Management of attention-deficit hyperactivity disorder in adults: focus on methylphenidate hydrochloride

Nair, Rajasree; Moss, Shannon B.

doi:10.2147/ndt.s4101

Cited by 5 publications

(4 citation statements)

References 75 publications

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“…Methylphenidate is the best-known psychostimulant and the most frequently prescribed for the treatment of ADHD, both in children and adults [17].…”

Section: Psychostimulantsmentioning

confidence: 99%

Attention Deficit Hyperactivity Disorder (ADHD) in Adults: A Mini Review

Bourin¹

2023

SAR J Psychiatry Neurosci

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Attention Deficit Hyperactivity Disorder (ADHD) is not exclusively limited to childhood and adolescence, but it often persists in adults, where its prevalence in the general population is estimated at around 4% to 5%. It is accompanied by significant psychological, social and professionals. It is essential to ensure the detection of this disorder in adults. Indeed, psychostimulants have demonstrated therapeutic efficacy by numerous controlled studies. ADHD treatment should have the primary objective of improving attentional abilities and reducing impulsive behavior.

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“…Methylphenidate is the best-known psychostimulant and the most frequently prescribed for the treatment of ADHD, both in children and adults [17].…”

Section: Psychostimulantsmentioning

confidence: 99%

Attention Deficit Hyperactivity Disorder (ADHD) in Adults: A Mini Review

Bourin¹

2023

SAR J Psychiatry Neurosci

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“…Open access equally effective for ADHD core symptoms as well as emotional symptoms, 14 15 and stable medication might bring a benefit for long-term outcomes. 16 However, because of side effects [17][18][19] and residual symptoms after treatment, [20][21][22] high treatment discontinuation and poor medication compliance are still an influencing factor for long-term outcomes. 23 24 CBT has been recommended as an adjunct to medication 13 when patients are still significantly symptomatic.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Cognitive behavioural therapy in groups for medicated adults with attention deficit hyperactivity disorder: protocol for a randomised controlled trial

et al. 2020

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IntroductionCognitive behavioural therapy (CBT) is an evidence-based treatment for adults with attention deficit hyperactivity disorder (ADHD). However, it is still inconsistent whether a combination of CBT would have additive effects in medicated ADHD in adulthood. And if CBT would have additional effects, what kind and which dimension would CBT play a part? This study estimates the efficacy of CBT in stable medicated adult ADHD, using long-term outcomes and multidimensional evaluations.Methods and analysisIt is a two-armed, randomised controlled trial on the superiority of the efficacy of 12 weeks of CBT on medicated adult ADHD. We compare the short-term and long-term outcomes between CBT combined with medication (CBT+M) group and the medication-only (M) group, including ADHD core symptoms, emotional symptoms, executive function, self-esteem, life quality and brain function using functional near-infrared spectroscopy data. Participants are outpatients of the Peking University Sixth Hospital and those recruited online, diagnosed as adult ADHD and with stable medication treatment. We estimate ADHD core symptoms and combined symptoms at baseline (T1) and week 12 (T2), week 24 (T3), week 36 (T4) and week 48 (T5).Ethics and disseminationThis trial has been approved by the Ethics and Clinical Research Committees of Peking University Sixth Hospital and will be performed under the Declaration of Helsinki with the Medical Research Involving Human Subjects Act (WMO). The results will be disseminated in a peer-reviewed journal and a conference presentation.Trial registration numberChiCTR (ChiCTR1900021705).

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“…Prevalence of adult ADHD in the United States is estimated at around 4.4%, and the disorder is highly co-morbid with many other DSM IV disorders [ 1 , 5 , 6 ]. Although clinicians widely agree that a treatment approach which combines psychotherapeutic and pharmacological interventions is optimal, the prescription of stimulant medication is clearly the first line of treatment and is known to improve symptoms in both pediatric and adult populations [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Oral formulations of MPH are available in short- and intermediate-acting preparations, as well as slow-release and long-acting ones. Oral administration of immediate-release MPH reaches peak plasma concentration after two hours, and decreases thereafter [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

High dose methylphenidate treatment in adult attention deficit hyperactivity disorder: a case report

Liebrenz

Hof

Buadze³

et al. 2012

J Med Case Reports

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IntroductionStimulant medication improves hyperactivity, inattention, and impulsivity in both pediatric and adult populations with Attention Deficit Hyperactivity Disorder (ADHD). However, data regarding the optimal dosage in adults is still limited.Case presentationWe report the case of a 38-year-old Caucasian patient who was diagnosed with Attention Deficit Hyperactivity Disorder when he was nine years old. He then received up to 10 mg methylphenidate (Ritalin®) and 20 mg sustained-release methylphenidate (Ritalin SR®) daily. When he was 13, his medication was changed to desipramine (Norpramin®), and both Ritalin® and Ritalin SR® were discontinued; and at age 18, when he developed obsessive-compulsive symptoms, his medication was changed to clomipramine (Anafranil®) 75 mg daily. Still suffering from inattention and hyperactivity, the patient began college when he was 19, but did not receive stimulant medication until three years later, when Ritalin® 60 mg daily was re-established. During the 14 months that followed, he began to use Ritalin® excessively, both orally and rectally, in dosages from 4800-6000 mg daily. Four years ago, he was referred to our outpatient service, where his Attention Deficit Hyperactivity Disorder was re-evaluated. At that point, the patient’s daily Ritalin® dosage was reduced to 200 mg daily orally, but he still experienced pronounced symptoms of, Attention Deficit Hyperactivity Disorder so this dosage was raised again. The patient’s plasma levels consistently remained between 60–187 nmol/l—within the recommended range—and signs of his obsessive-compulsive symptoms diminished with fluoxetine 40 mg daily. Finally, on a dosage of 378 mg extended-release methylphenidate (Concerta®), his symptoms of Attention Deficit Hyperactivity Disorder have improved dramatically and no further use of methylphenidate has been recorded during the 24 months preceding this report.ConclusionsSymptoms of Attention Deficit Hyperactivity Disorder (ADHD) in this adult patient, who also manifested a co-occurring obsessive compulsive disorder, dramatically improved only after application of a higher-than-normal dose of methylphenidate. We therefore suggest that clinicians consider these findings in relation to their adherence to current therapeutic guidelines.

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Management of attention-deficit hyperactivity disorder in adults: focus on methylphenidate hydrochloride

Cited by 5 publications

References 75 publications

Attention Deficit Hyperactivity Disorder (ADHD) in Adults: A Mini Review

Attention Deficit Hyperactivity Disorder (ADHD) in Adults: A Mini Review

Cognitive behavioural therapy in groups for medicated adults with attention deficit hyperactivity disorder: protocol for a randomised controlled trial

High dose methylphenidate treatment in adult attention deficit hyperactivity disorder: a case report

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