral hijyen alışkanlıkları ve yüksek diş çürüğü prevalansına sahip oldukları bildirilmiştir. Ayrıca bruksizm gibi parafonksiyonel alışkanlıklar ve dental travmalar da bu çocuklarda daha sık gözlenmektedir. Bu derlemede DEHB görülen çocuklarda ağız diş sağlığı ve davranış yönlendirme sorunlarından bahsedilmekte ve çözüm önerilerinde bulunulmaktadır. Anahtar Kelimeler: Dikkat eksikliği, hiperaktivite, diş sağlığı Attention deficit and hyperactivity disorder (ADHD) is the most common childhood onset behavioral disorder characterized by a developmentally inappropriate attention deficit, hyperactivity-impulsivity or a combination of these. Genetic and environmental factors play a role in the etiology. Because of the behavioral problems sourced from the disease itself and side effects of the drugs used in therapy, children with ADHD take place in the risk group in terms of oral and dental health problems and they are included in the group of patients who need special attention in pediatric dentistry. Drugs used in the treatment are known to cause dry mouth. Children with ADHD have been reported to have low oral hygiene habits and a high prevalence of dental caries. Also, parafunctional habits such as bruxism and dental trauma are observed more frequently in these children. In this review, oral health and behavior management problems in children with ADHD are pointed out, and solutions are suggested.

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A Randomized, Placebo-Controlled Trial of Three Fixed Dosages of Prolonged-Release OROS Methylphenidate in Adults with Attention-Deficit/Hyperactivity Disorder

Cited by 169 publications

References 24 publications

Randomized, 6-Week, Placebo-Controlled Study of Treatment for Adult Attention-Deficit/Hyperactivity Disorder

Randomized, 6-Week, Placebo-Controlled Study of Treatment for Adult Attention-Deficit/Hyperactivity Disorder

Multicenter Analysis of the SLC6A3/DAT1 VNTR Haplotype in Persistent ADHD Suggests Differential Involvement of the Gene in Childhood and Persistent ADHD

Oral and Dental Health Problems of Children with Attention Deficit/Hyperactivity Disorders, and Solution Proposals

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