Neurocognitive effects of methylphenidate in adults with attention-deficit/hyperactivity disorder: A meta-analysis

Pievsky, Michelle A.; McGrath, Robert E.

doi:10.1016/j.neubiorev.2018.05.012

Cited by 36 publications

(28 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Numerous studies, including this study, have provided strong evidence to support the fact that MPH is able to reduce the three core symptoms of ADHD, namely inattention, hyperactivity, and impulsivity (Gau et al 2006a;Shang et al 2015;Childress et al 2017;Clavenna and Bonati 2017). Such symptom improvement seems to be mediated by MPH bringing about an improvement in sustained attention (Tucha et al 2006;Bedard et al 2015;Chou et al 2015), response inhibition (Broyd et al 2005;Kratz et al 2009;Pauls et al 2012;Dougherty et al 2016;Pievsky and McGrath 2018), cognitive impulsivity, and motor impulsivity (Kratz et al 2009;Chou et al 2015;Dougherty et al 2016).…”

Section: Discussionsupporting

confidence: 58%

A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Clinical Trial of ORADUR-Methylphenidate for Treating Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

Huang

Yeh

Chen

et al. 2021

Journal of Child and Adolescent Psychopharmacology

View full text Add to dashboard Cite

Objective: Methylphenidate (MPH) is efficacious in reducing symptoms of attention-deficit/hyperactivity disorder (ADHD), but there are no data about the efficacy and safety of its new formulation (ORADUR ® -MPH extended release, ORADUR-MPH) in patients with ADHD, which is the study objective. Method: This was a Phase III, multicenter, randomized, double-blind, placebo-controlled, two-way crossover clinical trial. One hundred children and adolescents with a clinical diagnosis of ADHD (72.7% male) received at least one dose of ORADUR-MPH or a placebo during the 2-week treatment period of each phase. The primary efficacy measure was the Swanson, Nolan, and Pelham-IV-teacher (SNAP-IV-T) form. Secondary efficacy measures included the SNAP-IV-parent form, the Clinical Global Impression: ADHD-Severity score, the Conner's Teacher's Rating Scale score, and the investigator's rating for 18 Diagnostic and Statistical Manual of Mental Disorders, 5th edition ADHD symptoms. In addition, data related to vital signs, body weight, physical examination, laboratory testing, and adverse events (AEs) were also collected. All data were analyzed on an intent-to-treat basis. Results: Without adjusting for differences in demographics and baseline measures, both treatment groups showed significant reductions in ADHD and oppositional defiant disorder symptoms after a 2-week treatment with greater effect sizes (Cohen's d ) in the ORADUR-MPH group (Cohen's d ranging from −0.41 to −1.64; placebo, Cohen's d ranging from −0.26 to −1.18), except for oppositional symptoms, regardless of the informants. For the primary efficacy measure, ORADUR-MPH was significantly superior to the placebo, as evidenced by lower values for and greater reductions in the SNAP-IV-T scores at the endpoint (Cohen's d = −0.16, p = 0.005) and from baseline to the endpoint (Cohen's d = −0.19, p = 0.006), respectively. There were no serious AEs during the clinical study period. The most frequently observed AE was decreased appetite (49.1%). Most physical and laboratory test variables remained within the normal range. Conclusions: Once-daily ORADUR-MPH is an effective, well-tolerable, and safe treatment for children and adolescents with ADHD. number, NCT02450890.

show abstract

Section: Discussionsupporting

confidence: 58%

A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Clinical Trial of ORADUR-Methylphenidate for Treating Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

Huang

Yeh

Chen

et al. 2021

Journal of Child and Adolescent Psychopharmacology

View full text Add to dashboard Cite

show abstract

“…These findings are generally consistent with meta-analytic findings by [ 29 ] who found small effects of amphetamine and methylphenidate on working memory and inhibitory control in healthy adults but concluded that the effects are “probably modest”. It is important to note that a robust body of literature exists that supports the positive effects of prescription stimulants on neurocognitive functioning in children and adults with ADHD (e.g., [ 14 , 54 , 55 ]), underscoring the importance of baseline impairments in performance relative to improved effects.…”

Section: Discussionmentioning

confidence: 99%

Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students

et al. 2018

View full text Add to dashboard Cite

Prescription stimulant medications are considered a safe and long-term effective treatment for Attention Deficit Hyperactivity Disorder (ADHD). Studies support that stimulants enhance attention, memory, self-regulation and executive function in individuals with ADHD. Recent research, however, has found that many college students without ADHD report misusing prescription stimulants, primarily to enhance their cognitive abilities. This practice raises the question whether stimulants actually enhance cognitive functioning in college students without ADHD. We investigated the effects of mixed-salts amphetamine (i.e., Adderall, 30 mg) on cognitive, autonomic and emotional functioning in a pilot sample of healthy college students without ADHD (n = 13), using a double-blind, placebo-controlled, within-subjects design. The present study was the first to explore cognitive effects in conjunction with mood, autonomic effects, and self-perceptions of cognitive enhancement. Results revealed that Adderall had minimal, but mixed, effects on cognitive processes relevant to neurocognitive enhancement (small effects), and substantial effects on autonomic responses, subjective drug experiences, and positive states of activated emotion (large effects). Overall, the present findings indicate dissociation between the effects of Adderall on activation and neurocognition, and more importantly, contrary to common belief, Adderall had little impact on neurocognitive performance in healthy college students. Given the pilot design of the study and small sample size these findings should be interpreted cautiously. The results have implications for future studies and the education of healthy college students and adults who commonly use Adderall to enhance neurocognition.

show abstract

“…Three groups of disorders will be reviewed—mood, anxiety, and psychotic disorders—due to the consistency of findings in these areas and that working memory deficits appear to be part of the psychopathology presented. Working memory deficits are also documented in substance use disorders (Verdejo‐Garcia, ), eating disorders (Reville, O'Connor, & Frampton, ), and ADHD (Alderson, Kasper, Hudec, & Patros, ; Pievsky & McGrath, , ). However, the manner in which working memory deficits exist in these disorders is highly complex and may be related to factors peripheral to the pathophysiology of the diagnoses themselves (Lovallo et al, ).…”

Section: Relationship Between Working Memory and Emotion Regulationmentioning

confidence: 99%

Effects of working memory training on emotion regulation: Transdiagnostic review

Barkus

2020

PsyCh Journal

View full text Add to dashboard Cite

Working memory training is widely used transdiagnostically to improve cognition. However, more recently, studies using working memory training packages have targeted emotion-regulation outcomes to determine whether far transfer effects can be achieved.A narrative review is conducted of studies that have used standardized computerized working memory training packages across healthy volunteers, affect, anxiety, post-traumatic stress disorder (PTSD), and eating disordered populations with emotion-regulation outcomes.Working memory training has been used in children, adolescents, and adults to improve emotion regulation. Many studies have reported gains in mood as well as emotion-regulation strategies following working memory training, regardless of clinical indication and whether near transfer gains were achieved in cognitive domains. Significant emotion-regulation outcomes include: state and trait anxiety, rumination, brooding, positive appraisal, decreasing maladaptive emotion-regulation strategies, and decreasing intrusive thoughts. It is speculated that these far transfer outcomes from working memory training are possible due to the cognitive and neural overlap between cognitive and affective working memory, and emotion regulation. Working memory training could improve cognitive efficiency, which, in turn, increases the availability of cognitive resources during times when emotion regulation is taxed. Future studies need to consider the role of participant expectancy in predicting outcome measure performance, and including subjective and objective outcomes is paramount to study design. Furthermore, sample sizes require additional attention, given that the current review highlights that individual differences in non-clinical and clinical populations influence the outcomes from working memory training. Working memory training offers a possibility for improving emotion regulation transdiagnostically.

show abstract

Neurocognitive effects of methylphenidate in adults with attention-deficit/hyperactivity disorder: A meta-analysis

Cited by 36 publications

References 53 publications

A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Clinical Trial of ORADUR-Methylphenidate for Treating Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Clinical Trial of ORADUR-Methylphenidate for Treating Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students

Effects of working memory training on emotion regulation: Transdiagnostic review

Contact Info

Product

Resources

About