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Sample records for adhd transdermal methylphenidate

  1. Transdermal methylphenidate, behavioral, and combined treatment for children with ADHD.

    Pelham, William E; Burrows-Maclean, Lisa; Gnagy, Elizabeth M; Fabiano, Gregory A; Coles, Erika K; Tresco, Katy E; Chacko, Anil; Wymbs, Brian T; Wienke, Amber L; Walker, Kathryn S; Hoffman, Martin T

    2005-05-01

    Stimulant medication and behavioral treatments are evidence-based for children with attention-deficit/hyperactivity disorder, but the combination of the 2 treatments has been understudied. In this investigation, methylphenidate (MPH) was crossed with 2 levels of behavior modification (BMOD) in a summer treatment program. Twenty-seven children with attention-deficit/hyperactivity disorder, aged 6-12, participated. Children received placebo and 3 doses of transdermal MPH (12.5 cm(2), 25.0 cm(2), and 37.5 cm(2)). BMOD was implemented on alternating weeks. Both treatments produced large and significant effects. Combined treatment was superior to either treatment alone. The effects of transdermal MPH were comparable to those found in this setting in previous studies with multiple stimulant medications and formulations. Consistent with other research, low doses of MPH--even lower than in previous studies--yielded enhanced effects in combination with behavior modification. PMID:15943544

  2. Methylphenidate Transdermal Patch

    Methylphenidate transdermal patches are used as part of a treatment program to control symptoms of attention deficit ... than other people who are the same age). Methylphenidate is in a class of medications called central ...

  3. Effects of Once-Daily Oral and Transdermal Methylphenidate on Sleep Behavior of Children with ADHD

    Faraone, Stephen V.; Glatt, Stephen J.; Bukstein, Oscar G.; Lopez, Frank A.; Arnold, L. Eugene; Findling, Robert L.

    2009-01-01

    Objective: Methylphenidate is a leading first-line treatment for ADHD (AD/HD). This stimulant has long been suspected to adversely affect sleeping patterns of treated individuals, especially children. There are few studies on the effects of recently developed longer-acting methylphenidate treatments, such as once-daily oral or transdermal…

  4. Long-Term Effects of Methylphenidate Transdermal Delivery System Treatment of ADHD on Growth

    Faraone, Stephen V.; Giefer, Eldred E.

    2007-01-01

    Objective: To examine the long-term effects of the methylphenidate transdermal system (MTS) on the growth of children being treated for attention-deficit/hyperactivity disorder. Method: Height, weight, and body mass index (BMI) were measured in 127 children ages 6 to 12 at longitudinal assessments for up to 36 months of treatment with MTS. These…

  5. Methylphenidate Transdermal System in Adult ADHD and Impact on Emotional and Oppositional Symptoms

    Marchant, Barrie K.; Reimherr, Frederick W.; Robison, Reid J.; Olsen, John L.; Kondo, Douglas G.

    2011-01-01

    Objective: This trial evaluated the effect of methylphenidate transdermal system (MTS) on the full spectrum of adult symptoms (attention-disorganization, hyperactivity-impulsivity, emotional dysregulation [ED], and oppositional-defiant disorder [ODD]) found in this disorder. Method: This placebo-controlled, double-blind, flexible-dose, crossover…

  6. Efficacy of a Methylphenidate Transdermal System versus t.i.d. Methylphenidate in a Laboratory Setting

    Pelham, William E.; Waxmonsky, James G.; Schentag, Jerome; Ballow, Charles H.; Panahon, Carlos J.; Gnagy, Elizabeth M.; Hoffman, Martin T.; Burrows-MacLean, Lisa; Meichenbaum, David L.; Forehand, Gregory L.; Fabiano, Gregory A.; Tresco, Katy E.; Lopez-Williams, Andy; Coles, Erika K.; Gonzalez, Mario A.

    2011-01-01

    Objective: To test the efficacy and tolerability of the methylphenidate transdermal formulation (MTS) against immediate-release methylphenidate (IR MPH) and placebo in a 12-hr analog classroom setting. Method: A total of nine boys ages 6 to 9 years, medicated with MPH for ADHD, complete a within-subject, double-blind study. For the purpose of the…

  7. Methylphenidate Transdermal Patch

    ... for ADHD, which may include counseling and special education. Make sure to follow all of your doctor's ... that was covered by the patch seizures motion tics or verbal tics believing things that are not ...

  8. Varying the Wear Time of the Methylphenidate Transdermal System in Children with Attention-Deficit/Hyperactivity Disorder

    Wilens, Timothy E.; Boellner, Samuel W.; Lopez, Frank A.; Turnbow, John M.; Wigal, Sharon B.; Childress, Ann C.; Abikoff, Howard B.; Manos, Michael J.

    2008-01-01

    A study investigated the impact of variable wear times of the methylphenidate transdermal system in children with attention-deficit/hyperactivity disorder (ADHD). It was concluded that duration of medication effect was directly related to the wear time of the methylphenidate transdermal system patch.

  9. Methylphenidate Transdermal System in Adults with Past Stimulant Misuse: An Open-Label Trial

    McRae-Clark, Aimee L.; Brady, Kathleen T.; Hartwell, Karen J.; White, Kathleen; Carter, Rickey E.

    2011-01-01

    Objective: This 8-week, open-label trial assessed the efficacy of methylphenidate transdermal system (MTS) in 14 adult individuals diagnosed with ADHD and with a history of stimulant misuse, abuse, or dependence. Method: The primary efficacy endpoint was the Wender-Reimherr Adult ADHD Scale (WRAADS), and secondary efficacy endpoints included the…

  10. Does switching from oral extended-release methylphenidate to the methylphenidate transdermal system affect health-related quality-of-life and medication satisfaction for children with attention-deficit/hyperactivity disorder?

    Landgraf Jeanne M; Arnold L Eugene; Bukstein Oscar G; Hodgkins Paul

    2009-01-01

    Abstract Background To evaluate health-related quality of life (HRQL) and medication satisfaction after switching from a stable dose of oral extended-release methylphenidate (ER-MPH) to methylphenidate transdermal system (MTS) via a dose-transition schedule in children with attention-deficit/hyperactivity disorder (ADHD). Methods In a 4-week, multisite, open-label study, 171 children (164 in the intent-to-treat [ITT] population) aged 6-12 years diagnosed with ADHD abruptly switched from a sta...

  11. The Effect of Methylphenidate on Neurological Soft Signs in ADHD

    Hrtanek, Igor; Ondrejka, Igor; Tonhajzerova, Ingrid; Snircova, Eva; Kulhan, Tomas; Farsky, Ivan; Nosalova, Gabriela

    2015-01-01

    Objective Neurological soft signs are very common in children with the attention deficit hyperactivity disorder (ADHD), and the first line medication of this disorder is methylphenidate. The aim of the study was to assess the effect of methylphenidate on the neurological soft signs in children and adolescents suffering from ADHD depending on the dose of methylphenidate. Methods Thirty five patients with ADHD were investigated by the ADHD RS-IV parent version questionnaire and the Revised Neur...

  12. Methylphenidate significantly improves declarative memory functioning of adults with ADHD

    2010-01-01

    Background Declarative memory deficits are common in untreated adults with attention-deficit hyperactivity disorder (ADHD), but limited evidence exists to support improvement after treatment with methylphenidate. The objective of this study was to examine the effects of methylphenidate on memory functioning of adults with ADHD. Methods Eighteen adults with ADHD who were clinical responders to methylphenidate participated in this randomized crossover trial. After 3 days of no treatment, patien...

  13. The Effect of Personality Disorder Symptoms on Response to Treatment With Methylphenidate Transdermal System in Adults With Attention-Deficit/Hyperactivity Disorder

    Olsen, John L.; Reimherr, Frederick W; Marchant, Barrie K.; Wender, Paul H.; Robison, Reid J.

    2012-01-01

    Objective: This trial was designed to prospectively explore the relationship among personality disorder (PD) symptoms, attention-deficit/hyperactivity disorder (ADHD), and treatment response in a randomized, double-blind, crossover clinical trial of methylphenidate transdermal system (MTS) and to confirm results of a prior exploratory study.

  14. Methylphenidate-Induced Seizure, ADHD and Abnormal EEG

    J Gordon Millichap

    2013-01-01

    Investigators from Harvard Medical School, Boston, present the case of a 6-year-old girl with ADHD taking valproic acid for behavioral problems who had a generalized tonic-clonic convulsion shortly after a first dose of methylphenidate.

  15. Effects of Methylphenidate on Memory Functions of Adults with ADHD

    Fuermaier, Anselm B M; Tucha, Lara; Koerts, Janneke; Weisbrod, Matthias; Lange, Klaus W; Aschenbrenner, Steffen; Tucha, Oliver

    2016-01-01

    Neuropsychological research on adults with attention deficit hyperactivity disorder (ADHD) revealed considerable impairments in memory functions related to executive control. However, only limited evidence exists supporting the effects of pharmacological treatment using methylphenidate (MPH) on memo

  16. Pharmacogenetics of Methylphenidate Response in Preschoolers with ADHD

    McGough, James; McCracken, James; Swanson, James; Riddle, Mark; Kollins, Scott; Greenhill, Laurence; Abikoff, Howard; Davies, Mark; Chuang, Shirley; Wigal, Tim; Wigal, Sharon; Posner, Kelly; Skrobala, Anne; Kastelic, Elizabeth; Ghuman, Jaswinder; Cunningham, Charles; Shigawa, Sharon; Moyzis, Robert; Vitiello, Benedetto

    2006-01-01

    Objective: The authors explored genetic moderators of symptom reduction and side effects in methylphenidate-treated preschool-age children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Method: DNA was isolated from 81 subjects in a double-blind, placebo-controlled, crossover methylphenidate titration. Parents and teachers…

  17. Methylphenidate significantly improves declarative memory functioning of adults with ADHD.

    Verster, J.C.; Bekker, E.M.; Kooij, J.J.; Buitelaar, J.K.; Verbaten, M.N.; Volkerts, E.R.; Olivier, B.

    2010-01-01

    BACKGROUND: Declarative memory deficits are common in untreated adults with attention-deficit hyperactivity disorder (ADHD), but limited evidence exists to support improvement after treatment with methylphenidate. The objective of this study was to examine the effects of methylphenidate on memory fu

  18. Comorbidities in ADHD children treated with methylphenidate: a database study

    Kraut Angela A; Langner Ingo; Lindemann Christina; Banaschewski Tobias; Petermann Ulrike; Petermann Franz; Mikolajczyk Rafael T; Garbe Edeltraut

    2013-01-01

    Abstract Background Methylphenidate (MPH) is the most common drug treatment of attention deficit / hyperactivity disorder (ADHD) in children. Treatment with MPH is contraindicated in the presence of certain psychiatric, cerebro- and cardiovascular conditions. We assessed MPH treatment prevalence and incidence and the frequency of comorbid conditions related to these contraindications in new MPH users compared to a control group without ADHD and ADHD medication. Methods We used health care dat...

  19. A Randomized, Single-Blind, Substitution Study of OROS Methylphenidate (Concerta) in ADHD Adults Receiving Immediate Release Methylphenidate

    Spencer, Thomas J.; Mick, Eric; Surman, Craig B. H.; Hammerness, Paul; Doyle, Robert; Aleardi, Megan; Kotarski, Meghan; Williams, Courtney G.; Biederman, Joseph

    2011-01-01

    Objective: The main aim of this study was to examine the efficacy, tolerability, and compliance of an extended-release formulation of methylphenidate (OROS-MPH) in adults with ADHD receiving immediate-release methylphenidate (IR-MPH). Method: Participants were outpatient adults with ADHD who were stable on IR-MPH-administered TID. Participants…

  20. Methylphenidate in Treatment of ADHD and Comorbid Chronic Tic Disorder

    J Gordon Millichap

    2007-07-01

    Full Text Available The safety and efficacy of immediate-release methylphenidate (MPH-IR for the treatment of attention deficit hyperactivity disorder (ADHD in children (ages 6-12 years with Tourette's syndrome (96% or chronic motor tic disorder (4% were evaluated at State University of New York, Stony Brook.

  1. Methylphenidate-Induced Seizure, ADHD and Abnormal EEG

    J Gordon Millichap

    2013-09-01

    Full Text Available Investigators from Harvard Medical School, Boston, present the case of a 6-year-old girl with ADHD taking valproic acid for behavioral problems who had a generalized tonic-clonic convulsion shortly after a first dose of methylphenidate.

  2. Attributions and Perception of Methylphenidate Effects in Adolescents With ADHD.

    Pelham, William E; Gnagy, Elizabeth M; Sibley, Margaret H; Kipp, Heidi L; Smith, Bradley H; Evans, Steven W; Bukstein, Oscar

    2013-07-26

    Objective: Although a number of studies demonstrate that children with ADHD do not attribute their behavior to taking medication, it remains unstudied whether adolescents, who have a longer history of taking medication for ADHD, show performance attributions to medication. Method: A sample of 46 adolescents completed daily attributions for success or failure as a part of their participation in a summer treatment program with a double-blind, placebo-controlled assessment of methylphenidate. Results: Results demonstrated that adolescents with ADHD did not reliably discern active medication from placebo, rarely attributed their performance to the pill, and showed no differences in attributional style as a function of medication status. Conclusion: These data indicate that adolescents with ADHD may possess inaccurate beliefs about the effect of stimulant medication on their behavior. (J. of Att. Dis. 2013; XX(X) 1-XX). PMID:23893533

  3. Stimulant ADHD Medications -- Methylphenidate and Amphetamines

    ... to improve ADHD symptoms along with the patient’s self-esteem, thinking ability, and social and family interactions. Do ... that stimulants prescribed to treat a child’s or adolescent’s ADHD could affect an individual’s vulnerability to developing ...

  4. A One Year Trial of Methylphenidate in the Treatment of ADHD

    Wender, Paul H.; Reimherr, Frederick W.; Marchant, Barrie K.; Sanford, Mary Eve; Czajkowski, Laura A.; Tomb, David A.

    2011-01-01

    Objective: To determine the effects of long-term methylphenidate treatment on symptom severity and social adjustment in adult ADHD. Method: Adults (n = 116) meeting operational diagnostic criteria for ADHD (the "Utah Criteria") entered a randomized double-blind crossover trial of methylphenidate and placebo. Participants who improved on…

  5. Predicting Response of ADHD Symptoms to Methylphenidate Treatment Based on Comorbid Anxiety

    Blouin, Brittany; Maddeaux, Cindy; Stanley Firestone, Jill; van Stralen, Judy

    2010-01-01

    Objective: In this small pilot study, the association of comorbid anxiety with the treatment of ADHD is studied. Methods: Eighteen volunteers from a pediatric clinic are tested for ADHD and anxiety and assessed for behavioral and cognitive ADHD symptomology. Response to methylphenidate as treatment for ADHD symptoms is measured 2 to 3 weeks, and…

  6. Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD)

    Storebø, Ole Jakob; Ramstad, Erica; Krogh, Helle B;

    2015-01-01

    BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed and treated psychiatric disorders in childhood. Typically, children with ADHD find it difficult to pay attention, they are hyperactive and impulsive.Methylphenidate is the drug most often prescribed to...... treat children and adolescents with ADHD but, despite its widespread use, this is the first comprehensive systematic review of its benefits and harms. OBJECTIVES: To assess the beneficial and harmful effects of methylphenidate for children and adolescents with ADHD. SEARCH METHODS: In February 2015 we...... methylphenidate to request published and unpublished data. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) comparing methylphenidate versus placebo or no intervention in children and adolescents aged 18 years and younger with a diagnosis of ADHD. At least 75% of participants needed to have...

  7. Postural Instability in Children with ADHD Is Improved by Methylphenidate.

    Bucci, Maria P; Stordeur, Coline; Acquaviva, Eric; Peyre, Hugo; Delorme, Richard

    2016-01-01

    HIGHLIGHTS Both spatial and temporal analyses of the Center of Pressure demonstrate that children with ADHD have poorer postural control than typically developing sex-, age-, and IQ-matched children.Poor sensory integration in postural control could partially explained the deficits in postural stability in children with ADHD.MPH treatment improves postural performance in both spatial and temporal domains in children with ADHD.MPH improves postural control specifically when visual and proprioceptive inputs are misleading.Such improvement could be due to MPH effects on neurons, facilitating cerebellar processing of postural control. The aim of this study was to examine postural control in children with ADHD and explore the effect of methylphenidate (MPH), using spatial and temporal analyses of the center of pressure (CoP). Thirty-eight children with ADHD (mean age 9.82 ± 0.37 years) and 38 sex- age- and IQ-matched children with typically development were examined. Postural stability was evaluated using the Multitest Equilibre machine (Framiral®) at inclusion and after 1 month of MPH in children with ADHD. Postural stability was assessed by recording under several conditions: with eyes open and fixed on a target, with eyes closed and with vision perturbed by optokinetic stimulation, on stable and unstable platforms. At inclusion, we observed poor spatial and temporal postural stability in children with ADHD. The spectral power index was higher in children with ADHD than in controls. Canceling time was shorter at low and medium frequencies of oscillation and longer at higher frequencies in children with ADHD. After 1 month of MPH, the surface area and mean velocity of the CoP decreased significantly under the most complex conditions (unstable platform in the absence of proprioceptive and visual inputs). The spectral power index decreased significantly after MPH while the canceling time did not change. Poor postural control in children with ADHD supports the

  8. Comparative Cardiac Risks of Methylphenidate and Amphetamines in Treatment of ADHD

    J Gordon Millichap

    2009-08-01

    Full Text Available The risk for adverse cardiac events in subjects between 3 and 20 years of age treated with methylphenidate or amphetamine salts for ADHD was determined in a retrospective study at University of Florida, Gainesville, FL.

  9. Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents

    Storebø, Ole Jakob; Pedersen, Nadia; Ramstad, Erica;

    2016-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the harmful effects of methylphenidate treatment for children and adolescents with attention deficit hyperactivity disorder (ADHD) in non-randomised studies.......This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the harmful effects of methylphenidate treatment for children and adolescents with attention deficit hyperactivity disorder (ADHD) in non-randomised studies....

  10. Low dopamine transporter occupancy by methylphenidate as a possible reason for reduced treatment effectiveness in ADHD patients with cocaine dependence

    Crunelle, Cleo L.; van den Brink, Wim; Veltman, Dick J.; van Emmerik-van Oortmerssen, Katelijne; Dom, Geert; Schoevers, Robert A.; Booij, Jan

    2013-01-01

    Methylphenidate (MPH) occupies brain striatal dopamine transporters (DATs) and is an effective treatment for attention deficit hyperactivity disorder (ADHD). However, patients with ADHD and comorbid cocaine dependence do not benefit significantly from treatment with MPH. To better understand the neu

  11. Time Course of Treatment Effect of OROS[R] Methylphenidate in Children with ADHD

    Armstrong, Robert B.; Damaraju, C. V.; Ascher, Steve; Schwarzman, Lesley; O'Neill, James; Starr, H. Lynn

    2012-01-01

    Objective: The authors evaluated the time course of the treatment effect of Osmotic-Release Oral System methylphenidate (OROS[R] MPH) HCl (Concerta[R], Raritan, NJ) CII in children with ADHD. Method: Data were combined from two double-blind, randomized, placebo-controlled, cross-over, analog classroom studies in children (9-12 years) with ADHD.…

  12. Methylphenidate significantly reduces lapses of attention during on-road highway driving in patients with ADHD

    Verster, Joris C; Roth, Thomas

    2014-01-01

    Lapses of attention are characteristic for attention-deficit/hyperactivity disorder (ADHD) and as such may impair performance of daily activities. Data from an on-road driving study were reanalyzed to determine lapses in patients with ADHD after treatment with methylphenidate and placebo.A total of

  13. Is dopamine transporter gene effective on therapeutic response of methylphenidate in ADHD patients?

    Fatemeh Moharrari; Soheila Barabadian

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common neuropsychiatric illness, which affects about 5% of children worldwide. An 80% genetic background is responsible for ADHD due to its appearance in familial relationships. In addition, dopamine regulation in synaptic spaces, which have a central role in development of ADHD, is moderated by dopamine transporter neurotransmitter, which in turn is modulated by dopamine transporter gene named SLC6A3 or DAT1. Methylphenidate as the ...

  14. Comorbidities in ADHD children treated with methylphenidate: a database study

    Kraut Angela A

    2013-01-01

    Full Text Available Abstract Background Methylphenidate (MPH is the most common drug treatment of attention deficit / hyperactivity disorder (ADHD in children. Treatment with MPH is contraindicated in the presence of certain psychiatric, cerebro- and cardiovascular conditions. We assessed MPH treatment prevalence and incidence and the frequency of comorbid conditions related to these contraindications in new MPH users compared to a control group without ADHD and ADHD medication. Methods We used health care data for the years 2004 to 2006 from the German Pharmacoepidemiological Research Database (GePaRD which includes about 18% of the German population. MPH treatment prevalence and incidence was assessed based on at least one MPH prescription in the given year. In MPH users, the prevalence of psychiatric and other comorbidities was assessed in the quarter of the first MPH prescription and the three preceding quarters, whereas in controls it was assessed in the earliest four quarters of continuous insurance time starting at 01.01.2004 or the start of insurance if this was later. Differences in the presence of comorbid diagnoses between MPH users and controls were tested by logistic regression. Results In 2005, 1.5% of all children and adolescents aged 3 to 17 years (2.3% of males and 0.6% of females received MPH in Germany. The proportion of children with a record of a psychiatric comorbidity in any of the nine ICD categories of diagnoses was substantially higher in new MPH users (83% compared to controls (20%. Cerebro- and cardiovascular comorbidities were rare in general. Still, among new MPH users, 2% of males and females had a diagnosis of a pre-existing cardiovascular disorder but only 1.2% of controls. Conclusions Besides MPH treatment prevalence we first publish age-specific incidence rates for Germany. A high proportion of children who were started on MPH had a record of a psychiatric comorbidity preceding the first prescription. Cerebro- and cardiovascular

  15. Severe Recurrent Pancreatitis in a Child with ADHD after Starting Treatment with Methylphenidate (Ritalin)

    Suheil Artul; Faozi Artoul; George Habib; William Nseir; Bishara Bisharat; Yousif Nijim

    2014-01-01

    We present a case of a 10-year-old boy, who had severe relapsing pancreatitis, three times in two months within 3 weeks after starting treatment with methylphenidate (Ritalin) due to attention deficit hyperactivity disorder (ADHD). Pancreatitis due to the use of (methylphenidate) Ritalin was never published before. Attention must be made by the physicians regarding this possible complication, and this complication should be taken into consideration in every patient with abdominal pain who was...

  16. Severe Recurrent Pancreatitis in a Child with ADHD after Starting Treatment with Methylphenidate (Ritalin

    Suheil Artul

    2014-01-01

    Full Text Available We present a case of a 10-year-old boy, who had severe relapsing pancreatitis, three times in two months within 3 weeks after starting treatment with methylphenidate (Ritalin due to attention deficit hyperactivity disorder (ADHD. Pancreatitis due to the use of (methylphenidate Ritalin was never published before. Attention must be made by the physicians regarding this possible complication, and this complication should be taken into consideration in every patient with abdominal pain who was newly treated with Ritalin.

  17. Assessment of Methylphenidate and Propranolol Combination Treatment in Comparison with Methylphenidate and Placebo Among Children with Attention Deficit Hyperactivity Disorder (ADHD)

    Ghafari M; Riahi F; Ghaderi H; Tashakori A.; Sepandi M

    2011-01-01

    Background and Objective: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders in children and adolescents. Due to significance of this disorder in children and its complications, this study was done to determinate efficacy of propran- olol and methylphenidate combination in treatment of ADHD and in control of adverse effects of methylphenidate. Subjects and Methods: This study is a double blind–placebo control clinical trial which was conducted to c...

  18. Long-term functional outcome in adult prison inmates with ADHD receiving OROS-methylphenidate

    Ginsberg, Ylva; Hirvikoski, Tatja; Grann, Martin; Lindefors, Nils

    2012-01-01

    In a recent randomized, double-blind, placebo-controlled trial, we established a robust efficacy (Cohen’s d = 2.17) of osmotic release oral system-methylphenidate (OROS-methylphenidate) delivered 72 mg daily for 5 weeks versus placebo on attention deficit hyperactivity disorder (ADHD) symptoms, global severity and global functioning in 30 adult male prison inmates with ADHD and coexisting disorders. Outcomes continued to improve during the subsequent 47-week open-label extension with OROS-met...

  19. Prefrontal cortical and striatal transcriptional responses to the reinforcing effect of repeated methylphenidate treatment in the spontaneously hypertensive rat, animal model of attention-deficit/hyperactivity disorder (ADHD)

    dela Peña, Ike; Kim, Hee Jin; Sohn, Aeree; Kim, Bung-Nyun; Han, Doug Hyun; Ryu, Jong Hoon; Shin, Chan Young; Noh, Minsoo; Cheong, Jae Hoon

    2014-01-01

    Background Methylphenidate is the most commonly used stimulant drug for the treatment of attention-deficit/hyperactivity disorder (ADHD). Research has found that methylphenidate is a “reinforcer” and that individuals with ADHD also abuse this medication. Nevertheless, the molecular consequences of long-term recreational methylphenidate use or abuse in individuals with ADHD are not yet fully known. Methods Spontaneously hypertensive rats (SHR), the most validated and widely used ADHD animal mo...

  20. Oppositional Defiant Disorder in Adults with ADHD

    Reimherr, Frederick W.; Marchant, Barrie K.; Olsen, John L.; Wender, Paul H.; Robison, Reid J.

    2013-01-01

    Objective: Oppositional defiant disorder (ODD) is the most common comorbid condition in childhood ADHD. This trial was prospectively designed to explore ODD symptoms in ADHD adults. Method: A total of 86 patients in this placebo-controlled, double-blind trial of methylphenidate transdermal system (MTS) were categorized based on the presence of ODD…

  1. Is dopamine transporter gene effective on therapeutic response of methylphenidate in ADHD patients?

    Fatemeh Moharrari

    2015-01-01

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD is the most common neuropsychiatric illness, which affects about 5% of children worldwide. An 80% genetic background is responsible for ADHD due to its appearance in familial relationships. In addition, dopamine regulation in synaptic spaces, which have a central role in development of ADHD, is moderated by dopamine transporter neurotransmitter, which in turn is modulated by dopamine transporter gene named SLC6A3 or DAT1. Methylphenidate as the first line and most important prescribed medication for ADHD blocks dopamine transporter and increases the dopamine concentration in synaptic clefts. In theory, methylphenidate relay to dopamine transporter to play a role, and dopamine transporter synthesis is dependent on DAT1. This gene have 40 base pair in its 3`-untranslated region end that repeat from 3 to 11 times, with most frequent 9 and 10 repeats in human, forming several alleles in carriers including 9R and 10R and genotypes including 9R/9R, 10R/10R, 9R/10R. These genotypes, as the first suspected candidates, may explain why methylphenidate therapy is not sufficient some patients and how the side effects appear in some cases and not in all patients. Many studies have performed to investigate the association between responses to methylphenidate and genotypes and yet no consistency has occurred. This article has a rapid review on concerned literature.

  2. Relationship between Response to Methylphenidate Treatment in Children with ADHD and Psychopathology in Their Families

    Grizenko, Natalie; Kovacina, Bojan; Amor, Leila Ben; Schwartz, George; Ter-Stepanian, Marina; Joober, Ridha

    2006-01-01

    Objective: To compare the pattern of familial aggregation of psychopathology in children who are good responders (GR) to methylphenidate (MPH) versus those who are poor responders (PR). Method: A total of 118 clinically referred children ages 6 to 12 years, diagnosed with ADHD participated in a double-blind, placebo-controlled, randomized 2-week…

  3. Methylphenidate and Comorbid Anxiety Disorder in Children with both Chronic Multiple Tic Disorder and ADHD

    Gadow, Kenneth D.; Nolan, Edith E.

    2011-01-01

    Objective: To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD). Method: Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial…

  4. Reversible Dopamine Transporter Modifications in Response to Methylphenidate Treatment of ADHD

    J Gordon Millichap

    2005-09-01

    Full Text Available Single-photon emission computed tomography (SPECT was used to monitor the dopamine transporter activity in 5 males, ages 8 to 10, with ADHD, after cessation of methylphenidate (MPH treatment, in a study at the University Hospital Maastricht, The Netherlands.

  5. Methylphenidate significantly reduces lapses of attention during on-road highway driving in patients with ADHD.

    Verster, Joris C; Roth, Thomas

    2014-10-01

    Lapses of attention are characteristic for attention-deficit/hyperactivity disorder (ADHD) and as such may impair performance of daily activities. Data from an on-road driving study were reanalyzed to determine lapses in patients with ADHD after treatment with methylphenidate and placebo.A total of 18 adult ADHD patients performed a 100-km on-road driving test and were instructed to drive with a steady lateral position and constant speed. The SD of lateral position (SDLP), that is, the weaving of the car, lapses, and alertness, was assessed.Driving was significantly better (P = 0.006) with methylphenidate (SDLP, 18.8 cm) when compared with placebo (SDLP, 21.2 cm). Both the reduction in SDLP and the number of lapses (P = 0.003) confirm this significant improvement, which is further supported by subjective assessments of perceived driving performance. Although lapses were common in the placebo condition (11/18 patients), they were much less frequently observed (5/18 patients) after treatment with methylphenidate. Postdriving assessments suggest that lapses often go unnoticed by drivers.In conclusion, methylphenidate significantly improves driving of patients with ADHD by significantly reducing the number of lapses. PMID:24978156

  6. Methylphenidate Ameliorates Depressive Comorbidity in ADHD Children without any Modification on Differences in Serum Melatonin Concentration between ADHD Subtypes

    Isabel Cubero-Millán

    2014-09-01

    Full Text Available The vast majority of Attention-deficit/hyperactivity disorder (ADHD patients have other associated pathologies, with depressive symptoms as one of the most prevalent. Among the mediators that may participate in ADHD, melatonin is thought to regulate circadian rhythms, neurological function and stress response. To determine (1 the serum baseline daily variations and nocturnal excretion of melatonin in ADHD subtypes and (2 the effect of chronic administration of methylphenidate, as well as the effects on symptomatology, 136 children with ADHD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: DSM-IV-TR criteria were divided into subgroups using the “Children’s Depression Inventory” (CDI. Blood samples were drawn at 20:00 and 09:00 h, and urine was collected between 21:00 and 09:00 h, at inclusion and after 4.61 ± 2.29 months of treatment. Melatonin and its urine metabolite were measured by radioimmunoassay RIA. Factorial analysis was performed using STATA 12.0. Melatonin was higher predominantly in hyperactive-impulsive/conduct disordered children (PHI/CD of the ADHD subtype, without the influence of comorbid depressive symptoms. Methylphenidate ameliorated this comorbidity without induction of any changes in the serum melatonin profile, but treatment with it was associated with a decrease in 6-s-melatonin excretion in both ADHD subtypes. Conclusions: In untreated children, partial homeostatic restoration of disrupted neuroendocrine equilibrium most likely led to an increased serum melatonin in PHI/CD children. A differential cerebral melatonin metabolization after methylphenidate may underlie some of the clinical benefit.

  7. Does switching from oral extended-release methylphenidate to the methylphenidate transdermal system affect health-related quality-of-life and medication satisfaction for children with attention-deficit/hyperactivity disorder?

    Landgraf Jeanne M

    2009-12-01

    Full Text Available Abstract Background To evaluate health-related quality of life (HRQL and medication satisfaction after switching from a stable dose of oral extended-release methylphenidate (ER-MPH to methylphenidate transdermal system (MTS via a dose-transition schedule in children with attention-deficit/hyperactivity disorder (ADHD. Methods In a 4-week, multisite, open-label study, 171 children (164 in the intent-to-treat [ITT] population aged 6-12 years diagnosed with ADHD abruptly switched from a stable dose of oral ER-MPH to MTS nominal dosages of 10, 15, 20, and 30 mg using a predefined dose-transition schedule. Subjects remained on the scheduled dose for the first week, after which the dose was then titrated to an optimal effect. The ADHD Impact Module-Children (AIM-C, a disease-specific validated HRQL survey instrument measuring child and family impact, was used to assess the impact of ADHD symptoms on the lives of children and their families at baseline and study endpoint. Satisfaction with MTS use was assessed via a Medication Satisfaction Survey (MSS at study endpoint. Both the AIM-C and MSS were completed by a caregiver (parent/legally authorized representative. Tolerability was monitored by spontaneous adverse event (AE reporting. Results AIM-C child and family HRQL mean scores were above the median possible score at baseline and were further improved at endpoint across all MTS doses. Similar improvements were noted for behavior, missed doses, worry, and economic impact AIM-C item scores. Overall, 93.8% of caregivers indicated a high level of satisfaction with their child's use of the study medication. The majority of treatment-emergent AEs (> 98% were mild to moderate in intensity, and the most commonly reported AEs included headache, decreased appetite, insomnia, and abdominal pain. Seven subjects discontinued the study due to intolerable AEs (n = 3 and application site reactions (n = 4. Conclusion This study demonstrates that MTS, when carefully

  8. Assessment of Methylphenidate and Propranolol Combination Treatment in Comparison with Methylphenidate and Placebo Among Children with Attention Deficit Hyperactivity Disorder (ADHD

    Ghafari M

    2011-03-01

    Full Text Available Background and Objective: Attention Deficit Hyperactivity Disorder (ADHD is one of the most common psychiatric disorders in children and adolescents. Due to significance of this disorder in children and its complications, this study was done to determinate efficacy of propran- olol and methylphenidate combination in treatment of ADHD and in control of adverse effects of methylphenidate. Subjects and Methods: This study is a double blind–placebo control clinical trial which was conducted to compare propranolol and methylphenidate combination with placebo and methylphenidate. Thirty children with attention deficit hyperactivity disorder were assessed by Conner’s rating scale (parent version and psychiatric interview based on DSM-IV-TR and adverse effects check list of stimulant drugs and propranolol during 4 weeks in Ahvaz Golestan hospital child and adolescent psychiatric clinic.Results: Rate of response in combination treatment (methylphenidate and propranolol group was significantly greater than control group. Combination treatment was more effective in control of hyperactivity and impulsivity than inattention. The most common side effect was anorexia in both groups. Other adverse effects of methylphenidate such as increase of systolic blood pressure and pulse rate, abdominal pain, headache, insomnia and nausea were less common in combination treatment group than placebo group. Conclusion: The results were shown that combination of propranolol and methylphenidate is more effective in treatment of ADHD and decrease of adverse effects of methylphenidate than methylphenidate alone. This combination therapy was more effective in hyperactive- impulsive symptoms rather than inattention.Sci Med J 2011; 10(1:45-57

  9. The Effects of Methylphenidate on Goal-Directed Behavior in a Rat Model of ADHD

    Joman Y. Natsheh

    2015-11-01

    Full Text Available Although attentional and motor alterations in Attention Deficit Hyperactivity Disorder (ADHD have been well characterized, less is known about how this disorder impacts goal-directed behavior. To investigate whether there is a misbalance between goal-directed and habitual behaviors in an animal model of ADHD, we tested adult [P75-P105] Spontaneously Hypertensive Rats (SHR (ADHD rat model and Wistar-Kyoto rats (WKY, the normotensive control strain, on an instrumental conditioning paradigm with two phases: a free-operant training phase in which rats separately acquired two distinct action-outcome contingencies, and a choice test conducted in extinction prior to which one of the food outcomes was devalued through specific satiety. To assess the effects of Methylphenidate, a commonly used ADHD medication, on goal-directed behavior, we injected rats with either Methylphenidate or saline prior to the choice test. Both rat strains acquired an instrumental response, with SHR responding at greater rates over the course of training. During the choice test WKY demonstrated goal-directed behavior, responding more frequently on the lever that delivered, during training, the still-valued outcome. In contrast, SHR showed no goal-directed behavior, responding equally on both levers. However, methylphenidate administration prior to the choice test restored goal-directed behavior in SHR, and disrupted this behavior in WKY rats. This study provides the first experimental evidence for selective impairment in goal-directed behavior in rat models of ADHD, and how methylphenidate acts differently on SHR and WKY animals to restore or impair this behavior, respectively.

  10. A Preliminary Study on the Effect of Methylphenidate on Motor Performance in Children with Comorbid DCD and ADHD

    Bart, Orit; Podoly, Tamar; Bar-Haim, Yair

    2010-01-01

    Attention Deficit Hyperactive Disorder (ADHD) and Developmental Coordination Disorder (DCD) are two developmental disorders with considerable comorbidity. The impact of Methylphenidate (MPH) on ADHD symptoms is well documented. However, the effects of MPH on motor coordination are less studied. We assessed the influence of MPH on motor performance…

  11. Motor problems in children with ADHD and clinical effects of Methylphenidate as assessed with the MFNU

    Stray, Liv Larsen

    2009-01-01

    The Motor Function Neurological Assessment (MFNU) has been developed over a 25 year period based on clinical observations and assessments of children referred for evaluation of possible Attention Deficit Hyperactivity Disorder (ADHD)/Hyperkinetic disorder (HKD). The sub-tests of the MFNU were constructed to demonstrate these motor problems to parents and teachers of these children, and to make changes in motor performance observable when the child was medicated with Methylphenidate (...

  12. Methylphenidate

    Methylphenidate is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder ( ... are the same age) in adults and children. Methylphenidate (Methylin) is also used to treat narcolepsy (a ...

  13. Hyperactive night and day? Actigraphy studies in adult ADHD: a baseline comparison and the effect of methylphenidate.

    Boonstra, A.M.; Kooij, J.J.; Oosterlaan, J; Sergeant, J.A.; Buitelaar, J.K.; Someren, E.J. van

    2007-01-01

    STUDY OBJECTIVES: To investigate parameters of sleep, activity, and circadian rhythm, as well as the effects of methylphenidate on these variables, in adults with ADHD. DESIGN: 1) Baseline group comparison; 2) Double blind, placebo-controlled, cross-over medication trial. SETTING: Data collection took place during daily lives of participants. PARTICIPANTS: 39 normal controls and 33 adults with ADHD for baseline comparisons; 31 adults with ADHD in medication trial. INTERVENTIONS: Treatment wit...

  14. Long-term functional outcome in adult prison inmates with ADHD receiving OROS-methylphenidate.

    Ginsberg, Ylva; Hirvikoski, Tatja; Grann, Martin; Lindefors, Nils

    2012-12-01

    In a recent randomized, double-blind, placebo-controlled trial, we established a robust efficacy (Cohen's d = 2.17) of osmotic release oral system-methylphenidate (OROS-methylphenidate) delivered 72 mg daily for 5 weeks versus placebo on attention deficit hyperactivity disorder (ADHD) symptoms, global severity and global functioning in 30 adult male prison inmates with ADHD and coexisting disorders. Outcomes continued to improve during the subsequent 47-week open-label extension with OROS-methylphenidate delivered at a flexible daily dosage of up to 1.3 mg/kg body weight. In the present study, we evaluated long-term effectiveness and maintenance of improvement over the cumulated 52-week trial on cognition, motor activity, institutional behaviour and quality of life. Post hoc, we explored the associations between investigators' and self-ratings of ADHD symptoms and between ratings of symptoms and functioning, respectively. Outcomes, calculated by repeated measures ANOVA, improved from baseline until week 16, with maintenance or further improvement until week 52. Both verbal and visuospatial working memory, and abstract verbal reasoning improved significantly over time, as well as several cognition-related measures and motor activity. No substance abuse was detected and a majority of participants took part in psychosocial treatment programmes. The quality of life domains of Learning, and Goals and values improved over time; the latter domain was at open-label endpoint significantly related to improvements in attention. Investigators' and self-ratings of ADHD symptoms, as well as global symptom severity related most significantly to global functioning at week 52. Finally, investigators' and self-ratings of ADHD symptoms associated significantly at baseline with increasing convergence over time. PMID:22526730

  15. Associative learning in ADHD: improved expression under methylphenidate

    2011-01-01

    Attention Deficit/Hyperactivity Disorder (ADHD) is characterised by developmentally inappropriate levels of inattention, impulsivity and hyperactivity. As might be expected of a disorder in which inhibitory deficits form part of the diagnostic criteria, deficits in response inhibition in ADHD have been evidenced in a number of studies. To date, the tasks used in such studies have required participants to inhibit the learned stimulus-response associations that result in unwanted behavior. Howe...

  16. Effect of Methylphenidate and Folic Acid on ADHD Symptoms and Quality of Life and Aggression: A Randomized Double Blind Placebo Controlled Clinical Trial

    Ahmad Ghanizadeh; Zohreh Sayyari; Mohammad Reza Mohammadi

    2013-01-01

    Objective This clinical trial examines the effect of augmentation of methylphenidate (MPH) with folic acid to improve quality of life, and to treat aggression and ADHD symptoms. Method Participants of this eight week randomized double blind placebo controlled clinical trial were 49 children with ADHD. They were randomly assigned into one of the two groups: the first group receiving methylphenidate (10 to 20mg/day) plus folic (5mg/day), and the second group receiving methylphenidate plus place...

  17. A comparison of effectiveness of regulation of working memory function and methylphenidate on remediation of attention deficit hyperactivity disorder (ADHD.

    Mohammad Reza Mohammadi

    2014-03-01

    Full Text Available Attention Deficit/Hyperactivity Disorder (ADHD is a prevalent and serious disorder affecting such key cognitive components as working memory. Working memory serves to facilitate and check attention in any individual and to focus on those affairs that need to be retained in mind. This study examines whether a combination of the two therapeutic methods of working memory training and Methylphenidate might be more effective in treating ADHD in children aged 6 to 12 years of age than when methylphenidate is applied alone.Subjects of the study are 48 children suffering from ADHD. They were selected by random sampling. The experimental group included 23 children with ADHD who received a combination of working memory training and Methylphenidate, and the control group which included 25 children with ADHD received Methylphenidate only. To check the effects of the intervention, Conners' Parent Rating Scale (CPRS-48 was applied before and after the intervention. After intervention, data were collected from the remaining samples in the two groups. Data were examined both through descriptive statistical methods and analytic statistical methods, including T-student test and Quantile-Quantile Plots diagram.The study demonstrated that a combination of the cognitive intervention of working memory training and methylphenidate is more effective in alleviating ADHD symptoms rather than when methylphenidate is applied in isolation. In the CPRS pre-test and post-test, the mean difference of the experimental and the control group was 8.39 and 1.88 respectively, indicating that the working memory group has improved more than the control group.The study reveals that the ADHD symptoms were more contained in the test group than the control group due to working memory training. The cognitive intervention through working memory training may be effective in alleviating the severity of disorder measured in the pre-test.

  18. First evidence of HERV-H transcriptional activity reduction after methylphenidate treatment in a young boy with ADHD.

    D'Agati, Elisa; Pitzianti, Mariabernarda; Balestrieri, Emanuela; Matteucci, Claudia; Sinibaldi Vallebona, Paola; Pasini, Augusto

    2016-09-01

    Human endogenous retroviruses (HERVs) have been associated with many complex diseases including neuropsychiatric diseases, such as attention deficit hyperactivity disorder (ADHD). In ADHD an over-expression of HERV-H family in peripheral blood mononuclear cells has been documented. It has been hypothesized that HERVs may represent the link between genetic and environmental risk factors, contributing to the clinical onset and/or to the progression of the neurodevelopmental disease. The effect of pharmacological treatment on HERV transcriptional activity in psychiatric disorders has been attracting attention. Using a real-time RT-PCR we investigated the influence of methylphenidate on HERV transcription in peripheral blood mononuclear cells of a young patient with ADHD. In this clinical case we describe for the first time the reduction of HERV-H expression and the significant improvement of ADHD symptoms after 6 months of methylphenidate treatment. PMID:27602426

  19. A Comparison of Effectiveness of Regulation of Working Memory Function and Methylphenidate on Remediation of Attention Deficit Hyperactivity Disorder (ADHD)

    Mohammad Reza Mohammadi; Ali Akbar Soleimani; Zahra Farahmand; Samira Keshavarzi; Nastaran Ahmadi

    2014-01-01

    Attention Deficit/Hyperactivity Disorder (ADHD) is a prevalent and serious disorder affecting such key cognitive components as working memory. Working memory serves to facilitate and check attention in any individual and to focus on those affairs that need to be retained in mind. This study examines whether a combination of the two therapeutic methods of working memory training and Methylphenidate might be more effective in treating ADHD in children aged 6 to 12 years of age than when methylp...

  20. An observational study of once-daily modified-release methylphenidate in ADHD: effectiveness on symptoms and impairment, and safety

    Döpfner, Manfred; Görtz-Dorten, Anja; Breuer, Dieter; Rothenberger, Aribert

    2011-01-01

    ADHD affects over 5% of children worldwide. It is typically treated with stimulant medications, and methylphenidate (MPH) is the most commonly prescribed. This study investigated the effectiveness, on symptoms and impairment, and safety of Equasym XL®, a combination of 30% immediate-release and 70% modified-release MPH, in the treatment of ADHD in daily clinical practice. This open-label, observational, post-marketing surveillance study was conducted in 169 centres in Germany. Eligible patien...

  1. Impact of long-term treatment of methylphenidate on height and weight of school age children with ADHD.

    Zhang, H; Du, M; Zhuang, S

    2010-08-01

    Stimulant-associated growth deficits in children with attention deficit hyperactivity disorder (ADHD) have long been a concern. We chose 146 school age children diagnosed with ADHD being treated with methylphenidate (MPH) and 29 drug-free ADHD children, and followed them up for 2-4 years. We recorded the changes in height and weight after long-term methylphenidate treatment and analyzed the influence of confounding factors to growth in height, weight, and height velocity. The change of the gap between patients' height and mean height in the methylphenidate group was -1.86+/-0.82 cm ( Pmethylphenidate group and controls were -0.14+/-0.23 SD ( Pmethylphenidate was -0.14+/-1.25 kg ( P>0.05). From this study, a small but significant deceleration of height velocity has been identified as a long-term side effect of methylphenidate, the magnitude of the height deficit is related to the duration of treatment. Methylphenidate had no significant influence on weight and BMI values. PMID:20799150

  2. Adolescent methylphenidate treatment differentially alters adult impulsivity and hyperactivity in the Spontaneously Hypertensive Rat model of ADHD.

    Somkuwar, S S; Kantak, K M; Bardo, M T; Dwoskin, L P

    2016-02-01

    Impulsivity and hyperactivity are two facets of attention deficit/hyperactivity disorder (ADHD). Impulsivity is expressed as reduced response inhibition capacity, an executive control mechanism that prevents premature execution of an intermittently reinforced behavior. During methylphenidate treatment, impulsivity and hyperactivity are decreased in adolescents with ADHD, but there is little information concerning levels of impulsivity and hyperactivity in adulthood after adolescent methylphenidate treatment is discontinued. The current study evaluated impulsivity, hyperactivity as well as cocaine sensitization during adulthood after adolescent methylphenidate treatment was discontinued in the Spontaneously Hypertensive Rat (SHR) model of ADHD. Treatments consisted of oral methylphenidate (1.5mg/kg) or water vehicle provided Monday-Friday from postnatal days 28-55. During adulthood, impulsivity was measured in SHR and control strains (Wistar Kyoto and Wistar rats) using differential reinforcement of low rate (DRL) schedules. Locomotor activity and cocaine sensitization were measured using the open-field assay. Adult SHR exhibited decreased efficiency of reinforcement under the DRL30 schedule and greater levels of locomotor activity and cocaine sensitization compared to control strains. Compared to vehicle, methylphenidate treatment during adolescence reduced hyperactivity in adult SHR, maintained the lower efficiency of reinforcement, and increased burst responding under DRL30. Cocaine sensitization was not altered following adolescent methylphenidate in adult SHR. In conclusion, adolescent treatment with methylphenidate followed by discontinuation in adulthood had a positive benefit by reducing hyperactivity in adult SHR rats; however, increased burst responding under DRL compared to SHR given vehicle, i.e., elevated impulsivity, constituted an adverse consequence associated with increased risk for cocaine abuse liability. PMID:26657171

  3. Buspirone Versus Methylphenidate in the Treatment of Children with Attention- Deficit/ Hyperactivity Disorder: Randomized Double-Blind Study

    Shahin Akhondzadeh; Reza Hajiaghaee; Ali Galeiha; Poopak Hafezi; Mohammad-Reza Mohammadi

    2012-01-01

    A recent randomized clinical trial showed buspirone efficacy in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children. However, results from a recent multi-site controlled clinical trial of transdermal buspirone failed to separate it from placebo in a large sample of children with ADHD. Therefore, due to these inconsistent findings, this study was designed to assess the efficacy of buspirone in the treatment of children with ADHD compared to methylphenidate in a double ...

  4. Relation between therapeutic response and side effects induced by methylphenidate as observed by parents and teachers of children with ADHD

    Bhat Venkataramana; Grizenko Natalie; Lee James; Sengupta Sarojini; Polotskaia Anna; Joober Ridha

    2011-01-01

    Abstract Background The desired (therapeutic) and undesired (side) effects of methylphenidate might have underlying correlations. The aim of this study was to explore the strength and the possible sources of these correlations. Methods One hundred and fifty-seven children with ADHD (6-12 years) were administered placebo and methylphenidate (0.5 mg/kg in a divided b.i.d. dose), each for a one-week period, in a double-blind, crossover trial. Therapeutic response was assessed using the Conners' ...

  5. Methylphenidate

    ... for ADHD, which may include counseling and special education. Make sure to follow all of your doctor's ... or hearing voices that do not exist) motor tics or verbal tics depression abnormally excited mood mood ...

  6. Relation between therapeutic response and side effects induced by methylphenidate as observed by parents and teachers of children with ADHD

    Bhat Venkataramana

    2011-04-01

    Full Text Available Abstract Background The desired (therapeutic and undesired (side effects of methylphenidate might have underlying correlations. The aim of this study was to explore the strength and the possible sources of these correlations. Methods One hundred and fifty-seven children with ADHD (6-12 years were administered placebo and methylphenidate (0.5 mg/kg in a divided b.i.d. dose, each for a one-week period, in a double-blind, crossover trial. Therapeutic response was assessed using the Conners' Global Index for parents (CGI-Parents and teachers (CGI-Teachers, while side effects were assessed using the Barkley Side Effects Rating Scale (SERS. Results The side effect profile as assessed by the SERS was similar to that of previous studies with insomnia, decreased appetite, and headaches showing significant treatment effects (p Conclusion The greater "mood/anxiety" side effects on methylphenidate and placebo, the less the parents observe improvement of their children while treated with methylphenidate. This suggests that the correlations between "mood/anxiety" side effects and poor response to treatment may be driven by observer effects rather than biological commonalities between therapeutic and side effects of methylphenidate.

  7. Instrumental learning in ADHD in a context of reward: intact learning curves and performance improvement with methylphenidate.

    Luman, Marjolein; Goos, Vanessa; Oosterlaan, Jaap

    2015-05-01

    We tested the hypothesis that instrumental learning is impaired in children with attention deficit/hyperactivity disorder (ADHD) and tested whether this deficiency can be ameliorated by the use of three different doses of methylphenidate (MPH): a low, a medium, and a high dose. Fifty children (23 with ADHD, 27 typically developing) performed an instrumental learning task in which they had to map four stimuli to two responses using feedback that differed in information value and that was coupled to monetary gain (0.2). Feedback was either contingent, thus fully informative on performance, or probabilistic, and informative in only 88 % of the trials. Dependent variables were response accuracy and latency. Contrary to predictions, children with ADHD and typically developing controls did not differ in their ability to acquire the stimulus-response mappings, in either condition. This indicates that with a simple instrumental learning task, children with ADHD are able to learn from rewarded feedback, as controls do, suggesting that children with ADHD are capable of learning both at home and in class when the environment is adequate. Possibly, learning problems are more evident in children with comorbid ODD, as exploratory analyses indicated that accuracy scores were significantly reduced when children with ADHD exhibited high levels of parent-rated ODD symptoms. Medication analysis showed that children with ADHD completed the task more accurately and faster when taking MPH compared to placebo, particularly when the dose was high. PMID:25212229

  8. Effect of Methylphenidate and Folic Acid on ADHD Symptoms and Quality of Life and Aggression: A Randomized Double Blind Placebo Controlled Clinical Trial

    Ahmad Ghanizadeh

    2013-09-01

    Full Text Available bjective: This clinical trial examines the effect of augmentation of methylphenidate (MPH with folic acid to improve quality of life, and to treat aggression and ADHD symptoms .Method:Participants of this eight week randomized double blind placebo controlled clinical trial were 49 children with ADHD. They were randomly assigned into one of the two groups: the first group receiving methylphenidate (10 to 20mg/day plus folic (5mg/day, and the second group receiving methylphenidate plus placebo. Parent-reported ADHD symptoms and Overt Aggression Scale score were the outcome measures. Quality of life was assessed as well. Assessments were performed at pre-intervention, and at one month and two months after starting the interventions using repeated measure analysis Results:The mean age of children was 9.6(2.7 years. Age and gender were not associated with the groups. ADHD symptoms significantly decreased in both groups during the trial. However, no difference was observed between the groups. Moreover, aggression non-significantly decreased in both groups. Meanwhile, there was no difference between the two groups in efficacy for treating different types of aggressive behaviors including: verbal aggression, physical aggression against people, physical aggression against properties or objects, and aggression against self (self-injurious behavior. While methylphenidate improved quality of life of children with ADHD, folic acid did not improve it more than placebo. Both medications were well tolerated.Conclusion:considering the marked limitations of this trial, this primarily report suggests that methylphenidate may improve ADHD symptoms and the quality of life of children with ADHD. Current evidence does not support that folic acid as an adjuvant is effective for treating ADHD symptoms or aggression, or the improving quality of life of children with ADHD.

  9. The influence of methylphenidate on the power spectrum of ADHD children – an MEG study

    Bauer Susanne

    2005-07-01

    Full Text Available Abstract Background The present study was dedicated to investigate the influence of Methylphenidate (MPH on cortical processing of children who were diagnosed with different subtypes of Attention Deficit Hyperactivity Disorder (ADHD. As all of the previous studies investigating power differences in different frequency bands have been using EEG, mostly with a relatively small number of electrodes our aim was to obtain new aspects using high density magnetoencephalography (MEG. Methods 35 children (6 female, 29 male participated in this study. Mean age was 11.7 years (± 1.92 years. 17 children were diagnosed of having an Attention-Deficit/Hyperactivity Disorder of the combined type (ADHDcom, DSM IV code 314.01; the other 18 were diagnosed for ADHD of the predominantly inattentive type (ADHDin, DSM IV code 314.0. We measured the MEG during a 5 minute resting period with a 148-channel magnetometer system (MAGNES™ 2500 WH, 4D Neuroimaging, San Diego, USA. Power values were averaged for 5 bands: Delta (D, 1.5–3.5 Hz, Theta (T, 3.5–7.5 Hz, Alpha (A, 7.5–12.5 Hz, Beta (B, 12.5–25 Hz and Global (GL, 1.5–25 Hz.. Additionally, attention was measured behaviourally using the D2 test of attention with and without medication. Results The global power of the frequency band from 1.5 to 25 Hz increased with MPH. Relative Theta was found to be higher in the left hemisphere after administration of MPH than before. A positive correlation was found between D2 test improvement and MPH-induced power changes in the Theta band over the left frontal region. A linear regression was computed and confirmed that the larger the improvement in D2 test performance, the larger the increase in Theta after MPH application. Conclusion Main effects induced by medication were found in frontal regions. Theta band activity increased over the left hemisphere after MPH application. This finding contradicts EEG results of several groups who found lower levels of Theta power

  10. Effectiveness and safety of methylphenidate for ADHD in population between 6 and 19 years: a systematic review

    José Calleja

    2012-09-01

    Full Text Available Introduction: Attention deficit hyperactivity disorder (ADHD is generally treated with pharmacologic and non-pharmacologic interventions. Methylphenidate is the most widely used drug and is available to most patients. Purpose: To identify, synthesize and evaluate the best available evidence on the effectiveness and safety of methylphenidate (MPH in ADHD in the 6-19 year-old population. Methods: A systematic review of intervention studies was conducted with time limit February, 2012, in English and Spanish. The following databases were consulted: PubMed/MEDLINE, LILACS, Cochrane, DARE and National Guideline Clearinghouse. The articles were independently evaluated by two investigators and were assessed for methodological quality. Results: Of the 377 studies found initially, 14 were included, including two systematic reviews, 7 primary articles on therapeutic interventions and 5 clinical guidelines. Most of the studies have shortcoming with regards to search strategies, critical analysis, small samples and low Jadad scale. Conclusions: MPH is superior to placebo for moderate to severe cases of ADHD in the of 6-19 year-old population.

  11. OROS-methylphenidate efficacy on specific executive functioning deficits in adults with ADHD: a randomized, placebo-controlled cross-over study.

    Bron, Tannetje I; Bijlenga, Denise; Boonstra, A Marije; Breuk, Minda; Pardoen, Willem F H; Beekman, Aartjan T F; Kooij, J J Sandra

    2014-04-01

    Attention-deficit/hyperactivity disorder (ADHD) is linked to impaired executive functioning (EF). This is the first study to objectively investigate the effects of a long-acting methylphenidate on neurocognitive test performance of adults with ADHD. Twenty-two adults with ADHD participated in a 6-weeks study examining the effect of osmotic-release oral system methylphenidate (OROS-mph) on continuous performance tests (CPTs; objective measures), and on the self-reported ADHD rating scale (subjective measure) using a randomized, double-blind, placebo-controlled cross-over design. OROS-mph significantly improved reaction time variability (RTV), commission errors (CE) and d-prime (DP) as compared to baseline (Cohen's d>.50), but did not affect hit reaction time (HRT) or omission errors (OE). Compared to placebo, OROS-mph only significantly influenced RTV on one of two CPTs (peffects in ADHD patients with higher EF severity (RTV: β=.670, t=2.097, p=.042; omission errors (OE): β=-.098, t=-4.759, pSide effects rates were substantially but non-significantly greater for OROS-mph compared to placebo (77% vs. 46%, p=.063). OROS-mph effects indicated RTV as the most sensitive parameter for measuring both neuropsychological and behavioral deficits in adults with ADHD. These findings suggest RTV as an endophenotypic parameter for ADHD symptomatology, and propose CPTs as an objective method for monitoring methylphenidate titration. PMID:24508533

  12. Reinforcement enhances vigilance among children with ADHD: comparisons to typically developing children and to the effects of methylphenidate.

    Bubnik, Michelle G; Hawk, Larry W; Pelham, William E; Waxmonsky, James G; Rosch, Keri S

    2015-01-01

    Sustained attention and reinforcement are posited as causal mechanisms in Attention-Deficit/Hyperactivity Disorder (ADHD), but their interaction has received little empirical study. In two studies, we examined the impact of performance-based reinforcement on sustained attention over time, or vigilance, among 9- to 12-year-old children. Study 1 demonstrated the expected vigilance deficit among children with ADHD (n = 25; 12% female) compared to typically developing (TD) controls (n = 33; 22% female) on a standard continuous performance task (CPT). During a subsequent visit, reinforcement improved attention more among children with ADHD than controls. Study 2 examined the separate and combined effects of reinforcement and acute methylphenidate (MPH) on CPT performance in children with ADHD (n = 19; 21% female). Both reinforcement and MPH enhanced overall target detection and attenuated the vigilance decrement that occurred in no-reinforcement, placebo condition. Cross-study comparisons suggested that the combination of MPH and reinforcement eliminated the vigilance deficit in children with ADHD, normalizing sustained attention. This work highlights the clinically and theoretically interesting intersection of reinforcement and sustained attention. PMID:24931776

  13. An observational study of once-daily modified-release methylphenidate in ADHD: effectiveness on symptoms and impairment, and safety.

    Döpfner, Manfred; Görtz-Dorten, Anja; Breuer, Dieter; Rothenberger, Aribert

    2011-10-01

    ADHD affects over 5% of children worldwide. It is typically treated with stimulant medications, and methylphenidate (MPH) is the most commonly prescribed. This study investigated the effectiveness, on symptoms and impairment, and safety of Equasym XL(®), a combination of 30% immediate-release and 70% modified-release MPH, in the treatment of ADHD in daily clinical practice. This open-label, observational, post-marketing surveillance study was conducted in 169 centres in Germany. Eligible patients, aged 6-17 years, were diagnosed with ADHD and about to begin treatment with Equasym XL(®). Effectiveness was assessed by physicians using the clinical global impression (CGI) severity and improvement scales; teachers and parents completed questionnaires evaluating ADHD symptoms and behavioural problems (DAYAS, FBB-ADHD and SDQ-P). Assessments were carried out at baseline, after 1-3 and 6-12 weeks of treatment. Of 852 enrolled patients, 822 were evaluable; 25.30% were treatment naïve, 69.84% had previously received different MPH formulations, and 4.87% had received other medications. ADHD symptoms improved from baseline to last visit for the majority of patients for all outcome measures. According to physician ratings of core ADHD symptoms, 75.73% of patients showed improvements on the CGI-Improvement scale, 17.77% had no change, and 6.50% worsened. In teacher and parent ratings, the effectiveness of Equasym XL(®) was rated better than prior therapy at all measured time points across the day, particularly late morning (teachers) and early afternoon (parents). Equasym XL(®) was generally well tolerated; only 3.16% of patients permanently discontinued treatment due to adverse events. Equasym XL(®) is effective and well tolerated in daily clinical practice. PMID:21901417

  14. High sibling correlation on methylphenidate response but no association with DAT1-10R homozygosity in Dutch sibpairs with ADHD

    van der Meulen, Emma M; Bakker, Steven C; Pauls, David L; Oteman, Nicole; Kruitwagen, Cas L J J; Pearson, Peter L; Sinke, Richard J; Buitelaar, Jan K

    2005-01-01

    BACKGROUND: A minority of patients with attention-deficit hyperactivity disorder (ADHD) do not respond favorably to methylphenidate. This has been partially associated with homozygosity for the Dopamine transporter (DAT1) 10-repeat allele and the presence of one or two Dopamine D4 receptor (DRD4) 7-

  15. Long-Term Effects of Methylphenidate on Neural Networks Associated with Executive Attention in Children with ADHD: Results from a Longitudinal Functional MRI Study

    Konrad, Kerstin; Neufang, Susanne; Fink, Gereon R.; Herpertz-Dahlmann, Beate

    2007-01-01

    A longitudinal functional MRI study examines the effects of stimulants on neural activity in children with attention-deficit/hyperactivity disorder (ADHD). The results conclude that one year of methylphenidate treatment might be beneficial though insufficient to show normalization of neural correlates of attention.

  16. Sex Differences in the Response of Children with ADHD to Once-Daily Formulations of Methylphenidate

    Sonuga-Barke, J. S.; Coghill, David; Markowitz, John S.; Swanson, James M.; Vandenberghe, Mieke; Hatch, Simon J.

    2007-01-01

    Objectives: Studies of sex differences in methylphenidate response by children with attention-deficit/hyperactivity disorder have lacked methodological rigor and statistical power. This paper reports an examination of sex differences based on further analysis of data from a comparison of two once-daily methylphenidate formulations (the COMACS…

  17. A non-interventional study of extended-release methylphenidate in the routine treatment of adolescents with ADHD: effectiveness, safety and adherence to treatment.

    Sobanski, Esther; Döpfner, Manfred; Ose, Claudia; Fischer, Roland

    2013-12-01

    This multi-centre, open-label, non-interventional study evaluates effectiveness, safety and adherence to treatment of a specific extended-release methylphenidate with a 50 % immediate and a 50 % extended-release component (Medikinet(®) retard) in the clinical routine treatment of 381 adolescents with ADHD and a mean age of 14.0 ± 1.9 years. ADHD and associated psychiatric symptoms, medication status and dosage frequency, treatment adherence and adverse events were assessed at baseline and after a median treatment length with Medikinet(®) retard of 70 days. Primary outcome criterion was the change of ADHD symptom severity from baseline to endpoint according to the ADHD-KGE (German: ADHS-Klinische Gesamteinschätzung) change score. At baseline, 4.2 % of the patients were treatment naïve, 92.7 % had previously received different methylphenidate formulations and 3.1 % had received atomoxetine or amphetamine. During the study, patients received a mean daily dose of 35.7 ± 15.1 mg Medikinet(®) retard. At endpoint, in 78 % of patients, the total ADHD symptom severity was reduced, in 20.4 %, it remained unchanged and in 1.6 %, it was worsened. The mean ADHD-KGE total ADHD symptom score was reduced from 1.8 ± 0.7 (moderate) at baseline to 0.8 ± 0.5 (mild; p methylphenidate formulation to Medikinet(®) retard, multiple dosing with ≥3 daily medication intakes was reduced from 12.9 % at baseline to 3.1 % at endpoint (p problems. The findings suggest that pharmacologically treated adolescents with ADHD and insufficient symptom reduction and/or treatment adherence benefit from switching to Medikinet(®) retard and that it is well tolerated when given in clinical routine care. PMID:23794192

  18. Genetic evidence for the association of the hypothalamic-pituitary-adrenal (HPA) axis with ADHD and methylphenidate treatment response.

    Fortier, Marie-Ève; Sengupta, Sarojini M; Grizenko, Natalie; Choudhry, Zia; Thakur, Geeta; Joober, Ridha

    2013-03-01

    Exposure to stressors results in a spectrum of autonomic, endocrine, and behavioral responses. A key pathway in this response to stress is the hypothalamic-pituitary-adrenal (HPA) axis, which results in a transient increase in circulating cortisol, which exerts its effects through the two related ligand-activated transcription factors: the glucocorticoid receptor (GR) and mineralocorticoid receptor (MR). Genetic polymorphisms in these receptors have been shown to influence HPA axis reactivity, and chronic dysregulation of the HPA axis has been associated with the development of several psychiatric disorders. The objective of the study was to test the association between four functional polymorphisms in NR3C1 (encoding GR: ER22/23EK-rs6189, N363S-rs6195, BclI-rs41423247, A3669G-rs6198) and two in NR3C2 (encoding MR: 215G/C-rs2070951, I180 V-rs5522) with childhood ADHD. Family-based association tests (FBAT) were conducted with the categorical diagnosis of ADHD, behavioral and cognitive phenotypes related to ADHD, as well as with treatment response assessed in a 2-week, double-blind, placebo-controlled trial with methylphenidate. A specific haplotype (G:A:G:G; ER22/23EK- N363S- BclI- A3669G) of NR3C1 showed a significant association with behaviors related to ADHD (particularly thought and attention problems, aggressive behavior), comorbidity with oppositional defiant disorder, and executive function domains. An association was also observed with treatment response (assessed by the Conners'-Teachers and Restricted Academic Situation Scale). In contrast, MR gene polymorphisms were not associated with any of the variables tested. To the best of our knowledge, this is the first report showing an association between functional polymorphisms in NR3C1 and ADHD, providing genetic evidence for involvement of the HPA axis in the disorder and treatment response. PMID:23055001

  19. Effectiveness and safety of long-acting versus short acting methylphenidate in ADHD in population between 6 and 19 years: a systematic review

    José Calleja

    2012-09-01

    Full Text Available Introduction: Attention deficit hyperactivity disorder (ADHD is generally treated with short-acting methylphenidate, but recently a long-acting presentation has been introduced, hence the interest of the study to evaluate the two formulations. Purpse: To identify, synthesize and evaluate the best available evidence on the effectiveness and safety of long-acting methylphenidate versus short-acting treatment for ADHD in the 6-19 year-old population. Methods: A systematic review of intervention studies comparing the two presentations of methylphenidate was conducted. Effectiveness was measured in terms of educational performance, psychosocial functioning, quality of life and adverse effects. Databases were searched until February 2012 in English and Spanish: PubMed/MEDLINE, Lilacs, Cochrane, DARE and National Guideline Clearinghouse. The studies were evaluated by two investigators independently. Results: Of the 18 studies found initially, six were included, among which a systematic review, a primary article on therapeutic interventions and four clinical guidelines. Conclusions: Long-acting methylphenidate is not superior to short-acting methylphenidate in terms of educational performance, psychosocial functioning, quality of life. Few adverse effects were found in the treatment of patients between 6 and 19 years old with attention deficit disorder.

  20. Differential Effects of Methylphenidate on Problem Solving in Adults with ADHD

    Tucha, Lara; Tucha, Oliver; Sontag, Thomas A.; Stasik, Dorota; Laufkotter, Rainer; Lange, Klaus W.

    2011-01-01

    Objective: Two studies were performed to assess both divergent and convergent thinking in adults with ADHD. Method: The first study compared the problem-solving abilities of healthy participants (N = 144) and unmedicated adults with ADHD (N = 144). In the second study, problem-solving abilities of adults with diagnosed ADHD (N = 22) were examined…

  1. Reboxetine for ADHD in children non-responders or with poor tolerance to methylphenidate: a prospective long-term open-label study.

    Quintero, Javier; López-Muñoz, Francisco; Alamo, Cecilio; Loro, Mercedes; García-Campos, Natalia

    2010-11-01

    Up to 30% of patients with attention-deficit hyperactivity disorder (ADHD) treated with psychostimulants discontinue the treatment because of intolerance or lack of therapeutic response. Therapeutic alternatives are needed for such patients. In the present case series, we study the effectiveness of reboxetine over a period of 6 months in a sample of 14 children diagnosed with ADHD according to DSM-IV-TR criteria, who had responded only partially or had presented poor tolerance to conventional treatment with methylphenidate. Clinical efficacy was evaluated through the application of the 18-item Attention-Deficit Hyperactivity Disorder Rating Scale (ADHD-RS-IV) and the Clinical Global Impressions-Global Improvement Scale (CGI-I). Percentages of responders (ADHD-RS ≥ 25%) and improvers (CGI-I absolute value side-effects were observed during treatment, the most frequent effects being headaches and insomnia. The initial findings of our study show that reboxetine may constitute an effective tool for long-term treatment of children with ADHD who present poor response or poor tolerance to initial treatment with methylphenidate. PMID:21432596

  2. Methylphenidate and Amphetamine Do Not Induce Cytogenetic Damage in Lymphocytes of Children with ADHD

    Witt, Kristine L.; Shelby, Michael D.; Itchon-Ramos, Nilda; Faircloth, Melissa; Kissling, Grace E.; Chrisman, Allan K.; Ravi, Hima; Murli, Hemalatha; Mattison, Donald R.; Kollins, Scott H.

    2008-01-01

    The inducement of chromosomal damage in lymphocytes among children with attention deficit hyperactivity disorder receiving treatment with methylphenidate- or amphetamine-based drugs is investigated. Findings did not reveal significant increases in cytogenetic damage related to the treatment. The risk for cytogenetic damage posed by such products…

  3. Methylphenidate and Play Skills in Children with Intellectual Disability and ADHD

    Handen, Benjamin L.; Sagady, Amie E.; McAuliffe-Bellin, Sarah

    2009-01-01

    Attention-deficit/hyperactivity disorder (ADHD) affects 9-12% of individuals with intellectual disability (ID). Although psychostimulant medication is often the primary treatment modality, little is known regarding the effects of such agents on social interactions and play in this population. Additionally, the role of ADHD symptoms in social and…

  4. Phenotypic psychiatric characterization of children with Williams syndrome and response of those with ADHD to methylphenidate treatment.

    Green, Tamar; Avda, Sarit; Dotan, Inbar; Zarchi, Omer; Basel-Vanagaite, Lina; Zalsman, Gil; Weizman, Abraham; Gothelf, Doron

    2012-01-01

    Williams syndrome (WS) is associated with cognitive deficits, special behavioral phenotype, and high rates of psychiatric disorders. The aims of the present study were: (1) To compare the rates of psychiatric disorders and repetitive behaviors in children with WS to children with idiopathic developmental disability (DDs); (2) To longitudinally assess the change in psychiatric disorders during adolescence in WS; (3) To assess retrospectively the effectiveness and safety of methylphenidate (MPH) treatment in WS children with ADHD. The study consisted of a cohort of 38 children and adolescents (age 13.1 ± 5.2 years) with WS and a sample of age-matched DDs (age 15.0 ± 3.1 years). A current follow-up evaluation was conducted after 5.6 ± 1.6 years for 25 subjects (65.8%) of the WS cohort. The rate of most psychiatric disorders was found similar in children with WS and DD controls. Specific phobia, especially from noises, obsessive-compulsive symptoms (e.g., aggressive obsessions and repetitive questions), and stereotypic behaviors (e.g., glancing), were more common in WS than DDs. In a longitudinal follow-up of the WS children, we found a decrease in the rate of anxiety disorders. In addition, a clinically significant improvement was reported in 72.2% of WS children with ADHD following MPH treatment. Sadness/unhappiness was the most common side effect associated with MPH treatment in WS, occurring in 2/3 of treated individuals. The present study further elucidates the neuropsychiatric phenotype of WS. Our results also suggest that MPH treatment for ADHD in WS warrants future prospective controlled trials. PMID:22052570

  5. Meta-analysis of Effectiveness of Methylphenidate on the Rate of ADHD Symptoms

    Somaye Jamali-Paghale

    2012-10-01

    Full Text Available Background: In recent years, psychologists and psychiatrists in the field of Attention-Deficit/Hyperactivity-Disorder (ADHD have been research doing for measurement of validity and efficiency of available treatment and. In this regard, meta-analysis integrates the results of different studies then determines the effect size of drug treatment.This study seeks to investigate the effective rate of methylphenidateon on reducing ADHD symptoms by following the meta-analysis model.Materials and Methods: 21 Studies which were methodologically accepted were selected and meta-analysis was done on them. The research tool was meta-analysis check list.Results: the result indicated that rate of effect size drug treatment on reducing ADHD symptoms was 0.71 (p≤ 0.001. This rate of effective size according to Cohen table was higher than average and considered.Conclusion: Therefore, it seems that methylphenidateon can be applied as proper treatments for individuals suffering from ADHD symptoms.

  6. Meta-analysis of Effectiveness of Methylphenidate on the Rate of ADHD Symptoms

    Somaye Jamali-Paghale; Ahmad Abedi; Elham Aghaei; Salar Faramarzi; Arezou Gholami

    2012-01-01

    Background: In recent years, psychologists and psychiatrists in the field of Attention-Deficit/Hyperactivity-Disorder (ADHD) have been research doing for measurement of validity and efficiency of available treatment and. In this regard, meta-analysis integrates the results of different studies then determines the effect size of drug treatment.This study seeks to investigate the effective rate of methylphenidateon on reducing ADHD symptoms by following the meta-analysis model.Materials and Met...

  7. Aspects of ADHD in adults : neurocognitive functioning, actigraphy, effects of methylphenidate, and association with genetic polymorphisms

    Boonstra, Aukje Marije

    2006-01-01

    The current thesis encompasses a number of empirical, clinical studies into various aspects of ADHD in adults. The common theme of the studies and thereby the overall aim of the thesis is to further substantiate the external validity (especially the concurrent and predictive validity) of the diagnos

  8. Treatment Effects of Methylphenidate on Cognitive Functioning in Children with Mental Retardation and ADHD

    Pearson, Deborah A.; Santos, Cynthia W.; Casat, Charles D.; Lane, David M.; Jerger, Susan W.; Roache, John D.; Loveland, Katherine A.; Lachar, David; Faria, Laura P.; Payne, Christa D.; Cleveland, Lynne A.

    2004-01-01

    Objective: Cognitive effects of stimulant medication were investigated in children with mental retardation (MR) and attention-deficit/hyperactivity disorder (ADHD). Method: Performance on tasks tapping sustained attention, visual and auditory selective attention, inhibition, and immediate memory was assessed for 24 children (mean age 10.9 years)…

  9. Prospective observational study protocol to investigate long-term adverse effects of methylphenidate in children and adolescents with ADHD: the Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) study

    Inglis, S K; Carucci, S; Garas, P; Häge, A; Banaschewski, T; Buitelaar, J K; Dittmann, R W; Falissard, B; Hollis, C; Kovshoff, H; Liddle, E; McCarthy, S; Nagy, P; Neubert, A; Rosenthal, E; Sonuga-Barke, E; Wong, I; Zuddas, A; Coghill, D C

    2016-01-01

    Introduction Methylphenidate is the most frequently used medication for the treatment of attention-deficit/hyperactivity disorder (ADHD) in Europe. Following concerns about its safety, the European Commission called for research into the long-term effects of methylphenidate on children and adolescents with ADHD. The Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) research programme was designed to address this call. At the heart of this programme is a 2-year longitudinal naturalistic pharmacovigilance study being conducted in 27 European sites. Methods and analysis 3 cohorts of children and adolescents (aged 6–17) living in the UK, Germany, Italy and Hungary are being recruited: Group 1 (Medicated ADHD): 800 ADHD medication-naive children and adolescents with a clinical diagnosis of ADHD about to start methylphenidate treatment for the first time. Group 2 (Unmedicated ADHD): 400 children and adolescents with a clinical diagnosis of ADHD who have never been treated with ADHD medication and have no intention of beginning medication. Group 3 (Non-ADHD): 400 children and adolescents without ADHD who are siblings of individuals in either group 1 or 2. All participants will be assessed 5 times during their 2-year follow-up period for growth and development, psychiatric, neurological and cardiovascular health. The primary outcome measure will be the height velocity SD score. Ethics and dissemination Ethical approval for the study has been granted by the East of Scotland Research Ethics Service. Following this approval, patient information leaflets and consent forms were translated as necessary and submissions made by lead sites in each of the other 3 countries to their own ethics committees. Following ethical approval in each country, local ethical permissions at each site were sought and obtained as needed. The study's website (http://www.adhd-adduce.org/page/view/2/Home) provides information for researchers, participants and the general

  10. Methylphenidate-induced mania-like symptoms

    Kaustav Chakraborty; Sandeep Grover

    2011-01-01

    Therapeutic dose of methylphenidate is known to cause adverse effects (psychosis or mania), albeit in a small number of cases. Signs and symptoms of adverse effects usually disappear on stopping the medicine. Data regarding the safety of methylphenidate in comorbid attention deficit hyperactivity disorder (ADHD) and mental retardation are nonexistent. We describe a case of an 11-year-old girl with ADHD and mental retardation treated with methylphenidate, who developed mania like symptoms requ...

  11. MR imaging of the effects of methylphenidate on brain structure and function in Attention-Deficit/Hyperactivity Disorder

    Schweren, Lizanne J. S.; de Zeeuw, Patrick; Durston, Sarah

    2013-01-01

    Methylphenidate is the first-choice pharmacological intervention for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). The pharmacological and behavioral effects of methylphenidate are well described, but less is known about neurochemical brain changes induced by methylphenidate. Thi

  12. Actigraphic Recording of Manic Symptoms Induced by Methylphenidate

    Timo Partonen; Pekka Tani; Sami Leppämäki; Tuuli Lahti

    2009-01-01

    Objective. Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder characterized by a long-standing pattern of impulsive behavior, hyperkinesia, and inattention. Psychostimulants, for example, methylphenidate, are the treatment of choice for ADHD both in children, adolescents, and adults. Method. The effect of methylphenidate on sleep structure is not well known. We studied the effect of long-acting methylphenidate on sleep in adult ADHD patients, in a naturalistic treatme...

  13. ADHD

    ... be overly active. What are some of the signs of ADHD? Many children have trouble focusing and behaving at ... it is very important to get help for ADHD as early as possible. Additional Information: http: / / www. cdc. gov/ ...

  14. Effective Methylphenidate Treatment of an Adult Aspergers Syndrome and a Comorbid ADHD: A Clinical Investigation with fMRI

    Roy, Mandy; Dillo, Wolfgang; Bessling, Svenja; Emrich, Hinderk M.; Ohlmeier, Martin D.

    2009-01-01

    Objective: Aspergers Syndrome can present as comorbid with attention-deficit/hyperactivity disorder (ADHD). Very few cases of the assessment and treatment of this comorbidity in adulthood are described in the research literature. Method: A 26-year-old patient as suffering from ADHD in combination with Aspergers Syndrome is diagnosed. Treatment is…

  15. The Safety and Efficacy of Methylphenidate and Dexmethylphenidate in Adults with Attention Deficit/Hyperactivity Disorder

    Michael A. Sopko Jr; Harjeet Caberwal; Benjamin Chavez

    2010-01-01

    Objective To review the literature on the safety and efficacy of methylphenidate, OROS-methylphenidate, methylphenidate ER, and dexmethylphenidate in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). To analyze the effects of different doses of methylphenidate, it’s various formulations, and methylphenidate on efficacy and safety in this population. Data sources Literature retrieval was performed through Pubmed/MEDLINE (Up to May 2010) using the terms methylphenidate, dexmethylphen...

  16. Buspirone versus methylphenidate in the treatment of children with attention- deficit/ hyperactivity disorder: randomized double-blind study.

    Mohammadi, Mohammad-Reza; Hafezi, Poopak; Galeiha, Ali; Hajiaghaee, Reza; Akhondzadeh, Shahin

    2012-01-01

    A recent randomized clinical trial showed buspirone efficacy in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children. However, results from a recent multi-site controlled clinical trial of transdermal buspirone failed to separate it from placebo in a large sample of children with ADHD. Therefore, due to these inconsistent findings, this study was designed to assess the efficacy of buspirone in the treatment of children with ADHD compared to methylphenidate in a double blind randomized clinical trial. Forty outpatients with a DSM-IV-TR diagnosis of ADHD were study population of this trial. Subjects were recruited from an outpatient child and adolescent clinic for a 6 week double blind, randomized clinical trial. All study subjects were randomly assigned to receive treatment using tablet of buspirone at a dose of 20-30 mg/day depending on weight (20 mg/day for 30kg) (group 1) or methylphenidate at a dose of 20-30 mg/day depending on weight (20 mg/day for 30kg (group 2) for a 6 week double blind, randomized clinical trial. The principal measure of outcome was the Teacher and Parent ADHD Rating Scale IV. Patients were assessed at baseline and at 21 and 42 days after the medication started. Significant differences were observed between the two groups on the Parent and Teacher Rating Scale scores. The changes at the endpoint compared to baseline were: -8.95±8.73 (mean±SD) and -15.60±7.81 (mean±SD) for buspirone and methyphenidate, for Parent ADHD Rating Scale. The changes at the endpoint compared to baseline were: -9.80 ±7.06 (mean±SD) and -22.40±9.90 (mean±SD) for buspirone and methyphenidate, respectively for Teacher ADHD Rating Scale. The difference between the buspirone and methylphenidate groups in the frequency of side effects was not significant except for decreased appetite, headache and insomnia that were observed more frequently in the methylphenidate group. The results of this study suggest that administration of buspirone was

  17. Buspirone Versus Methylphenidate in the Treatment of Children with Attention- Deficit/ Hyperactivity Disorder: Randomized Double-Blind Study

    Shahin Akhondzadeh

    2012-11-01

    Full Text Available A recent randomized clinical trial showed buspirone efficacy in the treatment of attention-deficit/hyperactivity disorder (ADHD in children. However, results from a recent multi-site controlled clinical trial of transdermal buspirone failed to separate it from placebo in a large sample of children with ADHD. Therefore, due to these inconsistent findings, this study was designed to assess the efficacy of buspirone in the treatment of children with ADHD compared to methylphenidate in a double blind randomized clinical trial. Forty outpatients with a DSM-IV-TR diagnosis of ADHD were study population of this trial. Subjects were recruited from an outpatient child and adolescent clinic for a 6 week double blind, randomized clinical trial. All study subjects were randomly assigned to receive treatment using tablet of buspirone at a dose of 20-30 mg/day depending on weight (20 mg/day for 30kg (group 1 or methylphenidate at a dose of 20-30 mg/day depending on weight (20 mg/day for 30kg (group 2 for a 6 week double blind, randomized clinical trial. The principal measure of outcome was the Teacher and Parent ADHD Rating Scale IV. Patients were assessed at baseline and at 21 and 42 days after the medication started. Significant differences were observed between the two groups on the Parent and Teacher Rating Scale scores. The changes at the endpoint compared to baseline were: -8.95±8.73 (mean±SD and -15.60±7.81 (mean±SD for buspirone and methyphenidate, for Parent ADHD Rating Scale. The changes at the endpoint compared to baseline were: -9.80 ±7.06 (mean±SD and -22.40±9.90 (mean±SD for buspirone and methyphenidate, respectively for Teacher ADHD Rating Scale. The difference between the buspirone and methylphenidate groups in the frequency of side effects was not significant except for decreased appetite, headache and insomnia that were observed more frequently in the methylphenidate group. The results of this study suggest that administration of

  18. Reinforcement Enhances Vigilance Among Children With ADHD: Comparisons to Typically Developing Children and to the Effects of Methylphenidate

    Bubnik, Michelle G; Hawk, Larry W.; Pelham, William E.; Waxmonsky, James G.; Rosch, Keri S

    2015-01-01

    Sustained attention and reinforcement are posited as causal mechanisms in Attention-Deficit/Hyperactivity Disorder (ADHD), but their interaction has received little empirical study. In two studies, we examined the impact of performance-based reinforcement on sustained attention over time, or vigilance, among 9- to 12-year-old children. Study 1 demonstrated the expected vigilance deficit among children with ADHD (n=25; 12% female) compared to typically developing (TD) controls (n=33; 22% femal...

  19. Methylphenidate improves response inhibition but not reflection–impulsivity in children with attention deficit hyperactivity disorder (ADHD)

    DeVito, Elise E.; Blackwell, Andrew D.; Clark, Luke; Kent, Lindsey; Dezsery, Anna Maria; Turner, Danielle C; Aitken, Michael R.F.; Sahakian, Barbara J

    2008-01-01

    Rationale Impulsivity is a cardinal feature of attention deficit hyperactivity disorder (ADHD), which is thought to underlie many of the cognitive and behavioural symptoms associated with the disorder. Impairments on some measures of impulsivity have been shown to be responsive to pharmacotherapy. However, impulsivity is a multi-factorial construct and the degree to which different forms of impulsivity contribute to impairments in ADHD or respond to pharmacological treatments remains unclear....

  20. Should we continue methylphenidate treatment despite orofacial or extremity dyskinesias?

    selcen yaroglu kazanci

    2015-01-01

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD is the most common neuropsychiatric disease affecting 5.3% of school-aged children. Methylphenidate is the primary stimulant, which has been used widely more than 60 years to treat ADHD. In this paper 3 cases with orofacial and/or limb dyskinesia after methylphenidate administration are reported. In 2 of our patients, continuation of the methylphenidate treatment did not cause recurrent dyskinesia. We thought that despite dyskinetic side effects, in cases with normal IQ level, continuation of methylphenidate treatment may be safe and do not cause any recurrent dyskinetic movements. Despite dyskinesia, one more chance may be given to methylphenidate treatment.

  1. Methylphenidate off-label use and safety

    Trenque, Thierry; Herlem, Emmanuelle; Abou Taam, Malak; Drame, Moustapha

    2014-01-01

    Introduction Methylphenidate is a piperidine derivative structurally and pharmacologically similar to amphetamine. Methylphenidate is indicated for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 6 years of age and over when remedial measures alone prove insufficient. In adults, its indication, except in narcolepsy, is not defined. Methylphenidate received regulatory approval almost sixty years ago with a first registration in Switzerland in October 1954. Objective To evaluat...

  2. Preventative treatment in an animal model of ADHD: Behavioral and biochemical effects of methylphenidate and its interactions with ovarian hormones in female rats.

    Lukkes, Jodi L; Freund, Nadja; Thompson, Britta S; Meda, Shirisha; Andersen, Susan L

    2016-09-01

    Clinical and preclinical studies on attention deficit hyperactivity disorder (ADHD) show that juvenile males that are exposed to methylphenidate (MPH) show reduced risk for substance use later in life. In contrast, little is known about whether females have the same enduring treatment response to stimulants and how gonadal hormones influence their behavior later in life. Females received either a sham or 6-hydroxydopamine (6-OHDA) microinjection in the prefrontal cortex (PFC) at postnatal day (P)10. Subjects were then treated with Vehicle or MPH (2mg/kg, p.o.) between P20-35 and tested during late adolescence/young adulthood (P60); half of these subjects underwent ovariectomy at P55 to determine hormonal influences. Females with 6-OHDA were depleted of PFC dopamine by 61% and demonstrated increased impulsive choice (delayed discounting) and preferences for cocaine-associated environments relative to control females. Both MPH and ovariectomy reduced impulsive choice and cocaine preferences in 6-OHDA females, but had no enduring effect in Sham females. Ovariectomy itself did not significantly affect impulsivity. Juvenile MPH interacted strongly with 6-OHDA to increase D4, D5, Alpha-1A, Alpha-2A, and 5-HT-1A mRNA receptor expression in the PFC. MPH alone effected D1 mRNA, while 6-OHDA increased BDNF; all markers were decreased by ovariectomy. Together, these data suggest that 6-OHDA changes in dopamine are not only relevant for ADHD-like behaviors, but their long-term modulation by treatment and the influence of cyclical differences in menstrual cycle. PMID:27397110

  3. Should we continue methylphenidate treatment despite orofacial or extremity dyskinesias?

    selcen yaroglu kazanci; mahmut cem tarakcioglu; lida bulbul; neslihan ozkul saglam; sami hatipoglu

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common neuropsychiatric disease affecting 5.3% of school-aged children. Methylphenidate is the primary stimulant, which has been used widely more than 60 years to treat ADHD. In this paper 3 cases with orofacial and/or limb dyskinesia after methylphenidate administration are reported. In 2 of our patients, continuation of the methylphenidate treatment did not cause recurrent dyskinesia. We thought that despite dyskinetic side effects...

  4. ADHD

    ... been a problem. Schools can also play a part in helping students with ADHD. Most schools will develop a plan ... they head off to college or start a job. When the time comes for you to do this, you may ...

  5. Task-Related Default Mode Network Modulation and Inhibitory Control in ADHD: Effects of Motivation and Methylphenidate

    Liddle, Elizabeth B.; Hollis, Chris; Batty, Martin J.; Groom, Madeleine J.; Totman, John J.; Liotti, Mario; Scerif, Gaia; Liddle, Peter F.

    2011-01-01

    Background: Deficits characteristic of attention deficit/hyperactivity disorder (ADHD), including poor attention and inhibitory control, are at least partially alleviated by factors that increase engagement of attention, suggesting a hypodopaminergic reward deficit. Lapses of attention are associated with attenuated deactivation of the default…

  6. Methylphenidate-induced mania-like symptoms

    Kaustav Chakraborty

    2011-01-01

    Full Text Available Therapeutic dose of methylphenidate is known to cause adverse effects (psychosis or mania, albeit in a small number of cases. Signs and symptoms of adverse effects usually disappear on stopping the medicine. Data regarding the safety of methylphenidate in comorbid attention deficit hyperactivity disorder (ADHD and mental retardation are nonexistent. We describe a case of an 11-year-old girl with ADHD and mental retardation treated with methylphenidate, who developed mania like symptoms requiring inpatient treatment. The index case required psychopharmacological intervention with sodium valproate and olanzapine as the symptoms did not subside even after 3 days. This case highlights the fact that one has to exercise caution while prescribing methylphenidate in patients with comorbid ADHD and mental retardation.

  7. ADHD medication reduces cotinine levels and withdrawal in smokers with ADHD

    Gehricke, Jean-G.; Hong, Nuong; Wigal, Timothy L; Chan, Vivien; Doan, Ashley

    2011-01-01

    Individuals with ADHD may self-medicate with nicotine, the main psychoactive ingredient in tobacco smoke, in order to reduce symptoms and negative moods associated with ADHD. ADHD medication (e.g., methylphenidate, atomoxetine) may mimic some of the effects of nicotine and may aid smoking cessation in smokers with ADHD. The present study examined if ADHD medication reduces smoking and withdrawal in non-treatment seeking smokers with ADHD. Fifteen adult smokers with ADHD participated in the st...

  8. Objective versus Subjective Assessment of Methylphenidate Response

    Manor, Iris; Meidad, Sheera; Zalsman, Gil; Zemishlany, Zvi; Tyano, Sam; Weizman, Abraham

    2008-01-01

    Subjective improvement-assessment in attention deficit/hyperactivity disorder (ADHD), following a single dose of methylphenidate (MPH) was compared to performance on the Test-of-Variables-of-Attention (TOVA). Self-perception was assessed with the clinical-global-impression-of-change (CGI-C). Participants included 165 ADHD subjects (M:F ratio…

  9. Methylphenidate significantly improves driving performance of adults with attention-deficit hyperactivity disorder: a randomized crossover trial.

    Verster, J.C.; Bekker, E.M.; Roos, M.; Minova, A.; Eijken, E.J.; Kooij, J.J.; Buitelaar, J.K.; Kenemans, J.L.; Verbaten, M.N.; Olivier, B.; Volkerts, E.R.

    2008-01-01

    Although patients with attention-deficit hyperactivity disorder (ADHD) have reported improved driving performance on methylphenidate, limited evidence exists to support an effect of treatment on driving performance and some regions prohibit driving on methylphenidate. A randomized, crossover trial e

  10. Assessment of cardiovascular risks due to methylphenidate in six months of treatment in children with attention deficit and hyperactivity disorder

    mehmet emre ari; ibrahim ilker cetin; filiz ekici; abdullah kocabas; sancar eminoglu; esra guney; onder ozturk; gulser senses dinc; zeynep goker

    2014-01-01

    Objectives: Cardiovascular adverse effects can be seen rarely in patients receiving methylphenidate for attention deficit and hyperactivity disorder (ADHD). In this study, we planned to investigate the effects of methylphenidate on the cardiovascular system in ADHD patients. Methods: One hundred and forty-one patients, who were diagnosed with ADHD and started on methylphenidate treatment between May 2011 and May 2012, were investigated. A cardiologic evaluation was performed on all of the ...

  11. Methylphenidate Modifies the Motion of the Circadian Clock

    Antle, Michael C.; van Diepen, Hester C; Deboer, Tom; Pedram, Pardis; Pereira, Rob Rodrigues; Meijer, Johanna H.

    2012-01-01

    People with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, and these are frequently exacerbated by the methylphenidate they take to manage their ADHD symptoms. Many of the changes to sleep are consistent with a change in the underlying circadian clock. The present study was designed to determine if methylphenidate alone could alter properties of the circadian clock. Young male mice were examined in light–dark cycles and in constant darkness and recordings wer...

  12. Methylphenidate for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

    Storebø, Ole J; Simonsen, Erik; Gluud, Christian

    2016-01-01

    CLINICAL QUESTION: Is treatment with methylphenidate associated with benefits or harms for children and adolescents with attention-deficit/hyperactivity disorder (ADHD)? BOTTOM LINE: Methylphenidate is associated with improvement in ADHD symptoms, general behavior, and quality of life; however, due...... to the very low quality of the evidence, the magnitude of the associated improvement is uncertain. Methylphenidate was associated with an increased risk of nonserious adverse events. There are too few data to assess the association with serious adverse events....

  13. Bioequivalence of Sandoz methylphenidate osmotic-controlled release tablet with Concerta® (Janssen-Cilag)

    Schapperer, Elisabeth; Daumann, Heike; Lamouche, Stéphane; Thyroff-Friesinger, Ursula; Viel, François; Weitschies, Werner

    2015-01-01

    The aim was to assess the bioequivalence of Sandoz methylphenidate osmotic-controlled release (OCR) tablets (Sandoz [Methylphenidate[ MPH OCR) with Concerta®, a methylphenidate formulation indicated for the treatment of attention deficit/hyperactivity disorder (ADHD). Four open-label, randomized, single-dose, two-way crossover bioequivalence studies were conducted in healthy subjects: three fasting studies with 54-, 36- and 18-mg doses of methylphenidate, and one fed study with the 54-mg dose...

  14. Classics in Chemical Neuroscience: Methylphenidate.

    Wenthur, Cody J

    2016-08-17

    As the first drug to see widespread use for the treatment of attention deficit hyperactivity disorder (ADHD), methylphenidate was the forerunner and catalyst to the modern era of rapidly increasing diagnosis, treatment, and medication development for this condition. During its often controversial history, it has variously elucidated the importance of dopamine signaling in memory and attention, provoked concerns about pharmaceutical cognitive enhancement, driven innovation in controlled-release technologies and enantiospecific therapeutics, and stimulated debate about the impact of pharmaceutical sales techniques on the practice of medicine. In this Review, we will illustrate the history and importance of methylphenidate to ADHD treatment and neuroscience in general, as well as provide key information about its synthesis, structure-activity relationship, pharmacological activity, metabolism, manufacturing, FDA-approved indications, and adverse effects. PMID:27409720

  15. Commentary: RCT of Optimal Dose Methylphenidate in Children and Adolescents with Severe ADHD and ID--A Reply to Arnold (2013)

    Simonoff, Emily; Taylor, Eric; Baird, Gillian; Bernard, Sarah

    2013-01-01

    The commentary by Arnold (2013) raises a number of interesting issues and speculations about the action of methylphenidate in children with intellectual disability (ID) and associated neurodevelopmental disorders, such as autism spectrum disorders. In our article (Simonoff et al., 2013), we were careful to stick closely to the statistical analysis…

  16. Comparative efficacy of methylphenidate and atomoxetine in oppositional defiant disorder comorbid with attention deficit hyperactivity disorder

    Garg, Jasmin; Arun, Priti; Chavan, BS

    2015-01-01

    Background: Oppositional defiant disorder (ODD) is frequently comorbid with attention deficit hyperactivity disorder (ADHD) and is associated with substantial functional impairments. Methylphenidate and atomoxetine are well-established drugs for the management of ADHD. Some studies from Western countries have reported these drugs to be effective in the management of ODD comorbid with ADHD. This study aimed to assess if methylphenidate and atomoxetine are efficacious in treating Indian childre...

  17. Influence of Methylphenidate on Motor Performance and Attention in Children with Developmental Coordination Disorder and Attention Deficit Hyperactive Disorder

    Bart, Orit; Daniel, Liron; Dan, Orrie; Bar-Haim, Yair

    2013-01-01

    Individuals with attention deficit hyperactive disorder (ADHD) often have coexisting developmental coordination disorder (DCD). The positive therapeutic effect of methylphenidate on ADHD symptoms is well documented, but its effects on motor coordination are less studied. We assessed the influence of methylphenidate on motor performance in children…

  18. Buspirone versus Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder: A Double-Blind and Randomized Trial

    Davari-Ashtiani, Rozita; Shahrbabaki, Mahin Eslami; Razjouyan, Katayoon; Amini, Homayoun; Mazhabdar, Homa

    2010-01-01

    The efficacy and side effects of buspirone compared with methylphenidate (MPH) in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). A total of 34 children with ADHD as defined by DSM-IV-TR were randomized to buspirone or methylphenidate dosed on weight-adjusted basis at buspirone (0.5 mg/kg/day) and methylphenidate…

  19. Methylphenidate in the Treatment of Children and Adolescents with Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder

    Findling, Robert L.; Short, Elizabeth J.; McNamara, Nora K.; Demeter, Christine A.; Stansbrey, Robert J.; Gracious, Barbara L.; Whipkey, Resaca; Manos, Michael J.; Calabrese, Joseph R.

    2007-01-01

    The short-term efficacy of methylphenidate in the treatment of youths aged 5 to 17 years with bipolar disorder (BD) and comorbid attention deficit/hyperactivity disorder (ADHD) was investigated. The trial observation showed that euthymic youths with BD and ADHD might benefit from short-term concomitant treatment with methylphenidate.

  20. Methylphenidate alters selective attention by amplifying salience

    Huurne, N.; Fallon, S.J.; Schouwenburg, M. van; Schaaf, M.; Buitelaar, J.; Jensen, O.; Cools, R.

    2015-01-01

    RATIONALE: Methylphenidate, the most common treatment of attention deficit hyperactivity disorder (ADHD), is increasingly used by healthy individuals as a "smart drug" to enhance cognitive abilities like attention. A key feature of (selective) attention is the ability to ignore irrelevant but salien

  1. Questões atuais no tratamento farmacológico do TDAH em adultos com metilfenidato Actual issues in the pharmacological treatment of ADHD in adults with methylphenidate

    Mario R. Louzã

    2007-01-01

    Full Text Available O tratamento farmacológico do transtorno do déficit de atenção com hiperatividade (TDAH em adultos inclui o uso de psicoestimulantes, antidepressivos e atomoxetina, sendo o primeiro considerado a indicação de primeira escolha. A eficácia do metilfenidato foi demonstrada em adultos quando se empregavam doses maiores, proporcionalmente similares àquelas usadas em estudos em crianças. O perfil de eventos adversos do metilfenidato, incluindo aqueles relativos ao sistema cardiovascular, parece bastante seguro.Pharmacotherapy of attention-deficit/hyperactivity disorder in adulthood includes psychostimulants, antidepressants and atomoxetine, the first of them being considered the first choice. Methylphenidate efficacy has been demonstrated in adults when higher doses were used, in a proportionate similar way to what has been described in children. Methylphenidate profile of adverse events, including cardiovascular ones, seems to be safe.

  2. Effects of Methylphenidate and Bupropion on DHEA-S and Cortisol Plasma Levels in Attention-Deficit Hyperactivity Disorder

    Lee, Moon-Soo; Yang, Jae-Won; Ko, Young-Hoon; Han, Changsu; Kim, Seung-Hyun; Lee, Min-Soo; Joe, Sook-Haeng; Jung, In-Kwa

    2008-01-01

    We evaluated plasma levels of DHEA-S and cortisol before and after treating ADHD patients with one of two medications: methylphenidate (n = 12) or bupropion (n = 10). Boys with ADHD (combined type) were evaluated with the Korean ADHD rating scale (K-ARS) and the computerized ADHD diagnostic system (ADS). All assessments were measured at baseline…

  3. ADHD & Tourette Syndrome

    J Gordon Millichap

    2002-03-01

    Full Text Available The efficacy of methylphenidate (MPH and clonidine (CLON, alone and in combination, in 136 children with attention deficit hyperactivity disorder (ADHD and chronic tic disorder, was evaluated in a multicenter, randomized, double-blind clinical trial, and reported by the Tourette Syndrome Study Group from the University of Rochester, NY.

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

    Rajasree Nair

    2009-08-01

    Full Text Available Rajasree Nair, Shannon B MossBaylor Family Medicine Residency at Garland, Garland, Texas, USAAbstract: Attention-deficit hyperactivity disorder (ADHD is one of the most common psychiatric disorders in young adults and causes significant psychosocial impairment and economic burden to society. Because of the paucity of long-term evidence and lack of national guidelines for diagnosis and management of adult ADHD, most of the data are based on experience derived from management of childhood ADHD. This article reviews the current evidence for the diagnosis and management of adult ADHD with special emphasis on the role of methylphenidate hydrochloride preparations in its treatment. Methylphenidate hydrochloride, a stimulant that acts through the dopaminergic and adrenergic pathways, has shown more than 75% efficacy in controlling the symptoms of adult ADHD. Although concern for diversion of the drug exists, recent data have shown benefits in preventing substance use disorders in patients with adult ADHD.Keywords: adult ADHD, treatment, stimulants, methylphenidate hydrochloride

  5. Transdermal delivery: product and patent update.

    Gupta, Himanshu; Babu, R J

    2013-12-01

    Transdermal drug delivery is an attractive alternative to the oral and parenteral drug delivery. Drugs which are prone to first-pass metabolism can be delivered easily in small doses with sustained blood levels through this method. An update to available products along with a review of clinical trials and patents are discussed in this study. In this review, we have compiled 16 drugs, i.e. Buprenorphine, Clonidine, Estradiol, Fentanyl, Granisetron, Lidocaine, Methylphenidate, Nicotine, Nitroglycerin, Oxybutynin, Rivastigmine, Rotigotine, Scopolamine, Selegiline, Testosterone, Influenza virus vaccine (Microneedle) and covering about 22 marketed products on the transdermal system. We present instrumental information on them along with the compilation of current clinical trials on transdermal systems. We summarize the contents of patents granted in last 5 years under different pharmacological categories. This article serves, accordingly as a source of available information focused on transdermal drug delivery research. PMID:24025130

  6. Delta Plots in the Study of Individual Differences : New Tools Reveal Response Inhibition Deficits in AD-HD That Are Eliminated by Methylphenidate Treatment

    Ridderinkhof, K.R.; Scheres, A.P.J.; Oosterlaan, J.; Sergeant, J.A.

    2005-01-01

    The authors highlight the utility of distribution-analytical techniques in the study of individual differences and clinical disorders. Cognitive deficits associated with attention-deficit/hyperactivity disorder (AD/HD) were examined by using delta-plot analyses of performance data (reaction time and

  7. Delta Plots in the study of individual differences: New tools reveal response inhibition deficits in AD/HD That are eliminated by methylphenidate treatment

    K.R. Ridderinkhof; A. Scheres; J. Oosterlaan; J.A. Sergeant

    2005-01-01

    The authors highlight the utility of distribution-analytical techniques in the study of individual differences and clinical disorders. Cognitive deficits associated with attention-deficit/hyperactivity disorder (AD/HD) were examined by using delta-plot analyses of performance data (reaction time and

  8. Stimulant Treatment Reduces Lapses in Attention among Children with ADHD: The Effects of Methylphenidate on Intra-Individual Response Time Distributions

    Spencer, Sarah V.; Hawk, Larry W., Jr.; Richards, Jerry B.; Shiels, Keri; Pelham, William E., Jr.; Waxmonsky, James G.

    2009-01-01

    Recent research has suggested that intra-individual variability in reaction time (RT) distributions of children with ADHD is characterized by a particularly large rightward skew that may reflect lapses in attention. The purpose of the study was to provide the first randomized, placebo-controlled test of the effects of the stimulant methylphenidate…

  9. Persistent Behavioral Impairment Caused by Embryonic Methylphenidate Exposure in Zebrafish

    Levin, Edward D.; Sledge, Damiyon; Roach, Stephanie; Petro, Ann; Donerly, Susan; Linney, Elwood

    2011-01-01

    As more adults take the stimulant medication methylphenidate to treat attention deficit hyperactivity disorder (ADHD) residual type, the risk arises with regard to the potential risks of early developmental exposure if people taking the medication become pregnant. We studied the neurobehavioral effects of methylphenidate in zebrafish. Zebrafish offer cellular reporter systems, continuous visual access and molecular interventions such as morpholinos to help determine critical mechanisms underl...

  10. Methylphenidate Disrupts Social Play Behavior in Adolescent Rats

    Vanderschuren, Louk JMJ; Trezza, Viviana; Griffioen-Roose, Sanne; Schiepers, Olga JG; Van Leeuwen, Natascha; de Vries, Taco J.; Schoffelmeer, Anton NM

    2008-01-01

    Methylphenidate is the first-choice treatment for attention-deficit/hyperactivity disorder (ADHD), but its mechanism of action is incompletely understood. The cognitive effects of methylphenidate have been extensively studied, but little is known about its effects on spontaneous social behavior. During adolescence, rats display a characteristic, highly vigorous form of social behavior, termed social play behavior, which is of critical importance for social and cognitive development. We invest...

  11. Methylphenidate-induced dendritic spine formation and ΔFosB expression in nucleus accumbens

    Kim, Yong; Teylan, Merilee A.; Baron, Matthew; Sands, Adam; Nairn, Angus C.; Greengard, Paul

    2009-01-01

    Methylphenidate is the psychostimulant medication most commonly prescribed to treat attention deficit hyperactivity disorder (ADHD). Recent trends in the high usage of methylphenidate for both therapeutic and nontherapeutic purposes prompted us to investigate the long-term effects of exposure to the drug on neuronal adaptation. We compared the effects of chronic methylphenidate or cocaine (15 mg/kg, 14 days for both) exposure in mice on dendritic spine morphology and ΔFosB expression in mediu...

  12. Methylphenidate produces selective enhancement of declarative memory consolidation in healthy volunteers

    Linssen, A. M. W.; Vuurman, E.F.P.M.; Sambeth, A; Riedel, W. J.

    2011-01-01

    Rationale Methylphenidate inhibits the reuptake of dopamine and noradrenaline and is used to treat children with attention deficit hyperactivity disorder (ADHD). Besides reducing behavioral symptoms, it improves their cognitive function. There are also observations of methylphenidate-induced cognition enhancement in healthy adults, although studies in this area are relatively sparse. We assessed the possible memory-enhancing properties of methylphenidate. Objective In the current study, the p...

  13. Efficacy and safety of methylphenidate in 45 adults with attention-deficit/hyperactivity disorder. A randomized placebo-controlled double-blind cross-over trial.

    Kooij, J.J.; Burger, H.; Boonstra, A.M.; Linden, P.D. van der; Kalma, L.E.

    2004-01-01

    BACKGROUND: Data on the efficacy and safety of methylphenidate in adults with attention deficit/ hyperactivity disorder (ADHD) are lacking in Europe. This study was undertaken to report on the efficacy and safety of methylphenidate in an adult out-patient population with ADHD, and to compare results

  14. Aggressive, Prosocial, and Nonsocial Behavior in Hyperactive Boys: Dose Effects of Methylphenidate in Naturalistic Settings.

    Hinshaw, Stephen P.; And Others

    1989-01-01

    Evaluated impact of methylphenidate on social behavior in 25 boys with attention deficit-hyperactivity disorder (ADHD). Compared children given placebo, low, and moderate dosages of methylphenidate and 15 boys without problems in attention and behavior during naturalistic summer research program. Medication decreased noncompliance and physical and…

  15. Brief Report: Response to Methylphenidate in Two Children with William Syndrome.

    Power, Thomas J.; And Others

    1997-01-01

    This study explored the use of methylphenidate with two boys (ages 7 and 8 years) with Williams syndrome, a genetic disorder frequently accompanied by symptoms associated with Attention Deficit Hyperactivity Disorder (ADHD). Both boys performed optimally on 10 mg of methylphenidate administered twice daily, although one displayed increased…

  16. LETTER TO THE EDITOR - COMMENTS ON CYTOGENETIC EFFECTS IN CHILDREN TREATED WITH METHYLPHENIDATE

    The recent report by El-Zein et al. suggests that chromosome alterations may be a consequence of short-term methylphenidate use for the treatment of children with Attention Deficit Hyperactivity Disorder (ADHD). The report concludes that 3 months of treatment with methylphenidate...

  17. Risperidone Versus Methylphenidate in Treatment of Preschool Children With Attention-Deficit Hyperactivity Disorder

    Arabgol, Fariba; Panaghi, Leily; Nikzad, Vahid

    2015-01-01

    Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis among preschool children. Objectives: The aim of this study was to examine the Risperidone treatment compared to Methylphenidate (MPH) in preschool children with ADHD. Patients and Methods: Thirty three outpatient preschool children, aged 3-6 years, diagnosed with ADHD (The diagnosis of ADHD was established by two child and adolescent psychiatrists according to the DSM-IV-TR criteria), participated i...

  18. Selective effects of methylphenidate in attention deficit hyperactivity disorder: A functional magnetic resonance study

    Vaidya, Chandan J.; Austin, Glenn; Kirkorian, Gary; Ridlehuber, Hugh W.; Desmond, John E.; Glover, Gary H.; Gabrieli, John D. E.

    1998-01-01

    Functional MRI revealed differences between children with Attention Deficit Hyperactivity Disorder (ADHD) and healthy controls in their frontal–striatal function and its modulation by methylphenidate during response inhibition. Children performed two go/no-go tasks with and without drug. ADHD children had impaired inhibitory control on both tasks. Off-drug frontal–striatal activation during response inhibition differed between ADHD and healthy children: ADHD children had greater frontal activ...

  19. Methylphenidate induction of complex visual hallucinations.

    Halevy, Ayelet; Shuper, Avinoam

    2009-08-01

    A 15-year-old boy with attention-deficit hyperactivity disorder (ADHD) presented with complex visual hallucinations of rats running around and touching and smelling him soon after receiving a first low dose of methylphenidate. The hallucinations resolved upon discontinuation of the drug. Reintroduction of the drug 7 years later at an even lower dose had the same effect. Other cases of vivid complex hallucinations of living creatures associated with methylphenidate have been reported in the literature. The pathogenetic mechanism is still unknown. In our case, the occurrence of hallucinations after a very low dose of the drug on 2 occasions may suggest an idiosyncratic reaction. The phenomenon might also be explained by a drug-induced dysfunction of the monoamine transmitters. Given the wide use of methylphenidate, clinicians should be aware of this possible side effect. PMID:19502578

  20. [Efficacy and safety of stimulants and non-stimulants in adults with attention deficit hyperactivity disorder (ADHD)].

    Golubchik, Pavel; Sever, Jonatan; Weizman, Abraham

    2011-10-01

    Attention deficit hyperactivity disorder (ADHD) often persists into adulthood. Stimulants, including methylphenidate, as well as non-stimulants, have shown efficacy in treating adult ADHD. Comparative, double blind, placebo controlled studies, in adults with ADHD, demonstrate good efficacy and safety profile. Methylphenidate was found to be tolerable and safe in short term treatment when given in its immediate release and long-acting preparations to adults with ADHD. Methylphenidate treatment is recommended in cases when ADHD diagnosis was confirmed. Follow-up is required with special attention to possible cardiovascular, psychiatric and abusive side effects. PMID:22111124

  1. Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents

    Storebø, Ole Jakob; Krogh, Helle B; Ramstad, Erica;

    2015-01-01

    with placebo or no intervention in children and adolescents with ADHD. Meta-analyses and trial sequential analyses (TSA) were conducted. Quality was assessed using GRADE. Teachers, parents, and observers rated ADHD symptoms and general behaviour. STUDY ANSWER AND LIMITATIONS: The analyses included 38......STUDY QUESTION: Is methylphenidate beneficial or harmful for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents? METHODS: Electronic databases were searched up to February 2015 for parallel and crossover randomised clinical trials comparing methylphenidate...... considered high risk of bias trials according to the Cochrane guidelines. All outcomes were assessed very low quality according to GRADE. WHAT THIS STUDY ADDS: The results suggest that among children and adolescents with a diagnosis of ADHD, methylphenidate may improve teacher reported symptoms of ADHD and...

  2. ADHD Meds May Pose Heart Risks for Some Kids

    ... ADHD Meds May Pose Heart Risks for Some Kids Study found slightly higher chance of irregular heartbeat ... when putting a child on methylphenidate, Pratt added. Kids with existing congenital heart disease are most affected ...

  3. Does Methylphenidate Affect Cystometric Parameters in Spontaneously Hypertensive Rats?

    Kim, Khae Hawn; Jung, Ha Bum; Choi, Don Kyoung; Park, Geun Ho; Cho, Sung Tae

    2015-01-01

    Purpose: Methylphenidate (MPH) is one of the most commonly prescribed psychostimulants for attention deficit hyperactivity disorder (ADHD). However, there is limited research on its effects on lower urinary tract function. This study investigated changes in cystometric parameters after intragastric administration of MPH in conscious spontaneously hypertensive rats (SHRs), an animal model of ADHD. Methods: Fourteen- to 16-week-old male SHRs (n=10), weighing between 280 and 315 g, were used. Th...

  4. Nucleus accumbens lesions modulate the effects of Methylphenidate

    Podet, Adam; Lee, Min J.; Swann, Alan C.; Dafny, Nachum

    2010-01-01

    The psychostimulant methylphenidate (MPD, Ritalin) is the prescribed drug of choice for treatment of ADHD. In recent years, the diagnosis rate of ADHD has increased dramatically, as have the number of MPD prescriptions. Repeated exposure to psychostimulants produces behavioral sensitization in rats, an experimental indicator of a drug’s potential liability. In studies on cocaine and amphetamine, this effect has been reported to involve the nucleus accumbens (NAc), one of the nuclei belonging ...

  5. ADHD in Substance Use Disorders : Prevalence and Pharmacotherapy

    Konstenius, Maija

    2013-01-01

    Substance use disorders (SUD) and Attention deficit /hyperactivity disorder (ADHD) are persistent and prevailing disorders that conjointly are associated with negative lifeevents and mental distress. The overall aim of this thesis was to examine the rate of ADHD in substance using populations and to investigate the feasibility and efficacy of methylphenidate pharmacotherapy for treatment of co-existing ADHD and SUD. The prevalence of ADHD was investigated in Studies I and II...

  6. Adolescence methylphenidate treatment in a rodent model of attention deficit/hyperactivity disorder: Dopamine transporter function and cellular distribution in adulthood

    Somkuwar, Sucharita S.; Darna, Mahesh; Kantak, Kathleen M.; Dwoskin, Linda P.

    2013-01-01

    Attention deficit/hyperactivity disorder (ADHD) is attributed to dysfunction of the prefrontal cortex. Methylphenidate, an inhibitor of dopamine and norepinephrine transporters (DAT and NET, respectively), is a standard treatment for ADHD. The Spontaneously Hypertensive Rat (SHR) is a well-established animal model of ADHD. Our previous results showed that methylphenidate treatment in adolescent SHR enhanced cocaine self-administration during adulthood, and alterations in DAT function in prefr...

  7. Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents

    Storebø, Ole Jakob; Krogh, Helle B; Ramstad, Erica;

    2015-01-01

    STUDY QUESTION: Is methylphenidate beneficial or harmful for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents? METHODS: Electronic databases were searched up to February 2015 for parallel and crossover randomised clinical trials comparing methylphenidate...... parallel group trials (n=5111, median treatment duration 49 days) and 147 crossover trials (n=7134, 14 days). The average age across all studies was 9.7 years. The analysis suggested a beneficial effect of methylphenidate on teacher rated symptoms in 19 parallel group trials (standardised mean difference...... (SMD) -0.77, n=1698), corresponding to a mean difference of -9.6 points on the ADHD rating scale. There was no evidence that methylphenidate was associated with an increase in serious adverse events (risk ratio 0.98, nine trials, n=1532; TSA adjusted intervention effect RR 0.91). Methylphenidate was...

  8. Assessment of daily profiles of ADHD and ODD symptoms, and symptomatology related to ADHD medication, by parent and teacher ratings

    Breuer, Dieter; Görtz-Dorten, Anja; Rothenberger, Aribert; Döpfner, Manfred

    2011-01-01

    DAYAS is a new two-part rating scale that assesses: (1) ADHD and ODD symptoms (externalising symptom ratings) and (2) symptomatology potentially related to ADHD medication (potentially medication-related symptoms) in real-world settings at different time periods throughout a normal school day. Data from a proof-of-concept study and two observational trials (Medikinet® retard [methylphenidate] and the Equasym XL® [methylphenidate] OBSEER study) evaluated: (1) validity of weekly externalising s...

  9. Methylphenidate modifies the motion of the circadian clock.

    Antle, Michael C; van Diepen, Hester C; Deboer, Tom; Pedram, Pardis; Pereira, Rob Rodrigues; Meijer, Johanna H

    2012-10-01

    People with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, and these are frequently exacerbated by the methylphenidate they take to manage their ADHD symptoms. Many of the changes to sleep are consistent with a change in the underlying circadian clock. The present study was designed to determine if methylphenidate alone could alter properties of the circadian clock. Young male mice were examined in light-dark cycles and in constant darkness and recordings were performed on behavioral activity, sleep, and electrical activity in the suprachiasmatic nucleus (SCN) of freely moving mice. Methylphenidate in the drinking water (0.08%) significantly increased activity in the mid-to-late night, and led to a delay in the onset of activity and sleep relative to the light-dark cycle. While locomotor levels returned to baseline after treatment ended, the phase angle of entrainment required at least a week to return to baseline levels. In constant darkness, the free-running period of both wheel-running and general locomotor rhythms was lengthened by methylphenidate. When the treatment ended, the free-running period either remained stable or only partially reverted to baseline levels. Methylphenidate also altered the electrical firing rate rhythms in the SCN. It induced a delay in the trough of the rhythm, an increment in rhythm amplitude, and a reduction in rhythm variability. These observations suggest that methylphenidate alters the underlying circadian clock. The observed changes are consistent with clock alterations that would promote sleep-onset insomnia. PMID:22763623

  10. A Parent Guide To Understanding the Effects of Ritalin (Methylphenidate Hydrochloride).

    Villegas, Orlando; And Others

    This guide provides information to help parents decide whether their child with attention deficit hyperactivity disorder (ADHD) should take methylphenidate hydrochloride (Ritalin). Information is provided in a question-and-answer format on various concerns, including: the meaning of ADHD, whether Ritalin is overprescribed, when this medication is…

  11. A Candidate Gene Analysis of Methylphenidate Response in Attention-Deficit/Hyperactivity Disorder

    McGough, James J.; McCracken, James T.; Loo, Sandra K.; Manganiello, Marc; Leung, Michael C.; Tietjens, Jeremy R.; Trinh, Thao; Baweja, Shilpa; Suddath, Robert; Smalley, Susan L.; Hellemann, Gerhard; Sugar, Catherine A.

    2009-01-01

    Objective: This study examines the potential role of candidate genes in moderating treatment effects of methylphenidate (MPH) in attention-deficit/hyperactivity disorder (ADHD). Method: Eighty-two subjects with ADHD aged 6 to 17 years participated in a prospective, double-blind, placebo-controlled, multiple-dose, crossover titration trial of…

  12. Epilepsy and attention deficit hyperactivity disorder : Is methylphenidate safe and effective?

    GrossTsur, [No Value; vanderMeere, J; Joseph, A; Shalev, RS

    1997-01-01

    Objective: To study the safety and efficacy of methylphenidate in children with the dual diagnosis of epilepsy and attention deficit hyperactivity disorder (ADHD). Study design: Thirty children, aged 6.4 to 16.4 years, with epilepsy and ADHD were studied during a 4-month period. During the initial 2

  13. Epilepsy and attention deficit hyperactivity disorder : Is methylphenidate safe and effective? (vol 130, pg 40, 1997)

    GrossTsur, [No Value; Manor, O; VanderMeere, J; Joseph, A; Shalev, RS

    1997-01-01

    Objective: To study the safety and efficacy of methylphenidate in children with the dual diagnosis of epilepsy and attention deficit hyperactivity disorder (ADHD). Study design: Thirty children, aged 6.4 to 16.4 years, with epilepsy and ADHD were studied during a 4-month period. During the initial 2

  14. Differential Effects of Methylphenidate on Attentional Functions in Children with Attention-Deficit-Hyperactivity Disorder

    Konrad, Kerstin; Gunther, Thomas; Hanisch, Charlotte; Herpertz-Dahlmann, Beate

    2004-01-01

    Objective: To examine the effects of methylphenidate on different attentional functions and behavior in children with attention-deficit-hyperactivity disorder (ADHD). Method: A total of 60 ADHD children aged between 8 and 12 years completed a randomized, double-blind, placebo-controlled, within-subject crossover trial with two doses of…

  15. Adverse reactions of Methylphenidate in children with attention deficit-hyperactivity disorder: Report from a referral center

    Khajehpiri, Zahra; Mahmoudi-Gharaei, Javad; Faghihi, Toktam; Karimzadeh, Iman; Khalili, Hossein; Mohammadi, Mostafa

    2014-01-01

    Objective: The aim of the current study was to determine various aspects of methylphenidate adverse reactions in children with attention deficit-hyperactivity disorder (ADHD) in Iran. Methods: During the 6 months period, all children under methylphenidate treatment alone or along with other agents attending a university-affiliated psychology clinic were screened regarding all subjective and objective adverse drug reactions (ADRs) of methylphenidate. Causality and seriousness of detected ADRs ...

  16. Plasma and brain concentrations of oral therapeutic doses of methylphenidate and their impact on brain monoamine content in mice

    Balcioglu, Aygul; Ren, Jia-Qian; McCarthy, Deirdre; Spencer, Thomas J.; Biederman, Joseph; Bhide, Pradeep G

    2009-01-01

    Methylphenidate is a frequently prescribed stimulant for the treatment of attention deficit hyperactivity disorder (ADHD). An important assumption in the animal models that have been employed to study methylphenidate’s effects on the brain and behavior is that bioavailability of methylphenidate in the animal models reflects that in human subjects. From this perspective, the dose and route of administration of methylphenidate assume critical importance because both these factors likely influen...

  17. Priapism Associated with MethylphenidateSR (Concerta Withdrawal

    J Gordon Millichap

    2004-07-01

    Full Text Available A 15-year-old boy with attention deficit hyperactivity disorder, inattention subtype (ADHD, developed stuttering priapism (intermittent, prolonged, painful erections after withdrawal of OROS methylphenidate (ConcertaR 36 mg/day, and is reported from Inova Fairfax Hospital for Children, Falls Church, VA, and Children’s National Medical Center, Washington, DC.

  18. The Influences of Methylphenidate and Tomoxetine on the Function of HPA in Children with ADHD%哌甲酯及托莫西汀对注意缺陷多动障碍儿童HPA轴功能的影响

    陈燕惠; 陈辉; 刘艳艳; 林桂秀; 韦立新; 洪艳玲

    2011-01-01

    目的:通过研究哌甲酯(MPH)及托莫西汀(ATX)治疗前后注意缺陷多动障碍(ADHD)儿童下丘脑-垂体-肾上腺(HPA)轴的功能状态,探讨HPA轴在ADHD中的作用.方法:采用前瞻、双盲、随机对照研究方法,根据美国(第4版)(DSM-IV)ADHD诊断和分型标准确诊111例6~14岁ADHD男童,其中注意缺陷为主型(ADHD-I)33例,多动-冲动为主型(ADHD-HI)30例,混合型(ADHD-C)48例,对照组为年龄匹配健康男童35名.31例ADHD儿童随机给予MPH治疗和ATX治疗,于治疗前和治疗后1个月进行皮质醇测定.血浆皮质醇测定采用全自动微粒酶免疫分析法,于上午8:00空腹抽血测定.结果:ADHD各组血浆皮质醇水平[(236.12±109.77)nmol/L)均较对照组[(353.32±112.75)nmol/L)明显降低(P<0.01).ADHD-HI组[(177.62±62.99)nmol/L )]下降程度较ADHD-I组[(246.71±129.27)nmol/L,P<0.05]及ADHD-C组[(265.41±106.00)nmol/L,P<0.01]为著.31例ADHD男童,治疗后皮质醇浓度(249.84±87.86)nmol/L高于治疗前的(164.94±48.98)nmol/L(P<0.001),而治疗后符合DSM-IV的症状数中位数(M/QR)为10/3分,低于治疗前的12/4分(P<0.01).结论:在非应激状态下,ADHD儿童存在着HPA轴调节功能障碍,这可能系HPA轴低反应性所致.哌甲酯和托莫西汀均能提高ADHD患儿的皮质醇水平,皮质醇的提高与行为的改善密切相关.%Objective:To explore the relationship between hypothalanns-pituitary-adrenal (HPA) and ADHD. The function of HPA axis in children with ADHD has been investigated before and after the treatment of methylphenidate (MPH) and atomoxetine ( ATX).Methods: The clinical study was a prospective, double-blind, randomized case-control trail. One hundred and eleven male children with ADHD between the ages of 6 to 14 years old were included in this study. The diagnosis of ADHD and its tiree subtypes were according to the handbook for the diagnosis and treatment of ADHD by American Psychiatric Association ( DSM-iV). Among all the cases there were 33

  19. Melatonin Effects in Methylphenidate Treated Children with Attention Deficit Hyperactivity Disorder: A Randomized Double Blind Clinical Trial

    Mohammad Reza Mohammadi; Seyed Ali Mostafavi; Seyed Ali Keshavarz; Mohammad Reza Eshraghian; Payam Hosseinzadeh; Mohammad.Javad Hosseinzadeh-Attar; Maryam Chamari,; Shahin Akhondzadeh

    2012-01-01

    Objective: The aim of this study was to determine melatonin effects on sleep patterns, symptoms of hyperactivity and attention deficiency in children with attention-deficit hyperactivity disorder (ADHD).Methods: Children with age range of 7-12 years who had a combined form of ADHD were randomly divided in to 2 groups according to gender blocks. One group took melatonin (3 or 6mg) combined with methylphenidate (Ritalin) (1mg/kg), and the other group took placebo combined with methylphenidate (...

  20. Melatonin Effects in Methylphenidate Treated Children with Attention Deficit Hyperactivity Disorder: A Randomized Double Blind Clinical Trial

    Mohammadi, Mohammad Reza; Mostafavi, Seyed Ali; Keshavarz, Seyed Ali; Eshraghian, Mohammad Reza; Hosseinzadeh, Payam; Hosseinzadeh-Attar, Mohammad Javad; Kooshesh, Seyed Mohammad Ali; Chamari, Maryam; Shahin AKHONDZADEH

    2012-01-01

    Objective The aim of this study was to determine melatonin effects on sleep patterns, symptoms of hyperactivity and attention deficiency in children with attention-deficit hyperactivity disorder (ADHD). Methods Children with age range of 7-12 years who had a combined form of ADHD were randomly divided in to 2 groups according to gender blocks. One group took melatonin (3 or 6mg) combined with methylphenidate (Ritalin) (1mg/kg), and the other group took placebo combined with methylphenidate (1...

  1. Differences in methylphenidate abuse rates among methadone maintenance treatment patients in two clinics.

    Peles, Einat; Schreiber, Shaul; Linzy, Shirley; Domani, Yoav; Adelson, Miriam

    2015-07-01

    Methylphenidate, an amphetamine-like prescription medication for attention deficit hyperactivity disorder (ADHD) was suspected as being abused among methadone maintenance treatment (MMT) patients. We tested its presence in the routine urine monitoring of all patients in both Tel Aviv and Las Vegas MMT clinics. Data on demographic and addiction history, ADHD (Wender Utah Rating Scale), cognitive impairment (Mini Mental State Exam), and lifetime DSM-IV-TR psychiatric diagnosis from admission were retrieved, and retention following 6 months. None of the 190 patients in Las Vegas tested positive for methylphenidate, while 14.7% (45/306) did in Tel Aviv. Abusers were less educated (p = 0.01), had higher ADHD scores (p = 0.02), lower cognitive scores (p = 0.05), and a higher benzodiazepine (BDZ) abuse rate (p cannabis, opiates, and cocaine abuse and infectious disease. Of the methylphenidate abuse 42.2% have take-home methadone dose privileges. Not like opiate use, being methylphenidate positive did not relate to 6-months retention. Compared to Tel Aviv, Las Vegas patients were more educated, with lower BDZ, and cocaine abuse. The greater abuse of methylphenidate among ADHD subjects might indicate their using it as self-medication, raising a possible indication for its prescription for that subgroup of MMT patients. The high rate of methylphenidate abuse in Israel needs future study. PMID:25605438

  2. Transdermal selegiline.

    Patkar, Ashwin A; Pae, Chi-Un; Zarzar, Michael

    2007-06-01

    Although older monoamine oxidase inhibitors (MAOIs) are effective in the treatment of depressive disorders, they are underutilized in clinical practice due to main concerns about interaction with tyramine-containing food, and side effects. Efforts to address these safety issues led to the development of a transdermal formulation of selegiline, called selegiline transdermal system (STS). STS has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of major depression. Transdermal administration of selegiline bypasses gastrointestinal absorption and first-pass metabolism. Therefore, STS permits inhibition of monoamine oxidase (MAO)-A and MAO-B enzymes in the brain while preserving the activity of MAO-A in the gastrointestinal system, thereby minimizing the risk of possible interactions with tyramine-rich foods. Tyramine challenge tests have confirmed that dietary modifications are not required with the 6 mg STS. The FDA has required dietary modifications with the 9 mg and 12 mg STS. Compared to oral administration, transdermal selegiline leads to sustained (minimal peak-trough fluctuations) plasma concentrations of the parent compound, increasing the amount of drug delivered to the brain. The efficacy of STS has been established in several short-term and one long-term randomized controlled trials. In clinical trials, application site reactions and insomnia were observed more frequently with STS than placebo. Rates of orthostatic hypotension, sexual dysfunction and weight gain were comparable between STS and placebo. STS is a new generation of MAOI with superior safety profile to older MAOIs. It increases the pharmacological options available to treat depressive disorders and may benefit patients with major depression with atypical features and resistant depression. It is important for health-care professionals to be informed about the properties of STS. PMID:17612708

  3. FACTORS INFLUENCING THE MANAGEMENT OF ADHD

    S ARMAN

    2003-03-01

    Full Text Available Introduction: Attention deficit hyperactivity disorder (ADHDis the most common psychiatric disorder among school age children. It consists of hyperactivity, inattention and impulsive behavior. The onset of the disorder is before the age of 7 years and it happens at least in two situations. It causes significant impairment in social and academic functioning. A determination of factors that influences the therapeutic response in ADHD is the aim of this study. Methods: This study is designed as an analytic descriptive on hyperactive children. The tools that were used was the interview with parents and it provided CSI-4 checklist. Results: Methylphenidate was completely effective in ADHD and oppositional defiant disorder and was effective in majority sign of conduct disorder. There wasn't any relation between therapeutic response and demographic characteristics. Discussion: Methylphenidate is effective not only in ADHD but also in mixed ADHD and disruptive behavior.

  4. Switching from Methylphenidate-Immediate Release (MPH-IR) to Methylphenidate-OROS (OROS-MPH): A Multi-center, Open-label Study in Korea

    Kim, Bung-Nyun; Kim, Ye-Ni; Cheong, Un-Sun; Kim, Jae-Won; Hwang, Jun-Won; Shin, Min-Sup; Cho, Soo-Churl; ,

    2011-01-01

    Objective The objective of this study was to evaluate the efficacy and safety of methylphenidate HCL OROS extended-release (OROS-MPH) among children with attention deficit hyperactivity disorder (ADHD) who had been previously treated with methylphenidate HCL immediate-release (MPH-IR). Methods The sample included 102 children aged 6-12 (9.4±2.6) years who had been diagnosed with ADHD according the criteria of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; Am...

  5. Psychosis induced by the interaction between disulfiram and methylphenidate may be dose dependent.

    Grau-López, Lara; Roncero, Carlos; Navarro, Maria C; Casas, Miquel

    2012-01-01

    There are few studies describing psychiatric symptoms occurring when methylphenidate and disulfiram are used together. The authors report a case of disulfiram and methylphenidate interaction in which psychotic symptoms could be dose dependent. The patient, diagnosed of alcohol and cocaine dependence and attention deficit hyperactivity disorder (ADHD), started treatment with methylphenidate increasing doses and disulfiram 250 mg/day over 4 weeks. During the first 2 weeks at doses of 36 mg/day of methylphenidate and maintaining disulfiram, side effects were not observed. However, by increasing to 54 mg/day, psychotic symptoms were detected. The authors reported that the effects are dose dependent. This is the first report about dose-dependent side effects in substance use disorder with ADHD. PMID:22489591

  6. 托莫西汀对哌甲酯治疗无效的注意缺陷多动障碍患儿的疗效和安全性分析%Efficacy and Safety of Tomoxetine on ADHD Children That Underwent Ineffective Treatment with Methylphenidate

    王勇; 顾教伟; 王大斌

    2011-01-01

    目的:研究托莫西汀对哌甲酯治疗无效的注意缺陷多动障碍(ADHD)患儿的疗效和安全性.方法:对39例经哌甲酯治疗3~6个月无效的ADHD患儿给予托莫西汀治疗8周,分别于第4周和第8周采用Conners父母症状问卷评分评估其疗效和安全性.结果:托莫西汀治疗4周后,26例患儿症状得到缓解;8周后,28例患儿有效;Conners父母症状问卷评分品行、学习、心身障碍、冲动-多动、焦虑因子和多动指数均较治疗前明显降低(P<0.05).结论:托莫西汀可用于哌甲酯治疗无效的ADHD患儿,其不良反应轻微,可耐受.%Objective To evaluate the clinical efficacy and safety of tomoxetine on childhood attention deficit hyperactivity disorder(ADHA) in children with ineffective treatment by methylphenidate. Methods Tomoxetine was administrated for 8 weeks in 39 patients with ADHA unresponsive to 3 to 6 months treatment of methylphenidate. Conner's parents symptom questionnaire ( PSQ) was employed to evaluate the efficacy and safety of tomoxetine at 4 and 8 weeks. Results The clinical symptom was relieved in 26 patients with 4-week treatment of tomoxetine and in 28 patients with 8-week treatment. The scores in the subscales of Conner's PSQ were reduced significantly after treatment(P < 0. 05) ,including behavior scale, learning problem, psychosomatic problems, opposition-hyperactivity, anxious factor and hyperactivity scale. Conclusion Tomoxetine could be effectively and well tolerated used for treatment of childhood ADHD unresponsive to methylphenidate.

  7. Comparative Efficacy of Iranian and Foreign Methylphenidate in Children with Attention Deficit Hyperactive Disorder

    M Karahmadi; H Esmaili

    2008-01-01

    ABSTRACT: Introduction & Objective: Methylphenidate is one of the basic drugs in treating ADHD. According to many clinical studies, the foreign form of methylphenidate (ritalin) is more efficient than the Iranian form of the drug (stimidate). This study aimed to compare the efficacy of stimidate and Ritalin in the treatment of attention deficit hyperactive disorder. Materials & Methods: In this double blind, randomized clinical trial, 200 children with attention deficit hyperactive d...

  8. ADHD Medications

    ... How Can I Help a Friend Who Cuts? ADHD Medicines KidsHealth > For Teens > ADHD Medicines Print A ... Medicación para el tratamiento del TDAH (ADHD) Managing ADHD With Medicine Just about everyone has trouble concentrating ...

  9. Atomoxetine Open-Label Trial in ADHD

    J Gordon Millichap

    2002-07-01

    Full Text Available Atomoxetine (originally named tomoxetine, a new therapy for attention deficit hyperactivity disorder (ADHD marketed by Eli Lilly, was compared to methylphenidate in a prospective, randomized, open-label study for 10 weeks duration, at the University of Nebraska Medical Center, Massachusetts General Hospital, Mount Sinai Medical Center, Carolinas Medical Center, and Lilly Research Laboratories.

  10. Methylphenidate-Elicited Dopamine Increases in Ventral Striatum Are Associated with Long-Term Symptom Improvement in Adults with Attention Deficit Hyperactivity Disorder

    Volkow, Nora D.; Wang, Gene-Jack; Tomasi, Dardo; Kollins, Scott H.; Wigal, Tim L.; Newcorn, Jeffrey H.; Telang, Frank W.; Fowler, Joanna S.; Logan, Jean; Wong, Christopher T.; Swanson, James M.

    2012-01-01

    Stimulant medications, such as methylphenidate, which are effective treatments for attention deficit hyperactivity disorder (ADHD), enhance brain dopamine signaling. However, the relationship between regional brain dopamine enhancement and treatment response has not been evaluated. Here, we assessed whether the dopamine increases elicited by methylphenidate are associated with long-term clinical response. We used a prospective design to study 20 treatment-naive adults with ADHD who were evalu...

  11. Methylphenidate treatment of attention deficit hyperactivity disorder in young people with learning disability and difficult-to-treat epilepsy: Evidence of clinical benefit

    Fosi, T.; Lax-Pericall, M. T.; Scott, R C; Neville, B.G.; Aylett, S. E.

    2013-01-01

    Purpose To establish the efficacy and safety of methylphenidate (MPH) treatment for attention deficit hyperactivity disorder (ADHD) in a group of children and young people with learning disability and severe epilepsy. Methods This retrospective study systematically reviewed the case notes of all patients treated with methylphenidate (MPH) for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) ADHD at a specialist epilepsy center between 1998 and 2005. Treatment eff...

  12. Methylphenidate use in children with attention deficit hyperactivity disorder

    Felipe Salles Neves Machado

    2015-01-01

    Full Text Available A Brazilian Health Technology Assessment Bulletin (BRATS article regarding scientific evidence of the efficacy and safety of methylphenidate for treating attention deficit hyperactivity disorder (ADHD has caused much controversy about its methods. Considering the relevance of BRATS for public health in Brazil, we critically reviewed this article by remaking the BRATS search and discussing its methods and results. Two questions were answered: did BRATS include all references available in the literature? Do the conclusions reflect the reviewed articles? The results indicate that BRATS did not include all the references from the literature on this subject and also that the proposed conclusions are different from the results of the articles chosen by the BRATS authors themselves. The articles selected by the BRATS authors showed that using methylphenidate is safe and effective. However, the BRATS final conclusion does not reflect the aforementioned and should not be used to support decisions on the use of methylphenidate.

  13. Comparison of Therapeutic Effects of Omega-3 and Methylphenidate (Ritalin®) in Treating Children With Attention Deficit Hyperactivity Disorder

    Dashti, Naser; Hekmat, Hoda; Soltani, Hamid Reza; Rahimdel, Abolghasem; Javaherchian, Mohammad

    2014-01-01

    Objective: Attention deficit hyperactivity disorder (ADHD) is a fixed pattern of disregard and hyperactivity that is much more severe than what is normal in children of the same age. Multiple drugs are used for the treatment of children with ADHD; however, their side effects and efficacy are not clearly known. This study was designed to evaluate and compare the therapeutic effects of two drugs, that is, omega-3 and methylphenidate hydrochloride (Ritalin®), used to treat patients with ADHD. Me...

  14. Cost-Effectiveness of Extended-Release Methylphenidate in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder Sub-Optimally Treated with Immediate Release Methylphenidate

    van der Schans, Jurjen; Kotsopoulos, Niko; Hoekstra, Pieter J.; Hak, Eelko; Postma, Maarten J.

    2015-01-01

    BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common psychiatric disorder in children and adolescents. Immediate-release methylphenidate (IR-MPH) is the medical treatment of first choice. The necessity to use several IR-MPH tablets per day and associated potential social stigma at

  15. Methylphenidate Enhances NMDA-Receptor Response in Medial Prefrontal Cortex via Sigma-1 Receptor: A Novel Mechanism for Methylphenidate Action

    Zhang, Chun-lei; Feng, Ze-Jun; Liu, Yue; Ji, Xiao-Hua; Peng, Ji-Yun; Zhang, Xue-Han; Zhen, Xue-chu; Li, Bao-Ming

    2012-01-01

    Methylphenidate (MPH), commercially called Ritalin or Concerta, has been widely used as a drug for Attention Deficit Hyperactivity Disorder (ADHD). Noteworthily, growing numbers of young people using prescribed MPH improperly for pleasurable enhancement, take high risk of addiction. Thus, understanding the mechanism underlying high level of MPH action in the brain becomes an important goal nowadays. As a blocker of catecholamine transporters, its therapeutic effect is explained as being due t...

  16. The effect of methylphenidate on oppositional defiant disorder comorbid with attention deficit/hyperactivity disorder O efeito do metilfenidato sobre o transtorno opositivo-desafiador comórbido com transtorno do déficit de atenção e hiperatividade

    Maria Antonia Serra-Pinheiro; Paulo Mattos; Isabella de Souza; Giuseppe Pastura; Fernanda Gomes

    2004-01-01

    OBJECTIVE: To assess the effect of methylphenidate on the diagnosis of oppositional-defiant disorder (ODD) comorbid with attention-deficit hyperactivity disorder (ADHD). METHOD: We conducted an open-label study in which 10 children and adolescents with a dual diagnosis of ODD and ADHD were assessed for their ODD symptoms and treated with methylphenidate. At least one month after ADHD symptoms were under control, ODD symptoms were reevaluated with the Parent form of the Children Interview for ...

  17. Methylphenidate enhances working memory by modulating discrete frontal and parietal lobe regions in the human brain.

    Mehta, M A; Owen, A M; Sahakian, B J; Mavaddat, N; Pickard, J D; Robbins, T W

    2000-03-15

    The indirect catecholamine agonist methylphenidate (Ritalin) is the drug treatment of choice in attention deficit/hyperactivity disorder (AD/HD), one of the most common behavioral disorders of childhood (DSM-IV), although symptoms may persist into adulthood. Methylphenidate can enhance cognitive performance in adults and children diagnosed with AD/HD (Kempton et al., 1999; Riordan et al., 1999) and also in normal human volunteers on tasks sensitive to frontal lobe damage, including aspects of spatial working memory (SWM) performance (Elliott et al., 1997). The present study investigated changes in regional cerebral blood flow (rCBF) induced by methylphenidate during performance of a self-ordered SWM task to define the neuroanatomical loci of the beneficial effect of the drug. The results show that the methylphenidate-induced improvements in working memory performance occur with task-related reductions in rCBF in the dorsolateral prefrontal cortex and posterior parietal cortex. The beneficial effects of methylphenidate on working memory were greatest in the subjects with lower baseline working memory capacity. This is to our knowledge the first demonstration of a localization of a drug-induced improvement in SWM performance in humans and has relevance for understanding the treatment of AD/HD. PMID:10704519

  18. Effects of Methylphenidate and Behavior Modification on the Social and Academic Behavior of Children with Disruptive Behavior Disorders: The Moderating Role of Callous/Unemotional Traits

    Waschbusch, Daniel A.; Carrey, Normand J.; Willoughby, Michael T.; King, Sara; Andrade, Brendan F.

    2007-01-01

    This study examined whether response to behavior modification with and without methylphenidate differed for children with attention-deficit/hyperactivity disorder (ADHD) and conduct problems (CP) depending on the presence of callous/unemotional (CU) traits. Participants were 37 children ages 7 to 12, including 19 with ADHD/CP-only and 18 with…

  19. A randomized, placebo-controlled trial of three fixed dosages of prolonged-release OROS methylphenidate in adults with attention-deficit/hyperactivity disorder.

    Medori, R.; Ramos-Quiroga, J.A.; Casas, M.; Kooij, J.J.; Niemela, A.; Trott, G.E.; Lee, E.; Buitelaar, J.K.

    2008-01-01

    BACKGROUND: There is increasing recognition of attention-deficit/hyperactivity disorder (ADHD) in adults and the need to evaluate efficacy and safety of methylphenidate treatment in these patients. METHODS: In this double-blind trial, 401 adults with ADHD (218 men; 18-63 years) were randomly assigne

  20. Effect of Osmotic-Release Oral System Methylphenidate on Different Domains of Attention and Executive Functioning in Children with Attention-Deficit-Hyperactivity Disorder

    Blum, Nathan J.; Jawad, Abbas F.; Clarke, Angela T.; Power, Thomas J.

    2011-01-01

    Aim: This study investigated whether components of attention and executive functioning improve when children with attention-deficit-hyperactivity disorder (ADHD) are treated with osmotic-release oral system (OROS) methylphenidate. Method: Thirty children (24 males, six females; mean age 8y 6mo, SD 1y 11mo; range 6y 5mo-12y 6mo) with ADHD combined…

  1. Addressing the problem of ADHD medication as neuroenhancements.

    Graf, William D; Miller, Geoffrey; Nagel, Saskia K

    2014-05-01

    The prevalence of attention deficit hyperactivity disorder (ADHD) diagnoses is rising. ADHD is closely linked to its treatment with medications such as methylphenidate and amphetamines, which have popular appeal as neuroenhancement drugs by persons without a neurological disorder. The three main reasons for the increase in ADHD medication demand, production, and consumption are a) the inclusion of milder ADHD diagnoses; b) the vast marketing of ADHD medications by the pharmaceutical industry; and c) the illegal diversion of controlled ADHD medication to consumers seeking stimulants as neuroenhancements. Rapidly rising rates of any neurological disorder - especially a behaviorly-defined disorder closely linked to potent medications currently prescribed to more than 5% of the population - deserves ongoing scrutiny. Major social and ethical problems arise from vague-symptom medicalization, neurological disorder trivialization, medication overuse, and controlled substances diversion to healthy persons for nonmedical purposes. We argue against the 'spectrumization' of ADHD in an effort to curtail further diagnosis creep. PMID:24738763

  2. School-Based Administration of ADHD Drugs Decline, along with Diversion, Theft, and Misuse

    DuPont, Robert L.; Bucher, Richard H.; Wilford, Bonnie B.; Coleman, John J.

    2007-01-01

    Since 2000 researchers have reported a decline in the administration of attention-deficit/hyperactivity disorder (ADHD) medications given by school nurses, although no decline has been noted in the incidence of ADHD in school-age populations. Government data for the same period show reduced levels of methylphenidate abuse as measured by its…

  3. Examination of methylphenidate-mediated behavior regulation by glycogen synthase kinase-3 in mice

    Mines, Marjelo A.; Beurel, Eleonore; Jope, Richard S

    2012-01-01

    Abnormalities in dopaminergic activity have been implicated in psychiatric diseases, such as attention deficit hyperactivity disorder (ADHD), and are treated with therapeutic stimulants, commonly methylphenidate or amphetamine. Amphetamine administration increases glycogen synthase kinase-3 (GSK3) activation, which is necessary for certain acute behavioral responses to amphetamine, including increased locomotor activity and impaired sensorimotor gating. Here, we tested if modulating GSK3 by a...

  4. Dystonia in an Adolescent on Risperidone Following the Discontinuation of Methylphenidate: A Case Report

    Guler, Gulen; Yildirim, Veli; Kutuk, Meryem Ozlem; Fevziye TOROS

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with common comorbidities that include oppositional defiant disorder, conduct disorder, anxiety disorder, and affective disorders. Because of these comorbidities, drug combination treatments and drug-drug interactions are becoming increasingly more frequent. The present case report describes an acute dystonic reaction following the abrupt discontinuation of methylphenidate from a drug regimen with risperidone. Th...

  5. Pharmacogenetic Predictors of Methylphenidate Dose-Response in Attention-Deficit/Hyperactivity Disorder

    Froehlich, Tanya E.; Epstein, Jeffery N.; Nick, Todd G.; Melguizo Castro, Maria S.; Stein, Mark A.; Brinkman, William B.; Graham, Amanda J.; Langberg, Joshua M.; Kahn, Robert S.

    2011-01-01

    Objective: Because of significant individual variability in attention-deficit/hyperactivity disorder (ADHD) medication response, there is increasing interest in identifying genetic predictors of treatment effects. This study examined the role of four catecholamine-related candidate genes in moderating methylphenidate (MPH) dose-response. Method:…

  6. Animal Model of Methylphenidate's Longterm Memory-Enhancing Effects

    Carmack, Stephanie A.; Howell, Kristin K.; Rasaei, Kleou; Reas, Emilie T.; Anagnostaras, Stephan G.

    2014-01-01

    Methylphenidate (MPH), introduced more than 60 years ago, accounts for two-thirds of current prescriptions for attention deficit hyperactivity disorder (ADHD). Although many studies have modeled MPH's effect on executive function, almost none have directly modeled its effect on long-term memory (LTM), even though improvement in LTM is a…

  7. ADHD: current and future therapeutics.

    Heal, David J; Smith, Sharon L; Findling, Robert L

    2012-01-01

    The stimulants, amphetamine and methylphenidate, have long been the mainstay of attention-deficit hyperactivity disorder (ADHD) therapy. They are rapidly effective and are generally the first medications selected by physicians. In the development of alternative pharmacological approaches, drug candidates have been evaluated with a wide diversity of mechanisms. All of these developments have contributed real progress in the field, but there is still much room for improvement and unmet clinical need in ADHD pharmacotherapy. The availability of a wide range of compounds with a high degree of specificity for individual monoamines (dopamine and noradrenaline) and/or different pharmacological mechanisms has refined our understanding of the essential elements for optimum pharmacological effect in managing ADHD. In this chapter, we review the pharmacology of the different classes of drug used to treat ADHD and provide a neurochemical rationale, predominantly from the use of in vivo microdialysis experiments, to explain their relative efficacy and potential to elicit side effects. In addition, we will consider how predictions based on results from animal models translate into clinical outcomes. The treatment of ADHD is also described from the perspective of the physician. Finally, the new research development for drugs to treat ADHD is discussed. PMID:21487953

  8. Prevalence of Methylphenidate Prescription among School-Aged Children in a Swiss Population: Increase in the Number of Prescriptions in the Swiss Canton of Vaud, from 2002 to 2005, and Changes in Patient Demographics

    Gumy, Cedric; Huissoud, Therese; Dubois-Arber, Francoise

    2010-01-01

    Objective: Methylphenidate is prescribed for children and adolescents to treat ADHD. As in many Western countries, the increase in methylphenidate consumption is a public concern in Switzerland. The article discusses the authors' assessment of prescription prevalence in 2002 and 2005 for school-aged children in the canton of Vaud. Method: Pharmacy…

  9. First-Trimester In Utero Exposure to Methylphenidate

    Dideriksen, Dorthe; Pottegård, Anton; Hallas, Jesper;

    2013-01-01

    Methylphenidate is a centrally acting sympathomimetic used for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and adolescents and for narcolepsy in adults. Despite the growing use among adult women, no reliable data on the prevalence of use during pregnancy have been...... published, and safety during pregnancy has not been established. We systematically reviewed available data on birth outcome after human in utero exposure to methylphenidate. Systematic searches in PubMed/Embase were performed from origin to August 2012, and data from Michigan Medicaid recipients, The...... Collaborative Perinatal Project and the Swedish Birth Registry were evaluated. Excluding three case-reports, a total of 180 children exposed to methylphenidate in utero during first trimester were identified, among whom 4 children with major malformations were observed. Methylphenidate exposure during pregnancy...

  10. Attenuation of methylphenidate-induced sensitization by co-administration of buspirone.

    Alam, Nausheen; Najam, Rahila; Naeem, Sadaf

    2016-03-01

    Methylphenidate, which inhibit dopamine transporter is effective in the treatment of ADHD (attention deficit hyperactivity disorder), but long term use of this drug is often associated with addiction and dependence. Locomotor sensitization development to psychostimulants like methylphenidate is an important contributor to drug abuse induced by psychostimulants. Different studies have shown that long term administration of drugs of abuse increases the effectiveness of 5-hydroxytryptamine (5-HT)-1A somatodendritic receptors. Repeated buspirone administration reduces the effectiveness of 5-HT1A somatodendritic receptors. This study was designed to determine that buspirone co-administration may reduce methylphenidate-induced sensitization. The motor activity was compared by using familiar and novel environments after long-term administration of methylphenidate, buspirone and their co-administration. Long term oral administration of methylphenidate at a dose of 2.0mg/kg/day enhanced motor activity in home cage i.e. activity of familiar environment monitored at alternate day. Locomotor enhancing effects of methylphenidate were augmented on 13th day of drug administration suggesting sensitization induced by the drug. The sensitization effects were significant in home cage monitored on alternate day and also in an open field monitored weekly. Buspirone co-administration at a dose of 10mg/kg/day prevented methylphenidate-induced sensitization. It is suggested that the sensitization development to methylphenidate may oppose by buspirone co-administration due to the reduction in the sensitivity of 5-HT1A somatodendritic receptors. These findings may help extend future therapeutics in ADHD. PMID:27087081

  11. Dopamine and Norepinephrine Receptors Participate in Methylphenidate Enhancement of In Vivo Hippocampal Synaptic Plasticity

    Jenson, Daniel; Yang, Kechun; Acevedo-Rodriguez, Alexandra; Levine, Amber; Broussard, John I.; Tang, Jianrong; Dani, John A.

    2014-01-01

    Attention-deficit hyperactive disorder (ADHD) is the most commonly studied and diagnosed psychiatric disorder in children. Methylphenidate (MPH, e.g., Ritalin) has been used to treat ADHD for over 50 years. It is the most commonly prescribed treatment for ADHD, and in the past decade it was the drug most commonly prescribed to teenagers. In addition, MPH has become one of the most widely abused drugs on college campuses. In this study, we examined the effects of MPH on hippocampal synaptic pl...

  12. [Methylphenidate in the treatment of children with attention-deficit hyperactivity disorder: monitoring in biological matrices].

    Papaseit, E; García-Algar, O; Simó, S; Pichini, S; Farré, M

    2013-02-01

    Attention-deficit hyperactivity disorder (ADHD) has emerged in the last few years as the most commonly diagnosed and treated psychiatric disorder in the paediatric population. In 1980's, methylphenidate (MFD) a psychomotor stimulant drug, was approved in Spain for the symptomatic therapy of ADHD. Since then, MFD has become one of the most extensively prescribed and studied treatment for ADHD both in children and adults. In this paper, the main pharmacological issues of MFD are reviewed, focusing on its pharmacokinetics in conventional (blood and urine) and non-conventional (hair, oral fluid and sweat) biological matrices, its pharmaceutical preparations, therapeutic levels and side effects. PMID:23063334

  13. [Cardiovascular risks and management during Attention Deficit Hyperactivity Disorder treatment with methylphenidate].

    Bange, F; Le Heuzey, M-F; Acquaviva, E; Delorme, R; Mouren, M-C

    2014-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common of the pediatric neuropsychiatric disorders. Methylphenidate is an important element of therapeutic strategies for ADHD. Clinicians are interested in the safety of methylphenidate. Because this drug raises heart rate and blood pressure, concerns have been raised about its cardiovascular safety. Concerns were based on case reports of sudden cardiac death in methylphenidate users, plausible pharmacological pathways involving well-established stimulant effects on heart rate and blood pressure. Until recently, data were limited to a number of observational studies too small to examine serious cardiac events. In the past two years, large retrospective, population-based cohort studies were performed. These studies did not show any evidence that methylphenidate was associated with an increase in risk of myocardial infarction, sudden cardiac death, or stroke. Treatment of children with methylphenidate is not significantly associated with an increase in the short term or mid-term risk of severe cardiac events. For many, available data now will be seen as reassuring. But gaps persist in the methodical and comprehensive assessments of the safety of methylphenidate. Analyses cannot be generalized to children with long-term use of stimulants. Furthermore, long-term effects of slight increases in heart rate or blood pressure are unknown. Stimulant administration continues to have a detectable adrenergic effect even after years of treatment. In the MTA study, greater cumulative stimulant exposure was associated with a higher heart rate at years 3 and 8. Although less severe, such adverse cardiac events are nonetheless alarming to patients. This adrenergic effect may have clinical implications, especially for individual patients with underlying heart abnormalities and it deserves further investigation. More research is necessary to optimize a safe use of methylphenidate regarding its cardiovascular effects

  14. Methylphenidate-Elicited Dopamine Increases in Ventral Striatum Are Associated with Long-Term Symptom Improvement in Adults with Attention Deficit Hyperactivity Disorder

    Volkow N. D.; Wang G.; Volkow, N.D.; Wang, G.-J.; Tomasi, D.; Kollins, S.H.; Wigal, T.L.; Newcorn, J.H.; Telang, F.W.; Fowler, J.S.; Logan, J.; Wong, C.T.; Swanson, J.M.

    2012-01-18

    Stimulant medications, such as methylphenidate, which are effective treatments for attention deficit hyperactivity disorder (ADHD), enhance brain dopamine signaling. However, the relationship between regional brain dopamine enhancement and treatment response has not been evaluated. Here, we assessed whether the dopamine increases elicited by methylphenidate are associated with long-term clinical response. We used a prospective design to study 20 treatment-naive adults with ADHD who were evaluated before treatment initiation and after 12 months of clinical treatment with a titrated regimen of oral methylphenidate. Methylphenidate-induced dopamine changes were evaluated with positron emission tomography and [{sup 11}C]raclopride (D{sub 2}/D{sub 3} receptor radioligand sensitive to competition with endogenous dopamine). Clinical responses were assessed using the Conners Adult ADHD Rating Scale and revealed a significant reduction in symptoms of inattention and hyperactivity with long-term methylphenidate treatment. A challenge dose of 0.5 mg/kg intravenous methylphenidate significantly increased dopamine in striatum (assessed as decreases in D{sub 2}/D{sub 3} receptor availability). In the ventral striatum, these dopamine increases were associated with the reductions in ratings of symptoms of inattention with clinical treatment. Statistical parametric mapping additionally showed dopamine increases in prefrontal and temporal cortices with intravenous methylphenidate that were also associated with decreases in symptoms of inattention. Our findings indicate that dopamine enhancement in ventral striatum (the brain region involved with reward and motivation) was associated with therapeutic response to methylphenidate, further corroborating the relevance of the dopamine reward/motivation circuitry in ADHD. It also provides preliminary evidence that methylphenidate-elicited dopamine increases in prefrontal and temporal cortices may also contribute to the clinical response.

  15. Methylphenidate-Elicited Dopamine Increases in Ventral Striatum Are Associated with Long-Term Symptom Improvement in Adults with Attention Deficit Hyperactivity Disorder

    Stimulant medications, such as methylphenidate, which are effective treatments for attention deficit hyperactivity disorder (ADHD), enhance brain dopamine signaling. However, the relationship between regional brain dopamine enhancement and treatment response has not been evaluated. Here, we assessed whether the dopamine increases elicited by methylphenidate are associated with long-term clinical response. We used a prospective design to study 20 treatment-naive adults with ADHD who were evaluated before treatment initiation and after 12 months of clinical treatment with a titrated regimen of oral methylphenidate. Methylphenidate-induced dopamine changes were evaluated with positron emission tomography and (11C)raclopride (D2/D3 receptor radioligand sensitive to competition with endogenous dopamine). Clinical responses were assessed using the Conners Adult ADHD Rating Scale and revealed a significant reduction in symptoms of inattention and hyperactivity with long-term methylphenidate treatment. A challenge dose of 0.5 mg/kg intravenous methylphenidate significantly increased dopamine in striatum (assessed as decreases in D2/D3 receptor availability). In the ventral striatum, these dopamine increases were associated with the reductions in ratings of symptoms of inattention with clinical treatment. Statistical parametric mapping additionally showed dopamine increases in prefrontal and temporal cortices with intravenous methylphenidate that were also associated with decreases in symptoms of inattention. Our findings indicate that dopamine enhancement in ventral striatum (the brain region involved with reward and motivation) was associated with therapeutic response to methylphenidate, further corroborating the relevance of the dopamine reward/motivation circuitry in ADHD. It also provides preliminary evidence that methylphenidate-elicited dopamine increases in prefrontal and temporal cortices may also contribute to the clinical response.

  16. The Effect of Animal-assisted Play Therapy (AAT on Improving the Life Quality of Parents having Children with ADHD (Attention Deficit Hyperactivity Disorder in children Treated with Methylphenidate

    Nazila Motarabesoun

    2016-07-01

    Full Text Available Background and purpose: ADHD (Attention Deficit Hyperactivity Disorder in children is considered to be one of the most widespread neuro-behavioral disorders in children, which is typically characterized by problems such as poor educational performance, communication difficulties and other social inconsistencies. Timely identification and treatment of this disorder can result in significant improvement in their individual and social performances and it can reduce the symptoms of this disorder. Nowadays, play therapy is regarded as one of the recent treatments. One type of play therapy is referred to as animal-assisted play therapy. Methodology: This study was based on a single case study in which two children with ADHD were studied. Before the treatment intervention, the life quality questionnaire (SF-36 was conducted on three consecutive days as the baseline. Then, based on the designed operational procedure, the stages of treatment intervention were carried out with a domestic animal (rabbit within six 45-minute sessions. At the end of the two treatment sessions and during the whole intervention period, the dependent variable, the effect size and improvement rate were measured. Results: the results of the study indicated that the experimented animal-assisted play therapy was statistically significant for both children (P< 0.05. However, the rate of improvement in clinical terms was not meaningfully significant. Conclusion: with respect to the obtained significant differences in eye diagrams and the calculated physical and mental health indexes and the statistical significance of the effect size, it can be concluded that animal-assisted play therapy can contribute to the relative improvement of the life quality of these children’s parents. Keywords: ADHD (Attention Deficit Hyperactivity Disorder in children; animal-assisted play therapy; life quality of ADHD children’s parents;

  17. Methylphenidate Treatment in Adolescent Rats with an Attention Deficit/Hyperactivity Disorder Phenotype: Cocaine Addiction Vulnerability and Dopamine Transporter Function

    Harvey, Roxann C; Sen, Sucharita; Deaciuc, Agripina; Dwoskin, Linda P; Kantak, Kathleen M

    2011-01-01

    Appropriate animal models of attention deficit/hyperactivity disorder (ADHD) and drug reinforcement allow investigation of possible underlying biological bases of ADHD and its comorbidity with cocaine addiction. Toward this end, spontaneously hypertensive rats (SHRs) exhibiting an ADHD phenotype were compared with Wistar-Kyoto (WKY) and Wistar (WIS) rats. Initially, 1.5 mg/kg oral methylphenidate or vehicle was administered between postnatal days 28 and 55, and acquisition of visual discrimination learning was examined. After discontinuing adolescent treatments, adult rats were evaluated for cocaine self-administration and dopamine transporter (DAT) function in the prefrontal cortex (PFC) and striatum. During adolescence, SHRs showed deficits in visual discrimination relative to WKY and WIS rats when non-medicated. Methylphenidate improved visual discrimination only in SHRs. Compared with WKY and WIS rats, SHRs with previous methylphenidate treatment acquired cocaine self-administration faster, identified cocaine as a highly efficacious reinforcer by displaying an upward shift in the cocaine dose–response function, and showed the greatest motivation to self-administer cocaine by exhibiting the highest progressive ratio breakpoints. In the PFC, the maximal dopamine uptake (Vmax) at DAT was decreased in SHRs and increased in WKY and WIS rats by previous methylphenidate treatment. The affinity (Km) for dopamine at DAT in the PFC was not different between strains, nor was Vmax or Km altered in the striatum by previous methylphenidate treatment in any strain. Methylphenidate-induced decreases in dopamine clearance by DAT in the PFC may underlie increased cocaine self-administration in SHRs. These preclinical findings suggest that caution should be exercised when methylphenidate is prescribed for first-time treatment of ADHD in adolescent patients, as cocaine addiction vulnerability may be augmented. PMID:21150910

  18. Evaluation and treatment of ADHD.

    Smucker, W D; Hedayat, M

    2001-09-01

    Symptoms of attention-deficit/hyperactivity disorder (ADHD) are present in as many as 9 percent of school-age children. ADHD-specific questionnaires can help determine whether children meet diagnostic criteria for the disorder. The recommended evaluation also includes documenting the type and severity of ADHD symptoms, verifying the presence of normal vision and hearing, screening for comorbid psychologic conditions, reviewing the child's developmental history and school performance, and applying objective measures of cognitive function. The stimulants methylphenidate and dextroamphetamine remain the pharmacologic agents of first choice for the management of ADHD. These agents are equally effective in improving the core symptoms of the disorder, but individual children may respond better to one stimulant medication than to another. Achievement of maximal benefit may require titration of the initial dosage and dosing before breakfast, before lunch and in the afternoon. The family physician should tailor the treatment plan to meet the unique needs of the child and family. Psychosocial, behavioral and educational strategies that enhance specific behaviors may improve educational and social functioning in the child with ADHD. PMID:11563573

  19. What Exactly Are the Benefits of Stimulants for ADHD?

    Advokat, Claire

    2009-01-01

    Stimulant drugs (methylphenidate and amphetamine) have been used successfully for decades to improve the behavioral impairments of hyperactivity, impulsivity, and inattention in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). A voluminous literature supports the benefits of stimulants for improving classroom manageability…

  20. Prenatal Exposure to Methylphenidate Affects the Dopamine System and the Reactivity to Natural Reward in Adulthood in Rats

    Lepelletier, François-Xavier; Tauber, Clovis; NICOLAS, Céline; Solinas, Marcello; Castelnau, Pierre; Belzung, Catherine; Emond, Patrick; Cortese, Samuele; Faraone, Stephen V.; Chalon, Sylvie; Galineau, Laurent

    2015-01-01

    Background: Methylphenidate (MPH) is a commonly-used medication for the treatment of children with Attention-Deficit/Hyperactivity Disorders (ADHD). However, its prescription to adults with ADHD and narcolepsy raises the question of how the brain is impacted by MPH exposure during pregnancy. The goal of this study was to elucidate the long-term neurobiological consequences of prenatal exposure to MPH using a rat model. Methods: We focused on the effects of such treatment on the adult dopamine...

  1. No Relation Between Therapeutic Response to Methylphenidate and its Cardiovascular Side Effects in Children with Attention-Deficit/Hyperactivity Disorder

    Venkataramana Bhat; Natalie Grizenko; Steven Sanche; Ridha Joober

    2008-01-01

    Objective: The aim of this study was to examine the relation between therapeutic response to methylphenidate (MPH) and its associated short term cardiovascular side effects (Systolic Blood Pressure-SBP, Diastolic Blood Pressure-DBP and Heart Rate-HR changes) in children with ADHD, based on the hypothesis that these parameters share common underlying mechanisms.Method: A double-blind placebo-controlled crossover clinical trial of children 6 to 12 years old diagnosed with ADHD was done. The chi...

  2. Association Between 5-HTTLPR Polymorphism and Tics after Treatment with Methylphenidate in Korean Children with Attention-Deficit/Hyperactivity Disorder

    Park, Seo Yeon; Kim, Eun Joo; Cheon, Keun-Ah

    2015-01-01

    Abstract Objectives: The purpose of this study is to examine the relationship between 5-HTTLPR polymorphism (44-bp insertion/deletion polymorphism of serotonin transporter gene) and methylphenidate (MPH) treatment response, as well as the association between the adverse events of MPH treatment and 5-HTTLPR polymorphism in children with attention-deficit/hyperactivity disorder (ADHD). Methods: A total of 114 children with ADHD (mean age 9.08 ± 1.94 years) were recruited from the child psychiat...

  3. Effects of methylphenidate on attentional set-shifting in a genetic model of attention-deficit/hyperactivity disorder

    Cao Ai-hua; Yu Lin; Wang Yu-wei; Wang Jun-mei; Yang Le-jin; Lei Ge-fei

    2012-01-01

    Abstract Background Although deficits of attentional set-shifting have been reported in individuals with attention deficit/hyperactivity disorder (ADHD), it is rarely examined in animal models. Methods This study compared spontaneously hypertensive rats (SHRs; a genetic animal model of ADHD) and Wistar-Kyoto (WKY) and Sprague-Dawley (SD) rats (normoactive control strains), on attentional set-shifting task (ASST) performance. Furthermore, the dose-effects of methylphenidate (MPH) on attentiona...

  4. Effects of MPH-OROS on the Organizational, Time Management, and Planning Behaviors of Children with ADHD

    Abikoff, Howard; Nissley-Tsiopinis, Jenelle; Gallagher, Richard; Zambenedetti, Maurizio; Seyffert, Michael; Boorady, Roy; McCarthy, John

    2009-01-01

    A double-blind, placebo-controlled, crossover design study was done to evaluate the effects of methylphenidate-osmotic-release oral systems (MPH-OROS) on the organization, time management, and planning (OTMP) of children with attention deficit hyperactivity disorder (ADHD). Results show significant improvements on the OTMP of children with ADHD in…

  5. Music and Video as Distractors for Boys with ADHD in the Classroom: Comparison with Controls, Individual Differences, and Medication Effects

    Pelham, William E.; Waschbusch, Daniel A.; Hoza, Betsy; Gnagy, Elizabeth M.; Greiner, Andrew R.; Sams, Susan E.; Vallano, Gary; Majumdar, Antara; Carter, Randy L.

    2011-01-01

    This study examined the effects of music and video on the classroom behavior and performance of boys with and without attention deficit hyperactivity disorder (ADHD) and examined the effects of 0.3 mg/kg methylphenidate (MPH). In one study, 41 boys with ADHD and 26 controls worked in the presence of no distractor, music, or video. Video produced…

  6. The sleep of children with attention deficit hyperactivity disorder on and off methylphenidate: a matched case-control study.

    Galland, Barbara C; Tripp, E Gail; Taylor, Barry J

    2010-06-01

    In the present study, we assessed the effects of regular use of methylphenidate medication in children diagnosed with attention deficit hyperactivity disorder (ADHD) on sleep timing, duration and sleep architecture. Twenty-seven children aged 6-12 years meeting diagnostic criteria for Diagnostic and Statistical Manual version IV ADHD and 27 control children matched for age (+/-3 months) and gender. Two nights of standard polysomnographic (PSG) recordings were conducted. ADHD children were allocated randomly to an on- or 48 h off-methylphenidate protocol for first or second recordings. Control children's recordings were matched for night, but no medication was used. Mixed modelling was employed in the analyses so that the full data set was used to determine the degree of medication effects. Methylphenidate in ADHD children prolonged sleep onset by an average of 29 min [confidence interval (CI) 11.6, 46.7], reduced sleep efficiency by 6.5% (CI 2.6, 10.3) and shortened sleep by 1.2 h (CI 0.65, 1.9). Arousal indices were preserved. Relative amounts of stages 1, 2 and slow wave sleep were unchanged by medication. Rapid eye movement sleep was reduced (-2.4%) on the medication night, an effect that became non-significant when control data were incorporated in the analyses. PSG data from ADHD children off-medication were similar to control data. Our findings suggest that methylphenidate reduces sleep quantity but does not alter sleep architecture in children diagnosed with ADHD. An adequate amount of sleep is integral to good daytime functioning, thus the sleep side effects of methylphenidate may affect adversely the daytime symptoms the drug is targeted to control. PMID:20050995

  7. Extended-release Methylphenidate Treatment and Outcomes in Comorbid Social Anxiety Disorder and Attention-deficit/Hyperactivity Disorder: 2 Case Reports.

    Koyuncu, Ahmet; Çelebi, Fahri; Ertekin, Erhan; Kahn, David A

    2015-05-01

    Social anxiety disorder is frequently comorbid with attention-deficit/hyperactivity disorder (ADHD). However, treatment recommendations are not clear in the presence of such comorbidity. A few studies in the literature have reported improvement in symptoms of both disorders with treatment specific for ADHD (ie, stimulants and atomoxetine). In this report, we present cases of 2 adults with social anxiety disorder and ADHD who were treated with methylphenidate monotherapy. Both cases responded well in terms of not only their ADHD symptoms but also the social anxiety disorder symptoms. Methylphenidate was well tolerated with no significant side effects. More studies are needed to better establish the potential of ADHD medications to be effective for comorbid social anxiety disorder symptoms. PMID:25955266

  8. Alternative pharmacological strategies for adult ADHD treatment: a systematic review.

    Buoli, Massimiliano; Serati, Marta; Cahn, Wiepke

    2016-01-01

    Adult Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition associated with high disability and frequent comorbidity. Current standard pharmacotherapy (methylphenidate and atomoxetine) improves ADHD symptoms in the short-term, but poor data were published about long-term treatment. In addition a number of patients present partial or no response to methylphenidate and atomoxetine. Research into the main database sources has been conducted to obtain an overview of alternative pharmacological approaches in adult ADHD patients. Among alternative compounds, amphetamines (mixed amphetamine salts and lisdexamfetamine) have the most robust evidence of efficacy, but they may be associated with serious side effects (e.g. psychotic symptoms or hypertension). Antidepressants, particularly those acting as noradrenaline or dopamine enhancers, have evidence of efficacy, but they should be avoided in patients with comorbid bipolar disorder. Finally metadoxine and lithium may be particularly suitable in case of comorbid alcohol misuse or bipolar disorder. PMID:26693882

  9. Safety and tolerability of flexible dosages of prolonged-release OROS methylphenidate in adults with attention-deficit/hyperactivity disorder.

    Buitelaar, J.K.; Ramos-Quiroga, J.A.; Casas, M.; Kooij, J.J.; Niemela, A.; Konofal, E.; Dejonckheere, J.; Challis, B.H.; Medori, R.

    2009-01-01

    The osmotic release oral system (OROS) methylphenidate formulation is a prolonged-release medication for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults. We conducted a seven-week open-label extension of a double-blind study to assess the safety

  10. Assessment of cardiovascular risks due to methylphenidate in six months of treatment in children with attention deficit and hyperactivity disorder

    mehmet emre ari

    2014-01-01

    Conclusions: In ADHD patients, the elongation of QTc duration and increase in the systolic and diastolic blood pressures were statistically significant during 6 months of methylphenidate treatment. However, all these changes remained within normal limits. All patients receiving this drug should be monitored carefully for cardiovascular side effects.

  11. A pilot study for augmenting atomoxetine with methylphenidate: safety of concomitant therapy in children with attention-deficit/hyperactivity disorder

    Ball Susan

    2007-09-01

    Full Text Available Abstract Background This study examined augmenting atomoxetine with extended-release methylphenidate in children whose attention-deficit/hyperactivity disorder (ADHD previously failed to respond adequately to stimulant medication. Methods Children with ADHD and prior stimulant treatment (N = 25 received atomoxetine (1.2 mg/kg/day plus placebo. After 4 weeks, patients who were responders (n = 4 were continued on atomoxetine/placebo while remaining patients were randomly assigned to either methylphenidate (ATX/MPH (1.1 mg/kg/day or placebo augmentation (ATX/PB for another 6 weeks. Patients and sites were blind to timing of active augmentation. Safety measures included vital signs, weight, and adverse events. Efficacy was assessed by ADHD rating scales. Results Categorical increases in vital signs occurred for 5 patients (3 patients in ATX/MPH, 2 patients in ATX/PBO. Sixteen percent discontinued the study due to AE, but no difference between augmentation groups. Atomoxetine treatment was efficacious on outcome measures (P ≤ .001, but methylphenidate did not enhance response. Conclusion Methylphenidate appears to be safely combined with atomoxetine, but conclusions limited by small sample. With atomoxetine treatment, 43% of patients achieved normalization on ADHD ratings.

  12. Switch in Therapy from Methylphenidate to Atomoxetine in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

    Warrer, Pernille; Thomsen, Per Hove; Dalsgaard, Søren;

    2016-01-01

    OBJECTIVE: The purpose of this study was to investigate therapy switching from methylphenidate (MPH) to atomoxetine (ATX) in a clinical sample of Danish children and adolescents with attention-deficit/hyperactivity disorder (ADHD); specifically, to determine the duration of MPH treatment before...

  13. Motivational Incentives and Methylphenidate Enhance Electrophysiological Correlates of Error Monitoring in Children with Attention Deficit/Hyperactivity Disorder

    Groom, Madeleine J.; Liddle, Elizabeth B.; Scerif, Gaia; Liddle, Peter F.; Batty, Martin J.; Liotti, Mario; Hollis, Chris P.

    2013-01-01

    Background: Children with attention deficit hyperactivity disorder (ADHD) are characterised by developmentally inappropriate levels of hyperactivity, impulsivity and/or inattention and are particularly impaired when performing tasks that require a high level of cognitive control. Methylphenidate (MPH) and motivational incentives may help improve…

  14. Selegiline Transdermal Patch

    Transdermal selegiline is used to treat depression. Selegiline is in a class of medications called monoamine oxidase (MAO) inhibitors. It works by increasing the amounts of certain natural substances that are needed to maintain ...

  15. Diclofenac Transdermal Patch

    ... transdermal diclofenac may cause swelling, ulcers, bleeding, or holes in the stomach or intestines. These problems may ... right part of the stomach flu-like symptoms dark-colored urine rash blisters on skin fever pale ...

  16. Relationship between quality of life and psychopathological profile: data from an observational study in children with ADHD

    Becker, Andreas; Roessner, Veit; Breuer, Dieter; Döpfner, Manfred; Rothenberger, Aribert

    2011-01-01

    Although ADHD significantly affects the quality of life (QoL) of patients and their families, QoL in children with ADHD has rarely been investigated in association with psychopathological profile, and the relationship remains unclear. The open-label OBSEER study evaluated the effectiveness and tolerability of Equasym XL®, a modified-release methylphenidate, in routine care of children and adolescents (aged 6–17 years) with ADHD. At baseline, questionnaires assessing psychopathological profile...

  17. Transdermal Patches: A Complete Review on Transdermal Drug Delivery System

    Patel DS

    2012-03-01

    Full Text Available Today about 70% of drugs are taken orally and are found not to be as effective as desired. To improvesuch characters transdermal drug delivery system was emerged. Transdermal drug delivery system(TDDS provides a means to sustain drug release as well as reduce the intensity of action and thusreduce the side effects associated with its oral therapy and differs from traditional topical drug delivery.Transdermal Drug Delivery System is the system in which the delivery of the active ingredients of thedrug occurs by means of skin. Several important advantages of transdermal drug delivery are limitationof hepatic first pass metabolism, enhancement of therapeutic efficiency and maintenance of steadyplasma level of the drug. Various types of transdermal patches are used to incorporate the activeingredients into the circulatory system via skin. This review article covers a brief outline of theprinciples of transdermal permeation, various components of transdermal patch, approaches oftransdermal patch, evaluation of transdermal system, its application with its limitation.

  18. [Transdermal Delivery of NSAIDs].

    Nakajima, Takehisa; Makino, Kimiko

    2015-11-01

    Skin has been studied as administration site of drug for its systemic effects, since systemic therapeutic agents can be delivered for long time with a controlled ratio, escaping from the first pass effect by liver by the transdermal delivery, which can decrease the dosage form. The low permeability of drug molecules through stratum corneum has been the limiting factor for developing transdermal delivery system of therapeutic agents. To enhance the permeability of drug molecules, many studies have been reported. PMID:26689064

  19. Are GPs adequately equipped with the knowledge for educating and counseling of families with ADHD children?

    Zarei Nabi

    2010-01-01

    Full Text Available Abstract Background Attention deficit hyperactivity disorder is one of the most common child psychiatry disorders. General physicians (GP, as primary care providers, can have an important role in screening and treatment of ADHD. This study aimed to survey GPs' knowledge, attitude, and their views of their role in the screening, diagnosing and managing children with ADHD. Methods Six hundred and sixty five general physicians in Shiraz, Iran, answered a self-reported questionnaire on ADHD. The questionnaire consisted of questions regarding socio-demographic characteristics such as age, the duration of practice as a GP, marital status, general knowledge about ADHD, and the management of ADHD. Results Less than half of them believed that they have adequate knowledge and information about this disorder. They usually do not like to be the primary care providers for children with ADHD. The majority of them prefer to refer the children to related specialists, mostly psychiatrists or psychologists. More than one third of them believed that sugar is a cause of ADHD. Only 6.6% of them reported that ADHD persists for the whole life. Their knowledge about methylphenidate is reasonable. Conclusions As many other countries worldwide, the knowledge of GPs about ADHD should be improved. They do not asses and manage children with probable ADHD by themselves without referring to related professionals. They do not opt for the use of methylphenidate.

  20. Response to methylphenidate by adult and pediatric patients with attention-deficit/hyperactivity disorder: the Spanish multicenter DIHANA study

    Valdizán-Usón, JR; Cánovas-Martínez, A; De Lucas-Taracena, MT; Díaz-Atienza, F; Eddy-Ives, LS; Fernández-Jaén, A; Fernández-Pérez, M; García-Giral, M; García-Magán, P; Garraus-Oneca, M; Idiazábal-Alecha, MA; López-Benito, M; Lorenzo-Sanz, G; Martínez-Antón, J; Martínez-Granero, MA; Montañés-Rada, F; Mulas-Delgado, F; Ochando-Perales, G; Ortega-García, E; Pelaz-Antolín, A; Ramos-Quiroga, JA; Ruiz-Sanz, FC; Vaquerizo-Madrid, J; Yusta-Izquierdo, A

    2013-01-01

    Background: The purpose of this multicenter Spanish study was to evaluate the response to immediate-release methylphenidate by children and adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), as well as to obtain information on current therapy patterns and safety characteristics. Methods: This multicenter, observational, retrospective, noninterventional study included 730 patients aged 4–65 years with a diagnosis of ADHD. Information was obtained based on a review of medical records for the years 2002–2006 in sequential order. Results: The ADHD predominantly inattentive subtype affected 29.7% of patients, ADHD predominantly hyperactive-impulsive was found in 5.2%, and the combined subtype in 65.1%. Overall, a significant lower Clinical Global Impression (CGI) score and mean number of DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision) symptoms by subtype were found after one year of treatment with immediate-release methylphenidate; CGI decreased from 4.51 to 1.69, symptoms of inattention from 7.90 to 4.34, symptoms of hyperactivity from 6.73 to 3.39, and combined subtype symptoms from 14.62 to 7.7. Satisfaction with immediate-release methylphenidate after one year was evaluated as “very satisfied” or “satisfied” by 86.90% of the sample; 25.75% of all patients reported at least one adverse effect. At the end of the study, 41.47% of all the patients treated with immediate-release methylphenidate were still receiving it, with a mean time of 3.80 years on therapy. Conclusion: Good efficacy and safety results were found for immediate-release methylphenidate in patients with ADHD. PMID:23430373

  1. Selegiline in Comparison with Methylphenidate in Treatment of Adults with Attention Deficit yperactivity Disorder: A Double-blind, Randomized Trial

    Farbod Fadai

    2009-12-01

    Full Text Available  Objective: "n "nAttention-Deficit/Hyperactivity Disorder (ADHD is one of the most common mental disorders in childhood and it continues to adulthood without proper treatment. Stimulants have been used in treatment of ADHD for many years and the efficacy of methylphenidate (MPH in the treatment of adults with ADHD has been proven to be acceptable according to meta-analysis studies. However, there are some concerns about stimulants. Finding other effective medications for the treatment of adult ADHD seems necessary. We tried a monoamine oxidase inhibitor, Selegiline, as there are some theoretical and experimental evidences for the efficacy of this medication . "nMethod: Forty patients were randomized to receive Selegiline or methylphenidate in an equal ratio for an 8-week double-blind clinical trial. Each patient filled the CAARS self report screening form before starting to take the medication and in weeks 2-4-6 and 8. Patients were also assessed by a psychiatrist at the baseline and on each 14 days up to the 8 weeks period. "nResults: The mean score of the two groups- receiving Selegiline or methylphenidate- decreased over the 8 weeks. There was not a significant difference between the two groups. The most prevalent side-effect of methylphenidate was decrease of appetite and for Selegiline change in sleep pattern . "nConclusion: Selegiline is as effective as methylphenidate in the treatment of adults with Attention-Deficit/Hyperactivity Disorder. Selegiline can be an alternative medication for the treatment of adult ADHD If its clinical efficacy is proven by other larger studies .

  2. TRANSDERMAL DRUG DELIVERY SYSTEM: REVIEW

    Vishvakarama Prabhakar; Agarwal Shivendra; Sharma Ritika; Saurabh Sharma

    2012-01-01

    Various new technologies have been developed for the transdermal delivery of some important drugs. Today about 74% of drugs are taken orally and are found not to be as effective as desired. To improve such characters transdermal drug delivery system was emerged. Drug delivery through the skin to achieve a systemic effect of a drug is commonly known as transdermal drug delivery and differs from traditional topical drug delivery. Transdermal drug delivery systems (TDDS) are dosage forms involve...

  3. Parental perceived benefits of OROS-methylphenidate treatment for the child with attention-deficit/hyperactivity disorder and for parents themselves.

    Kim, J-W; Park, S; Kim, B-N; Shin, M-S; Cho, S-C; Kim, J-H; Son, J-W; Shin, Y-M; Chung, U-S; Han, D-H

    2013-06-01

    Given the shortage of studies on parental perceived benefits of OROS-methylphenidate treatment in Asian populations, we assessed parental response to OROS-methylphenidate treatment of Korean children with attention-deficit/hyperactivity disorder (ADHD), in relation to children's academic performance and behavioral symptoms as well as parental rearing stress and depressive symptoms.We enrolled 132 medication-naïve children with ADHD into a multicenter, open-label, 12-week trial of OROS-MPH. The outcome measures were the ADHD rating scale-IV (ADHD-RS), the comprehensive attention test and academic performance rating scale, and the clinical global impression (CGI)-severity/improvement instrument (for the children) and Beck depression inventory and parenting stress index (for their parents).We found parent-perceived improvements in children's ADHD-related behavioral symptoms and academic function and their parents' depressive symptoms and parenting stress. Investigator-rated ADHD symptoms and subjects' neuropsychological function were also improved (pParents of Korean children with ADHD perceive that OROS-methylphenidate treatment improves their children's academic function and behavior as well as their own child-rearing stress and emotional state. These findings must be interpreted with caution, due to a non-comparative open-label trial. PMID:23364873

  4. Melatonin Effects in Methylphenidate Treated Children with Attention Deficit Hyperactivity Disorder: A Randomized Double Blind Clinical Trial

    Mohammad Reza Mohammadi

    2012-06-01

    Full Text Available Objective: The aim of this study was to determine melatonin effects on sleep patterns, symptoms of hyperactivity and attention deficiency in children with attention-deficit hyperactivity disorder (ADHD.Methods: Children with age range of 7-12 years who had a combined form of ADHD were randomly divided in to 2 groups according to gender blocks. One group took melatonin (3 or 6mg combined with methylphenidate (Ritalin (1mg/kg, and the other group took placebo combined with methylphenidate (1mg/kg. ADHD rating scale and sleep patterns questionnaires were completed. Research hypotheses were assessed at the baseline, the second, fourth and eighth weeks after the treatment.Results: The mean sleep latency and total sleep disturbance scores were reduced in melatonin group, while the scores increased in the placebo group (p≥0.05. Data analysis, using ANOVA with repeated measures, did not show any statistically significant differences between the two groups in ADHD scores.Conclusion: Administration of melatonin along with methylphenidate can partially improve symptoms of sleep disturbance. However, it does not seem to reduce attention deficiency and hyperactivity behavior of children with ADHD.

  5. A systematic review of randomized controlled trials of bupropion versus methylphenidate in the treatment of attention-deficit/hyperactivity disorder

    Maneeton N

    2014-08-01

    Full Text Available Narong Maneeton,1 Benchalak Maneeton,1 Suthi Intaprasert,1 Pakapan Woottiluk2 1Department of Psychiatry, Faculty of Medicine, 2Psychiatric Nursing Division, Faculty of Nursing, Chiang Mai University, Chiang Mai, ThailandBackground: Some trials have suggested that bupropion, as well as methylphenidate, is bene­ficial in the treatment of attention-deficit/hyperactivity disorder (ADHD.Objectives: The purpose of this systematic review was to summarize the efficacy, acceptability, and tolerability of bupropion in comparison with methylphenidate for ADHD treatment. Included studies were randomized controlled trials (RCTs that compared bupropion and methylphenidate. Clinical studies conducted between January 1991 and January 2014 were reviewed.Data sources: MEDLINE®, EMBASE™, CINAHL, PsycINFO®, and the Cochrane Controlled Trials Register were searched in January 2014. Additionally, clinical trials were identified from the databases of ClinicalTrials.gov and the EU Clinical Trials Register.Study eligible criteria, participants, and interventions: All RCTs of bupropion and methylphenidate reporting final outcomes relevant to 1 ADHD severity, 2 response or remission rates, 3 overall discontinuation rate, or 4 discontinuation rate due to adverse events. Language restriction was not applied.Study appraisal and synthesis methods: The relevant clinical trials were examined and the data of interest were extracted. Additionally, the risks of bias were also inspected. The efficacy outcomes were the mean changed scores of ADHD rating scales, the overall response rate, and the overall remission rates. The overall discontinuation rate and the discontinuation rate due to adverse events were determined. Relative risks and weighted mean differences or standardized mean differences with 95% confidence intervals were estimated using a random effect model.Results: A total of 146 subjects in four RCTs comparing bupropion with methylphenidate in the treatment of

  6. A young man with acute dilated cardiomyopathy associated with methylphenidate

    Tor-Bjarne Nymark

    2008-05-01

    Full Text Available Tor-Bjarne Nymark1, A Hovland2, H Bjørnstad2, E W Nielsen1,31Section for Emergency Medicine; 2Department of Cardiology, Nordland Hospital, Bodø, Norway; 3University of Tromsø, Tromsø, NorwayAbstract: An 18-year-old obese man with a body mass index of 40, diagnosed with attention-deficit hyperactivity disorder and treated with methylphenidate (Concerta® was acutely admitted to hospital with hypoxia and dyspnoea. On investigation signs of liver-, renal-, and heart-failure were found. Noradrenalin infusion was started. Echocardiography showed dilated left ventricle and an ejection fraction (EF of 25%. Liver function improved, noradrenalin and dobutamine were tapered, but three days after admission a new echocardiography showed an EF of 10%. The patient was transferred to the National Hospital (Rikshospitalet, Oslo, where intensified treatment including intra aortic balloon pump (IABP was instituted. Cardiac function improved, and 3 weeks later the IABP was disconnected. EF at this point was 15%. The patient was denied heart transplantation due to various cofactors. The investigation concluded with a probable relationship between his cardiomyopathy and the use of methylphenidate (Concerta.Keywords: cardiomyopathy, heart failure, ADHD, methylphenidate

  7. The clinical effectiveness and cost-effectiveness of methylphenidate for hyperactivity in childhood

    Lord, J.; Paisley, S.

    2000-01-01

    Hyperkinetic Disorder (HD) is characterised by the presence of severe and pervasive signs of inattention, hyperactivity and impulsiveness. It is estimated that approximately 1% of children may meet the diagnostic criteria for HD. The broader definition of Attention Deficit/ Hyperactivity Disorder (ADHD) leads to higher estimates of prevalence. Methylphenidate is a central nervous system stimulant that is indicated for use as part of a comprehensive treatment programme for attention deficit hy...

  8. High dose methylphenidate treatment in adult Attention Deficit Hyperactivity Disorder: a case report

    Liebrenz Michael; Hof Danielle; Buadze Anna; Stohler Rudolf; Eich Dominique

    2012-01-01

    Abstract Introduction Stimulant 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 presentation We 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 sustai...

  9. Methylphenidate and the Juvenile Brain: Enhancement of Attention at the Expense of Cortical Plasticity?

    Urban, Kimberly R.; Gao, Wen-Jun

    2013-01-01

    Methylphenidate (Ritalin) is the most commonly prescribed psychoactive drug for juveniles and adolescents. Used to treat attention-deficit/hyperactivity disorder (ADHD) and for cognitive enhancement in healthy individuals, it has been regarded as a relatively safe medication for the past several decades. However, a thorough review of the literature reveals that the age-dependent activities of the drug, as well as potential developmental effects, are largely ignored. In addition, the diagnosis...

  10. Descending glutamatergic pathways of PFC are involved in acute and chronic action of Methylphenidate

    Wanchoo, S.J.; Swann, A.C.; Dafny, N

    2009-01-01

    Progressive augmentation of behavioral response following repeated psychostimulant administrations is known as behavioral sensitization, and is an indicator of a drug’s liability for abuse. It is known that methylphenidate (MPD) (also known as Ritalin), a drug used to treat Attention-Deficit Hyperactivity Disorder (ADHD), induces sensitization in animals following repeated injections. It was recently reported that bilateral electric (non-specific) lesion of prefrontal cortex (PFC) prevented M...

  11. Methylphenidate and Atomoxetine Inhibit Social Play Behavior through Prefrontal and Subcortical Limbic Mechanisms in Rats

    2015-01-01

    Positive social interactions during the juvenile and adolescent phases of life, in the form of social play behavior, are important for social and cognitive development. However, the neural mechanisms of social play behavior remain incompletely understood. We have previously shown that methylphenidate and atomoxetine, drugs widely used for the treatment of attention-deficit hyperactivity disorder (ADHD), suppress social play in rats through a noradrenergic mechanism of action. Here, we aimed t...

  12. Bulimia nervosa patient diagnosed with previously unsuspected ADHD in adulthood: clinical case report, literature review, and diagnostic challenges.

    Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich

    2014-05-01

    There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account. PMID:24311027

  13. Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance dependence : a 24-week randomized placebo-controlled trial.

    Konstenius, Maija; Jayaram-Lindström, Nitya; Guterstam, Joar; Beck, Olof; Philips, Björn; Franck, Johan

    2014-01-01

    AIM: To test the efficacy and safety of osmotic release oral system (OROS) methylphenidate (MPH) in doses up to 180 mg/day to treat attention deficit hyperactivity disorder (ADHD) and prevent any drug relapse in individuals with a co-diagnosis of ADHD and amphetamine dependence. DESIGN: Randomized placebo-controlled 24-week double-blind trial with parallel groups design. SETTING: Participants were recruited from medium security prisons in Sweden. The medication started within 2 weeks before r...

  14. An observational study of response heterogeneity in children with attention deficit hyperactivity disorder following treatment switch to modified-release methylphenidate

    Hautmann, Christopher; Rothenberger, Aribert; Döpfner, Manfred

    2013-01-01

    Background Methylphenidate (MPH) has been shown to be effective in the treatment of attention deficit hyperactivity disorder (ADHD) in children. The overall population of children and adolescents with ADHD may comprise distinct clusters of patients that differ in response to MPH. The aim of this analysis was to look for subgroups with different treatment trajectories and to identify their distinctive features. Methods OBSEER was a prospective, observational study examining the effectiveness a...

  15. Effects of methylphenidate on sensitivity to reinforcement in children diagnosed with attention deficit hyperactivity disorder: an application of the matching law.

    Murray, L K; Kollins, S H

    2000-01-01

    The behavior of children diagnosed with attention deficit hyperactivity disorder (ADHD) has been hypothesized to be the result of decreased sensitivity to consequences compared to typical children. The present study examined sensitivity to reinforcement in 2 boys diagnosed with ADHD using the matching law to provide more precise and quantitative measurement of this construct. This experiment also evaluated the effects of methylphenidate (MPH) on sensitivity to reinforcement of children with A...

  16. [Update on Current Care guidelines: ADHD (attention-deficit/hyperactivity disorder, children and adolescents)].

    2012-01-01

    The updated Current Care guideline for children and adolescents with ADHD covers both diagnosis and treatment. Psychosocial support is provided when hyperactivity problems arise, even before specific diagnosis. While psychosocial interventions are effective in the treatment of ADHD, the core symptoms are best treated with medication, such as methylphenidate, dexamphetamine, lisdexamphetamine or atomoxetine. Collaboration between families, primary health care services, specialist consultation services and day-care and school professionals is essential within the chain of care. PMID:22486070

  17. Processing of Continuously Provided Punishment and Reward in Children with ADHD and the Modulating Effects of Stimulant Medication: An ERP Study

    Groen, Yvonne; Tucha, Oliver; Wijers, Albertus A.; Althaus, Monika

    2013-01-01

    Objectives Current models of ADHD suggest abnormal reward and punishment sensitivity, but the exact mechanisms are unclear. This study aims to investigate effects of continuous reward and punishment on the processing of performance feedback in children with ADHD and the modulating effects of stimulant medication. Methods 15 Methylphenidate (Mph)-treated and 15 Mph-free children of the ADHD-combined type and 17 control children performed a selective attention task with three feedback condition...

  18. Processing of Continuously Provided Punishment and Reward in Children with ADHD and the Modulating Effects of Stimulant Medication: An ERP Study

    Groen, Yvonne; Tucha, Oliver; Wijers, Albertus A.; Althaus, Monika

    2013-01-01

    Objectives: Current models of ADHD suggest abnormal reward and punishment sensitivity, but the exact mechanisms are unclear. This study aims to investigate effects of continuous reward and punishment on the processing of performance feedback in children with ADHD and the modulating effects of stimulant medication. Methods: 15 Methylphenidate (Mph)-treated and 15 Mph-free children of the ADHD-combined type and 17 control children performed a selective attention task with three feedback conditi...

  19. A network meta-analysis of atomoxetine and osmotic release oral system methylphenidate in the treatment of attention-deficit/hyperactivity disorder in adult patients.

    Bushe, Chris; Day, Kathleen; Reed, Victoria; Karlsdotter, Kristina; Berggren, Lovisa; Pitcher, Ashley; Televantou, Foula; Haynes, Virginia

    2016-05-01

    The lack of head-to-head clinical studies powered to compare atomoxetine and osmotic release oral system (OROS) methylphenidate necessitates treatment comparison by methods that include indirect evidence such as network meta-analysis (NMA). A NMA assessing the relative treatment effects of atomoxetine and OROS methylphenidate in adults with attention-deficit/hyperactivity disorder (ADHD) was conducted. Studies were identified by systematic literature review. Analyses summarised improvements in efficacy, measured by ADHD-specific scales, using Cohen'sdto calculate the standardised mean difference (SMD), and all cause discontinuations. Results showed effect sizes (SMD, 95% credible interval (CrI)) relative to placebo that did not differ significantly between atomoxetine (0.46, 0.36-0.56) and OROS methylphenidate (0.51, 0.40-0.63) in clinical studies of up to 12 weeks' duration (SMD, 95% CrI for atomoxetine versus OROS methylphenidate: -0.05, -0.18-0.08). Patients treated with these medications responded better than those given placebo across all analyses. There was also no significant difference in discontinuation rates between atomoxetine and OROS methylphenidate (odds ratio, 95% CrI: 0.85, 0.53-1.35). Between-study heterogeneity was low overall. Results of this NMA suggest that the efficacy of atomoxetine and OROS methylphenidate in adults does not differ significantly. Clinical guidelines may require amendment to reflect these recent data. PMID:27005307

  20. Open-Label Dose Optimization of Methylphenidate Modified Release Long Acting (MPH-LA): A Post Hoc Analysis of Real-Life Titration from a 40-Week Randomized Trial

    Huss, Michael; Ginsberg, Ylva; Arngrim, Torben; Philipsen, Alexandra; Carter, Katherine; Chen, Chien-Wei; Gandhi, Preetam; Kumar, Vinod

    2014-01-01

    Background and Objectives In the management of attention-deficit hyperactivity disorder (ADHD) in adults it is important to recognize that individual patients respond to a wide range of methylphenidate doses. Studies with methylphenidate modified release long acting (MPH-LA) in children have reported the need for treatment optimization for improved outcomes. We report the results from a post hoc analysis of a 5-week dose optimization phase from a large randomized, placebo-controlled, multicen...

  1. Clinical use of a modified release methylphenidate in the treatment of childhood attention deficit hyperactivity disorder.

    Takon, Inyang

    2011-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioural disorder in childhood, affecting over 5% of children worldwide. As well as the core symptoms of inattention, hyperactivity and impulsivity, patients often exhibit learning difficulties and impairment in social functioning. The frequency of referral is higher for boys than for girls (about 2:1), and girls are generally older at the time of referral.Pharmacological therapy is considered the first-line treatment for patients with severe ADHD and severe impairment. Stimulant medications are licensed in the UK for the management of ADHD in school-age children and young people, and are effective in controlling ADHD symptoms.While immediate-release preparations of methylphenidate (MPH) have proven effective in the treatment of ADHD, there are a number of problems associated with their use, most notably compliance, stigma and medication diversion. Modified release preparations are now available that overcome the need for multiple daily dosing, and which offer different MPH release profiles, thereby enabling the physician to match the medication to the patient's particular requirements.This review describes the diagnosis, referral and treatment pathways for patients with ADHD in the UK and the practical considerations when initiating pharmacological treatment. The clinical experience of treating ADHD with a modified-release MPH preparation (Equasym XL®) is illustrated with case studies. PMID:21962224

  2. Clinical use of a modified release methylphenidate in the treatment of childhood attention deficit hyperactivity disorder

    Takon Inyang

    2011-09-01

    Full Text Available Abstract Attention deficit hyperactivity disorder (ADHD is the most commonly diagnosed neurobehavioural disorder in childhood, affecting over 5% of children worldwide. As well as the core symptoms of inattention, hyperactivity and impulsivity, patients often exhibit learning difficulties and impairment in social functioning. The frequency of referral is higher for boys than for girls (about 2:1, and girls are generally older at the time of referral. Pharmacological therapy is considered the first-line treatment for patients with severe ADHD and severe impairment. Stimulant medications are licensed in the UK for the management of ADHD in school-age children and young people, and are effective in controlling ADHD symptoms. While immediate-release preparations of methylphenidate (MPH have proven effective in the treatment of ADHD, there are a number of problems associated with their use, most notably compliance, stigma and medication diversion. Modified release preparations are now available that overcome the need for multiple daily dosing, and which offer different MPH release profiles, thereby enabling the physician to match the medication to the patient's particular requirements. This review describes the diagnosis, referral and treatment pathways for patients with ADHD in the UK and the practical considerations when initiating pharmacological treatment. The clinical experience of treating ADHD with a modified-release MPH preparation (Equasym XL® is illustrated with case studies.

  3. Transdermal Patches: A Complete Review on Transdermal Drug Delivery System

    Patel DS; Patel MV; Patel KN; Patel BA; Patel PA

    2012-01-01

    Today about 70% of drugs are taken orally and are found not to be as effective as desired. To improvesuch characters transdermal drug delivery system was emerged. Transdermal drug delivery system(TDDS) provides a means to sustain drug release as well as reduce the intensity of action and thusreduce the side effects associated with its oral therapy and differs from traditional topical drug delivery.Transdermal Drug Delivery System is the system in which the delivery of the active ingredients o...

  4. Association among SNAP-25 Gene "Dd"eI and "Mnl"I Polymorphisms and Hemodynamic Changes during Methylphenidate Use: A Functional Near-Infrared Spectroscopy Study

    Oner, Ozgur; Akin, Ata; Herken, Hasan; Erdal, Mehmet Emin; Ciftci, Koray; Ay, Mustafa Ertan; Bicer, Duygu; Oncu, Bedriye; Bozkurt, Ozlem Hekim; Munir, Kerim; Yazgan, Yanki

    2011-01-01

    Objective: To investigate the interaction of treatment-related hemodynamic changes with genotype status for Synaptosomal associated protein 25 (SNAP-25) gene in participants with attention deficit hyperactivity disorder (ADHD) on and off single dose short-acting methylphenidate treatment with functional near-infrared spectroscopy (fNIRS). Method:…

  5. Self-Regulation of Visual Attention and Facial Expression of Emotions in ADHD Children

    Kuhle, Hans J.; Kinkelbur, Jorg; Andes, Kerstin; Heidorn, Fridjof M.; Zeyer, Solveigh; Rautzenberg, Petra; Jansen, Fritz

    2007-01-01

    Objective: To test if visual focusing and mimic display as features of self-regulation in ADHD children show a curvilinear relation to rising methylphenidate (MPH) doses. To test if small dose steps of 2.5mg MPH cause significant changes in behavior. And to test the relation of these features to intellectual performance, parents' ratings, and…

  6. Treatment-Continuity of ADHD Compared Using Immediate-Release and Extended-Release MPH

    J Gordon Millichap

    2005-07-01

    Full Text Available The continuity of methylphenidate (MPH therapy for ADHD in young Medicaid beneficiaries (ages 6 to 17 years treated with immediate-release (IR or extended-release (ER MPH formulations was compared in an analysis of statewide California Medicaid claims (2000-2003 conducted at Columbia University, New York; University of Pennsylvania, Philadelphia; and McNeil Pharmaceuticals, Fort Washington, PA.

  7. ADHD-like behavior in a patient with hypothalamic hamartoma.

    Katayama, Koujyu; Yamashita, Yushiro; Yatsuga, Shuichi; Koga, Yasutoshi; Matsuishi, Toyojiro

    2016-01-01

    We report a male patient with hypothalamic hamartoma (HH) who manifested central precocious puberty (CPP) at 4 years of age. Gonadotropin-releasing hormone (GnRH) analogue treatment was started at 6 years of age and his pubertal signs were suppressed. At 9 years of age, the patient was emotionally unstable, aggressive, and antisocial. He had severe attention deficit hyperactivity disorder (ADHD)-like behavior and conduct disorder. No seizure activity was observed. GnRH analogue treatment was discontinued for 8 months from 9 years and 4 months of age due to his mother's illness. During this period sexual urges were observed. Treatment with daily methylphenidate markedly improved his behavioral problems. However, his sexual urges were not suppressed until 3 months after the GnRH analogue treatment was restarted. The present case is unique because the patient's behavioral problems were observed despite the parahypothalamic type of HH and absence of seizures. This case is also rare because behavioral problems were observed without seizures, and no ADHD cases with hamartoma have been reported previously. Recently, clinical studies have described an association between psychiatric morbidity, including ADHD, and hyperandrogenism disorders. Our patient's ADHD-like symptoms might be due to hyperandrogenism. In such cases, GnRH analogue with methylphenidate could be effective for improving ADHD-like symptoms. PMID:26028458

  8. Risky behavior in gambling tasks in individuals with ADHD--a systematic literature review.

    Yvonne Groen

    Full Text Available OBJECTIVE: The aim of this review was to gain insight into the relationship between Attention deficit hyperactivity disorder (ADHD and risky performance in gambling tasks and to identify any potential alternate explanatory factors. METHODS: PsycINFO, PubMed, and Web of Knowledge were searched for relevant literature comparing individuals with ADHD to normal controls (NCs in relation to their risky performance on a gambling task. In total, fourteen studies in children/adolescents and eleven studies in adults were included in the review. RESULTS: Half of the studies looking at children/adolescents with ADHD found evidence that they run more risks on gambling tasks when compared to NCs. Only a minority of the studies on adults with ADHD reported aberrant risky behavior. The effect sizes ranged from small to large for both age groups and the outcome pattern did not differ between studies that applied an implicit or explicit gambling task. Two studies demonstrated that comorbid oppositional defiant disorder (ODD and conduct disorder (CD increased risky behavior in ADHD. Limited and/or inconsistent evidence was found that comorbid internalizing disorders (IDs, ADHD subtype, methylphenidate use, and different forms of reward influenced the outcomes. CONCLUSION: The evidence for increased risky performance of individuals with ADHD on gambling tasks is mixed, but is stronger for children/adolescents with ADHD than for adults with ADHD, which may point to developmental changes in reward and/or penalty sensitivity or a publication bias for positive findings in children/adolescents. The literature suggests that comorbid ODD/CD is a risk factor in ADHD for increased risky behavior. Comorbid IDs, ADHD subtype, methylphenidate use, and the form of reward received may affect risky performance in gambling tasks; however, these factors need further examination. Finally, the implications of the findings for ADHD models and the ecological validity of gambling tasks

  9. Deviant patterns of methylphenidate use in adults

    Rasmussen, Lotte; Zoëga, Helga; Hallas, Jesper;

    2015-01-01

    PURPOSE: Several survey studies have documented misuse of methylphenidate defined as the use of non-prescribed methylphenidate or use different from what was prescribed. We aimed to identify and characterize adults with deviant patterns of methylphenidate use in Denmark during 2007-2012. Further......, we aimed to identify risk factors associated with deviant patterns of use. METHODS: Based on individual-level prescription data, new users of methylphenidate were followed for one year after filling their first prescription on methylphenidate. Adult patients were identified with deviant patterns of...... use if they had ≥4 different prescribers and filled ≥1095 defined daily doses of methylphenidate during the year of follow-up. Risk factors were estimated by using logistic regression. RESULTS: Among 20 829 new users of methylphenidate, we identified 82 (0.39%) patients displaying deviant patterns of...

  10. A randomized crossover clinical study showing that methylphenidate-SODAS improves attention-deficit/hyperactivity disorder symptoms in adolescents with substance use disorder

    C.M. Szobot; Rohde, L. A.; Katz, B; P. Ruaro; Schaefer, T; Walcher, M; Bukstein, O.; F. Pechansky

    2008-01-01

    Our objective was to evaluate the effectiveness of a long-acting formulation of methylphenidate (MPH-SODAS) on attention-deficit/hyperactivity disorder (ADHD) symptoms in an outpatient sample of adolescents with ADHD and substance use disorders (SUD). Secondary goals were to evaluate the tolerability and impact on drug use of MPH-SODAS. This was a 6-week, single-blind, placebo-controlled crossover study assessing efficacy of escalated doses of MPH-SODAS on ADHD symptoms in 16 adolescents with...

  11. Lisdexamfetamine: A Review in ADHD in Adults.

    Frampton, James E

    2016-04-01

    Lisdexamfetamine dimesylate (lisdexamfetamine) is a long-acting amfetamine prodrug with a convenient once-daily oral regimen that offers the potential for improved adherence and reduced abuse compared with short-acting preparations of amfetamines. Lisdexamfetamine (as Elvanse Adult(®); Tyvense Adult™) has been approved for use in adults with attention-deficit hyperactivity disorder (ADHD) under the EU decentralization procedure, with the first approvals in the UK, Sweden and Denmark. This approval reflects the results of three short-term trials in adults with ADHD in which fixed- or flexible-dose lisdexamfetamine produced significantly greater improvements than placebo in ADHD symptoms, overall functioning, executive functioning (including in patients with significant pre-existing impairment) and quality of life. Of note, a post hoc analysis of one of these studies suggested that the response to lisdexamfetamine was generally similar in treatment-naïve patients and those who had already received-and not responded satisfactorily to-previous ADHD therapies, including methylphenidate (MPH). Two further studies demonstrated the longer-term effectiveness of flexible-dose lisdexamfetamine in reducing ADHD symptoms, albeit maintenance of efficacy required ongoing treatment with the drug. Lisdexamfetamine was generally well tolerated in clinical trials, with an adverse event profile typical of that reported for other long-acting stimulants. Head-to-head comparisons with other long-acting agents, notably MPH and atomoxetine, are lacking. Nonetheless, on the basis of the available data, lisdexamfetamine provides a useful alternative option for the treatment of adults with ADHD, including those who have not responded adequately to previous ADHD therapies, including MPH. PMID:27048350

  12. Transdermal hyoscine induced unilateral mydriasis.

    Hannon, Breffni

    2012-03-20

    The authors present a case of unilateral mydriasis in a teenager prescribed transdermal hyoscine hydrobromide (scopolamine) for chemotherapy induced nausea and vomiting. The authors discuss the ocular side-effects associated with this particular drug and delivery system and the potential use of transdermal hyoscine as an antiemetic agent in this group.

  13. Methylphenidate in Adults with Attention Deficit Hyperactivity Disorder and Substance Use Disorders.

    Simon, Nicolas; Rolland, Benjamin; Karila, Laurent

    2015-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopment disorder occurring during childhood. However, ADHD persists into adulthood in 45.7% of cases. The global prevalence of adult ADHD is estimated to 5.3%, with no difference between Europe and North America. ADHD is often comorbid with substance use disorder (SUD), with Odds Ratio ranges from 1.5 to 7.9, depending on the substance and the dependence level. Conversely, the prevalence of ADHD among patients with SUD is 10.8%, versus 3.8% for patients without SUD. Methylphenidate (MPH) alleviates ADHD symptoms and, as such, is currently considered as a first choice medication. MPH blocks the dopamine and norepinephrine transporters leading to an increase in extracellular dopamine. It should be noted that its subjective effects are highly dependent on the pharmacokinetic and especially on the rate of input, which highlights the importance of choosing a sustained-release formulation. Meanwhile, prescribing MPH to patients with comorbid SUD has always been challenging for clinicians. The aim of this review is to address the benefits and pitfalls of using MPH in adults with ADHD comorbid SUD, depending on each of the following types of SUD: amphetamine, cocaine, nicotine, alcohol, cannabis and opiates. Overall, due to the prevalence of ADHD in SUD and to the benefits of MPH observed in this population, and considering the mild or low side effects observed, the response to MPH treatment should be evaluated individually in adults with comorbid ADHD and SUD. The choice of the formulation should favor sustained- release MPH over immediate release MPH. Cardiovascular parameters also have to be monitored during long-term use. PMID:26088112

  14. Additional biological therapies for attention-deficit hyperactivity disorder: repetitive transcranical magnetic stimulation of 1 Hz helps to reduce methylphenidate

    Helmut Niederhofer

    2011-12-01

    Full Text Available Excessive hyperactivity, impulsiveness and attentional difficulties characterize attentiondeficit hyperactivity disorder (ADHD. The aim of this case report is to signal the possible therapeutic effectiveness of the repetitive transcranial magnetic stimulation (rTMS. Low frequency (1Hz, 1200 stim/die for five days was applied on the impending scalp in the motor additional area of a patient suffering from combined type ADHD who received methylphenidate (MPH. We saw a significant improvement, especially according to criteria associated with hyperactivity. The improvement lasted for at least three weeks and suggested the final reduction in dosage of MPH.to 10 mg.

  15. Adolescent exposure to methylphenidate has no effect on the aversive properties of cocaine in adulthood.

    Wetzell, Bradley; Riley, Anthony L

    2012-05-01

    Methylphenidate is the most widely prescribed pharmacotherapeutic treatment of AD/HD in children and teens and has actions that are also involved in drug reward and reinforcement. Its clinical use has often raised concerns over the possibility that it could potentiate the risk for later drug-related problems. Animals exposed to methylphenidate during adolescence exhibit attenuated cocaine-induced conditioned place preference, but tend to self-administer cocaine more quickly than controls. A drug's abuse potential, as reflected by self-administration, is thought to be the product of a balance between its rewarding and aversive properties, thus the present research assessed the effects of adolescent exposure to methylphenidate on conditioned taste aversions induced by cocaine in adulthood in 132 male Sprague Dawley rats. Although cocaine induced robust dose-dependent taste aversions in accordance with previous research, there were no effects of adolescent exposure to methylphenidate in spite of evidence that it was behaviorally active. The present results indicate that changes in adult cocaine self-administration are not likely mediated by changes in the aversive response. The possibility that such changes are a function of reductions in reward threshold is discussed. PMID:22342661

  16. Effectiveness and safety of atomoxetine for ADHD in population between 6 and 19 years: a systematic review

    José Calleja; José Uribarr

    2012-01-01

    Introduction: Attention deficit hyperactivity disorder (ADHD) is generally treated with pharmacological interventions such as psychostimulants. The most used widely used one is methylphenidate followed by atomoxetine. Purpose: To identify, synthesize and evaluate the best available evidence on the effectiveness and safety of atomoxetine in ADHD treatment in the 6-19 year-old population. Methods: A systematic review of intervention studies that evaluated effectiveness of atomoxetine compared w...

  17. Behavioral sensitization and cross-sensitization between methylphenidate amphetamine, and 3-4, methylenedioxymethamphetamine (MDMA) in female SD rats

    Yang, Pamela B; Atkins, Kristal D; Dafny, Nachum

    2011-01-01

    The psychostimulants amphetamine and methylphenidate (MPD / Ritalin) are the drugs most often used to treat attention deficit hyperactivity disorder (ADHD). In addition, students of all ages take these drugs to improve academic performance but also abuse them for pleasurable enhancement. In addition, other psychostimulants such 3,4 methylenedioxymethamphetamine (MDMA / ecstasy) are used / abused for similar objectives. One of the experimental markers for the potential of a drug to produce dep...

  18. The effects of clinically relevant doses of amphetamine and methylphenidate on signal detection and DRL in rats

    Andrzejewski, Matthew E.; Spencer, Robert C.; Harris, Rachel L.; Feit, Elizabeth C.; McKee, Brenda L.; Berridge, Craig W.

    2014-01-01

    Low dose amphetamine (AMPH) and methylphenidate (MPH, Ritalin®) are the most widely prescribed and most effective pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD). Certain low, clinically relevant doses of MPH improve sustained attention and working memory in normal rats, in contrast to higher doses that impair cognitive ability and induce locomotor activity. However, the effects of AMPH of MPH on sustained attention and behavioral inhibition remain poorly characterized. Th...

  19. Ginkgo biloba as an adjunct to methylphenidate in the treatment of attention deficit hyperactivity disorder in children: review of articles

    Paria Hebrani; Fatemeh Behdani; Hoda Jalayer

    2015-01-01

    Attention-deficit/hyperactivity disorder is one of the most common psychiatric disorders in childhood. The medications which inhibit the reuptake of noradrenline and dopamine including psychostimulants such as methylphenidate and dextroamphetamine and non-stimulating pre-frontal cortex noradrenaline reuptake inhibitor such as atomoxetine, are the standard treatment of ADHD. Adverse effects of stimulants have been reported in thirty percent of patients with attention-deficit/hyperactivity diso...

  20. Coaching for ADHD

    Murphy, Kevin; Ratey, Nancy; Maynard, Sandy; Sussman, Susan; Wright, Sarah D.

    2010-01-01

    Despite limited scientific study on ADHD coaching as an intervention for adults with ADHD, the field of ADHD coaching has grown significantly and gained popularity in recent years. ADHD coaching is becoming a bona fide profession where one must advance through a rigorous training process, in order to be certified as a professional ADHD coach.…

  1. Differences in the neurochemical and behavioural profiles of lisdexamfetamine methylphenidate and modafinil revealed by simultaneous dual-probe microdialysis and locomotor activity measurements in freely-moving rats.

    Rowley, Helen L; Kulkarni, Rajiv S; Gosden, Jane; Brammer, Richard J; Hackett, David; Heal, David J

    2014-03-01

    Lisdexamfetamine dimesylate is a novel prodrug approved in North America, Europe and Brazil for treating attention deficit hyperactivity disorder (ADHD). It undergoes rate-limited hydrolysis by red blood cells to yield d-amphetamine. Following our previous work comparing lisdexamfetamine with d-amphetamine, the neurochemical and behavioural profiles of lisdexamfetamine, methylphenidate and modafinil were compared by dual-probe microdialysis in the prefrontal cortex (PFC) and striatum of conscious rats with simultaneous locomotor activity measurement. We employed pharmacologically equivalent doses of all compounds and those that spanned the therapeutically relevant and psychostimulant range. Lisdexamfetamine (0.5, 1.5, 4.5 mg/kg d-amphetamine base, per os (po)), methylphenidate (3, 10, 30 mg/kg base, po) and modafinil (100, 300, 600 mg/kg base, po) increased efflux of dopamine and noradrenaline in PFC, and dopamine in striatum. Only lisdexamfetamine increased 5-hydroxytryptamine (5-HT) efflux in PFC and striatum. Lisdexamfetamine had larger and more sustained effects on catecholaminergic neurotransmission than methylphenidate or modafinil. Linear correlations were observed between striatal dopamine efflux and locomotor activity for lisdexamfetamine and methylphenidate, but not modafinil. Regression slopes revealed greater increases in extracellular dopamine could be elicited without producing locomotor activation by lisdexamfetamine than methylphenidate. These results are consistent with clinical findings showing that lisdexamfetamine is an effective ADHD medication with prolonged duration of action and good separation between its therapeutic actions and stimulant side-effects. PMID:24327450

  2. Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports

    Duric Nezla S

    2012-08-01

    Full Text Available Abstract Background A randomized and controlled clinical study was performed to evaluate the use of neurofeedback (NF to treat attention-deficit/hyperactivity disorder (ADHD in children and adolescents. Methods The ADHD population was selected from an outpatient clinic for Child and Adolescent Mental Health in Norway. Ninety-one of the 275 children and adolescents ranging in age from 6 to 18 years (10.5 years participated in 30 sessions of an intensive NF program. The reinforcement contingency was based on the subjects’ production of cortical beta1 activity (15–18 Hz. The ADHD participants were randomized into three groups, with 30 in the NF group, 31 controls in a group that was given methylphenidate, and 30 in a group that received NF and methylphenidate. ADHD core symptoms were reported by parents using the parent form of the Clinician’s Manual for Assessment by Russell A. Barkley. Results Ninety-one children and adolescents were effectively randomized by age, sex, intelligence and distribution of ADHD core symptoms. The parents reported significant effects of the treatments, but no significant differences between the treatment groups were observed. Conclusions NF was as effective as methylphenidate at treating the attentional and hyperactivity symptoms of ADHD, based on parental reports. Trial registration Current Controlled Trials NCT01252446

  3. Diagnosis and management of ADHD in children.

    Felt, Barbara T; Biermann, Bernard; Christner, Jennifer G; Kochhar, Param; Harrison, Richard Van

    2014-10-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children, and the prevalence is increasing. Physicians should evaluate for ADHD in children with behavioral concerns (e.g., inattention, hyperactivity, impulsivity, oppositionality) or poor academic progress using validated assessment tools with observers from several settings (home, school, community) and self-observation, if possible. Physicians who inherit a patient with a previous ADHD diagnosis should review the diagnostic process, and current symptoms and treatment needs. Coexisting conditions (e.g., anxiety, learning, mood, or sleep disorders) should be identified and treated. Behavioral treatments are recommended for preschool-aged children and may be helpful at older ages. Effective behavioral therapies include parent training, classroom management, and peer interventions. Medications are recommended as first-line therapy for older children. Psychostimulants, such as methylphenidate and dextroamphetamine, are most effective for the treatment of core ADHD symptoms and have generally acceptable adverse effect profiles. There are fewer supporting studies for atomoxetine, guanfacine, and clonidine, and they are less effective than the psychostimulants. Height, weight, heart rate, blood pressure, symptoms, mood, and treatment adherence should be recorded at follow-up visits. PMID:25369623

  4. What place for lisdexamfetamine in children and adolescents with ADHD?

    2013-10-01

    Attention deficit hyperactivity disorder (ADHD) is the commonest behavioural disorder in the UK, affecting 2-5% of school-aged children and young people.(1) Guidelines from the National Institute for Health and Care Excellence (NICE) state that medication is not indicated as first-line treatment for school-age children and young people with ADHD, but should be reserved for those with severe symptoms and impairment, or those with moderate levels of impairment who have refused non-drug interventions, or those whose symptoms have not responded sufficiently to parent-training/education programmes or group psychological treatment.(2) Current drug options include methylphenidate (first-line), atomoxetine (first- or second-line) or dexamfetamine (second- or third-line).(2) Lisdexamfetamine (Elvanse-Shire Pharmaceuticals) is a prodrug of dexamfetamine, licensed as part of a comprehensive treatment programme for ADHD in children aged 6 years and over when response to previous methylphenidate treatment is considered clinically inadequate.(3,4) Here we review the place of lisdexamfetamine in the management of ADHD in children and adolescents. PMID:24113146

  5. Exposure to methylphenidate during infancy and adolescence in non-human animals and sensitization to abuse of psychostimulants later in life: a systematic review

    Juliana Jaboinski

    2015-09-01

    Full Text Available Introduction:Attention deficit hyperactivity disorder (ADHD is a neuropsychiatric pathology that has an important prevalence among young people and is difficult to diagnose. It is usually treated with methylphenidate, a psychostimulant with a mechanism of action similar to that of cocaine. Previous studies show that repeated use of psychostimulants during childhood or adolescence may sensitize subjects, making them more prone to later abuse of psychostimulant drugs such as cocaine and methamphetamine.Objective: To review experimental studies in non-human models (rodents and monkeys treated with methylphenidate during infancy or adolescence and tested for reinforcing effects on psychostimulant drugs in adulthood.Method: Systematic collection of data was performed on four databases (Web of Knowledge, PsycARTICLE, PubMed and SciELO. The initial search identified 202 articles published from 2009 to 2014, which were screened for eligibility. Seven articles met the inclusion criteria and were reviewed in this study.Results: The findings indicate that early exposure to methylphenidate has an effect on an ADHD animal model, specifically, on spontaneously hypertensive strain rats, especially those tested using the self-administration paradigm.Conclusion:Future studies should prioritize the spontaneously hypertensive rat strain - an animal model of ADHD. Experimental designs comparing different behavioral paradigms and modes of administration using this strain could lead to improved understanding of the effects of exposure to methylphenidate during childhood and adolescence.

  6. Dystonia in an adolescent on risperidone following the discontinuation of methylphenidate: a case report.

    Guler, Gulen; Yildirim, Veli; Kutuk, Meryem Ozlem; Toros, Fevziye

    2015-04-30

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with common comorbidities that include oppositional defiant disorder, conduct disorder, anxiety disorder, and affective disorders. Because of these comorbidities, drug combination treatments and drug-drug interactions are becoming increasingly more frequent. The present case report describes an acute dystonic reaction following the abrupt discontinuation of methylphenidate from a drug regimen with risperidone. The patient experienced acute dystonic reactions on three separate occasions when he forgot to take his methylphenidate medication. The present report informs clinicians about the possible side effects, such as dystonia, when psychostimulant and antipsychotic drug combinations are altered and suggests that the abrupt cessation of stimulants may lead to the development of movement disorders. Therefore, appropriate care is necessary when changing the dose of a drug or abruptly discontinuing a drug from a combination of psychostimulants and antipsychotics. PMID:25912546

  7. Adverse pregnancy outcomes after exposure to methylphenidate or atomoxetine during pregnancy

    Bro SP

    2015-01-01

    Full Text Available Søren Pauli Bro,1 Maiken Ina Siegismund Kjaersgaard,2 Erik Thorlund Parner,2 Merete Juul Sørensen,3 Jørn Olsen,4 Bodil Hammer Bech,4 Lars Henning Pedersen,4,5 Jakob Christensen,6,7 Mogens Vestergaard11Research Unit and Section for General Practice, Department of Public Health, 2Section for Biostatistics, Department of Public Health, Aarhus University, 3Regional Center for Child and Adolescent Psychiatry, Aarhus University Hospital, 4Section for Epidemiology, Department of Public Health, 5Department of Clinical Medicine – Obstetrics and Gynecology, Aarhus University, 6Department of Clinical Pharmacology, 7Department of Neurology, Aarhus University Hospital, Aarhus, DenmarkObjective: To determine if prenatal exposure to methylphenidate (MPH or atomoxetine (ATX increases the risk of adverse pregnancy outcomes in women with attention deficit/hyperactivity disorder (ADHD.Materials and methods: This was a population-based cohort study of all pregnancies in Denmark from 1997 to 2008. Information on use of ADHD medication, ADHD diagnosis, and pregnancy outcomes was obtained from nationwide registers.Results: We identified 989,932 pregnancies, in which 186 (0.02% women used MPH/ATX and 275 (0.03% women had been diagnosed with ADHD but who did not take MPH/ATX. Our reference pregnancies had no exposure to MPH/ATX and no ADHD diagnosis. Exposure to MPH/ATX was associated with an increased risk of spontaneous abortion (SA; ie, death of an embryo or fetus in the first 22 weeks of gestation (adjusted relative risk [aRR] 1.55, 95% confidence interval [CI] 1.03–2.36. The risk of SA was also increased in pregnancies where the mother had ADHD but did not use MPH/ATX (aRR 1.56, 95% CI 1.11–2.20. The aRR of Apgar scores <10 was increased among exposed women (aRR 2.06, 95% CI 1.11–3.82 but not among unexposed women with ADHD (aRR 0.99, 95% CI 0.48–2.05.Conclusion: MPH/ATX was associated with a higher risk of SA, but our study indicated that it may at

  8. Attention deficit hyperactivity disorder: binding of [{sup 99m}Tc]TRODAT-1 to the dopamine transporter before and after methylphenidate treatment

    Dresel, S.; LaFougere, C.; Brinkbaeumer, K.; Hahn, K.; Tatsch, K. [Dept. of Nuclear Medicine, Univ. of Munich (Germany); Krause, J.; Krause, K.-H. [Inst. for Psychiatry and Psychotherapy, Ottobrunn (Germany); Friedrich Baur Inst., Univ. of Munich (Germany); Kung, H.F. [Dept. of Radiology, Univ. of Pennsylvania (United States)

    2000-10-01

    Involvement of the dopaminergic system has been suggested in patients suffering from attention deficit hyperactivity disorder (ADHD) since the symptoms can be successfully treated with methylphenidate, a potent blocker of the dopamine transporter (DAT). This study reports the findings on the status of the DAT in adults with ADHD before and after commencement of treatment with methylphenidate, as measured using [{sup 99m}Tc]TRODAT-1. Seventeen patients (seven males, ten females, aged 21-64 years, mean 38 years) were examined before and after the initiation of methylphenidate treatment (3 x 5 mg/day). All subjects were injected with 800 MBq [{sup 99m}Tc]TRODAT-1 and imaged 3 h p.i. Single-photon emission tomography (SPET) scans were acquired using a triple-headed gamma camera. For semi-quantitative evaluation of the DAT, transverse slices corrected for attenuation were used to calculate specific binding in the striatum, with the cerebellum used as background [(STR-BKG)/BKG]. Data were compared with an age-matched control group. It was found that untreated patients presented with a significantly increased specific binding of [{sup 99m}Tc]TRODAT-1 to the DAT as compared with normal controls [(STR-BKG)/BKG: 1.43{+-}0.18 vs 1.22{+-}0.06, P<0.001]. Under treatment with methylphenidate, specific binding decreased significantly in all patients [(STR-BKG)/BKG: 1.00{+-}0.14, P<0.001]. Our findings suggest that the number of DAT binding sites is higher in drug-naive patients suffering from ADHD than in normal controls. The decrease in available DAT binding sites under treatment with methylphenidate correlates well with the improvement in clinical symptoms. The data of this study help to elucidate the complex dysregulation of the dopaminergic neurotransmitter system in patients suffering from ADHD and the effect of treatment with psychoactive drugs. (orig.)

  9. Attention deficit hyperactivity disorder: binding of [99mTc]TRODAT-1 to the dopamine transporter before and after methylphenidate treatment

    Involvement of the dopaminergic system has been suggested in patients suffering from attention deficit hyperactivity disorder (ADHD) since the symptoms can be successfully treated with methylphenidate, a potent blocker of the dopamine transporter (DAT). This study reports the findings on the status of the DAT in adults with ADHD before and after commencement of treatment with methylphenidate, as measured using [99mTc]TRODAT-1. Seventeen patients (seven males, ten females, aged 21-64 years, mean 38 years) were examined before and after the initiation of methylphenidate treatment (3 x 5 mg/day). All subjects were injected with 800 MBq [99mTc]TRODAT-1 and imaged 3 h p.i. Single-photon emission tomography (SPET) scans were acquired using a triple-headed gamma camera. For semi-quantitative evaluation of the DAT, transverse slices corrected for attenuation were used to calculate specific binding in the striatum, with the cerebellum used as background [(STR-BKG)/BKG]. Data were compared with an age-matched control group. It was found that untreated patients presented with a significantly increased specific binding of [99mTc]TRODAT-1 to the DAT as compared with normal controls [(STR-BKG)/BKG: 1.43±0.18 vs 1.22±0.06, P<0.001]. Under treatment with methylphenidate, specific binding decreased significantly in all patients [(STR-BKG)/BKG: 1.00±0.14, P<0.001]. Our findings suggest that the number of DAT binding sites is higher in drug-naive patients suffering from ADHD than in normal controls. The decrease in available DAT binding sites under treatment with methylphenidate correlates well with the improvement in clinical symptoms. The data of this study help to elucidate the complex dysregulation of the dopaminergic neurotransmitter system in patients suffering from ADHD and the effect of treatment with psychoactive drugs. (orig.)

  10. Methodological Issues in the Assessment of Medication Effects in Children Diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)

    Kollins, Scott H.

    2004-01-01

    Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders in school-aged children and is usually treated with stimulant medications, including methylphenidate (MPH; Ritalin[R], Ritalin-LA[R], Concerta[R], Metadate[R], or Focalin[R]) and other drug compounds (e.g., Adderall[R], Adderall-XR[R], or Dexedrine).…

  11. College Students with ADHD

    ... AACAP Facts for Families Guide Skip breadcrumb navigation College Students with ADHD Quick Links Facts For Families Guide ... with Attention Deficit Hyperactivity Disorder (ADHD) attend college. College students with ADHD face a number of challenges, including ...

  12. Getting Treatment for ADHD

    Full Text Available ... for your child. Medications Most children with ADHD benefit from taking medication. Medications do not cure ADHD. ... for side effects. A majority of children who benefit from medication for ADHD will continue to benefit ...

  13. ADHD-associated dopamine transporter, latrophilin and neurofibromin share a dopamine-related locomotor signature in Drosophila.

    van der Voet, M; Harich, B; Franke, B; Schenck, A

    2016-04-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common, highly heritable neuropsychiatric disorder with hyperactivity as one of the hallmarks. Aberrant dopamine signaling is thought to be a major theme in ADHD, but how this relates to the vast majority of ADHD candidate genes is illusive. Here we report a Drosophila dopamine-related locomotor endophenotype that is shared by pan-neuronal knockdown of orthologs of the ADHD-associated genes Dopamine transporter (DAT1) and Latrophilin (LPHN3), and of a gene causing a monogenic disorder with frequent ADHD comorbidity: Neurofibromin (NF1). The locomotor signature was not found in control models and could be ameliorated by methylphenidate, validating its relevance to symptoms of the disorder. The Drosophila ADHD endophenotype can be further exploited in high throughput to characterize the growing number of candidate genes. It represents an equally useful outcome measure for testing chemical compounds to define novel treatment options. PMID:25962619

  14. Lobeline Effects on Cognitive Performance in Adult ADHD.

    Martin, Catherine A; Nuzzo, Paul A; Ranseen, John D; Kleven, Mark S; Guenthner, Greg; Williams, Yolanda; Walsh, Sharon L; Dwoskin, Linda P

    2013-08-21

    Objective: In preclinical studies, lobeline inhibited hyperactivity induced by nicotine and amphetamine, and improved performance and learning in studies utilizing radial-arm maze and spatial-discrimination water maze. This laboratory proof-of-concept study investigated lobeline as a treatment for ADHD symptoms in adults (31.11 ± 7.08 years). Method: Using cognitive tasks and self-report measures, the effects of lobeline (0, 7.5, 15, or 30 mg, s.l.) and methylphenidate (0, 15, or 30 mg, p.o.) were assessed in nine volunteers with ADHD. Results: Evidence suggested that lobeline could modestly improve working memory in adults with ADHD, but no significant improvement in attention was observed. Lobeline administration was associated with mild adverse side effects (nausea). Conclusion: Further investigation of lobeline on working memory may be warranted. PMID:23966351

  15. Impact of methylphenidate formulation on treatment patterns and hospitalizations: a retrospective analysis

    Lage Maureen J

    2006-04-01

    Full Text Available Abstract Background While stimulant therapy has been shown to be effective in the treatment of attention-deficit/hyperactivity disorder (ADHD, there is less information concerning differences between alternative stimulant medications. The purpose of this study is to examine how different formulations of methylphenidate (MPH affect treatment patterns and hospitalizations. Methods From a large claims database we retrospectively identified individuals age 6 or older who were diagnosed with ADHD and who received either once daily, extended-release oral system methylphenidate (OROS® MPH (e.g., Concerta® or three-times daily immediate-release generic methylphenidate (TID MPH. There were 5,939 individuals included in the analysis – 4,785 who initiated therapy with OROS MPH and 1,154 who initiated therapy with TID MPH. We used Analyses of Covariance (ANCOVAs to examine differences in treatment patterns between individuals who initiated therapy on OROS MPH and those who initiated therapy on TID MPH. We used logistic and negative binomial multivariate regressions to examine the probability of being hospitalized and the hospital length of stay. Results Controlling for demographic characteristics, patient general health status, and comorbid diagnoses, significantly fewer individuals who initiated therapy with OROS MPH had a 15-day gap in therapy (85% vs. 97%, p Conclusion Results demonstrate that among individuals diagnosed with ADHD who receive either OROS MPH or TID MPH, the use of OROS MPH is associated with fewer gaps in medication, less switches in medication, and more days on intent-to-treat therapy. In addition, use of OROS MPH compared to TID MPH was associated with improved outcomes, as measured by the reduced use of hospitalizations.

  16. Long-Term Treatment Outcome in Adult Male Prisoners With Attention-Deficit/Hyperactivity Disorder: Three-Year Naturalistic Follow-Up of a 52-Week Methylphenidate Trial.

    Ginsberg, Ylva; Långström, Niklas; Larsson, Henrik; Lindefors, Nils

    2015-10-01

    Despite high rates of attention-deficit/hyperactivity disorder (ADHD) among adult lawbreakers, particularly the long-term effects of ADHD pharmacotherapy remain unclear, not the least because of ethical challenges with preventing control subjects in randomized controlled trials from receiving medication over prolonged time. We followed up adult male prisoners with ADHD who completed a 5-week randomized, double-blind, placebo-controlled trial followed by a 47-week open-label extension of osmotic-release oral system methylphenidate in a Swedish high-security prison from 2007 to 2010 (ClinicalTrials.gov: NCT00482313). Twenty-five trial completers were prospectively followed up clinically 1 year (24/25, 96% participated fully or in part) and 3 years (20/25, 80% participation) after trial regarding ADHD symptoms (observer and self-reports), psychosocial functioning, substance misuse, and criminal reoffending. Methylphenidate-related improvements in ADHD symptoms and psychosocial functioning obtained during the 52-week trial were maintained at 1- and 3-year follow-ups. Specifically, after 3 years, 75% (15/20) of the respondents had been released from prison, and 67% of these (10/15) had employment, usually full time. In contrast, nonmedicated respondents at the 3-year follow-up (5/20) reported more ADHD symptoms, functional impairment, and substance misuse compared with currently medicated respondents (15/20). Further, 40% of the respondents self-reported reoffending, indicating a substantially lower relapse rate than expected (70%-80%).In summary, although these observations need validation from new and larger samples, positive effects were maintained after 4 years of methylphenidate treatment. Most study completers were employed and had no relapse in substance misuse or criminality. These results suggest that motivational support and continued medication are important for improved outcome in adult criminal offenders with ADHD. PMID:26284932

  17. Acute oral administration of low doses of methylphenidate targets calretinin neurons in the rat septal area.

    Alvaro eGarcía-Aviles

    2015-03-01

    Full Text Available Methylphenidate (MPD is a commonly administered drug to treat children suffering from attention deficit hyperactivity disorder (ADHD. Alterations in septal driven hippocampal theta rhythm may underlie attention deficits observed in these patients. Amongst others, the septo-hippocampal connections have long been acknowledged to be important in preserving hippocampal function. Thus, we wanted to ascertain if methylphenidate administration, which improves attention in patients, could affect septal areas connecting with hippocampus. We used low and orally administered methylphenidate doses (1.3; 2.7 and 5mg/Kg to rats what mimics the dosage range in humans. In our model, we observed no effect when using 1.3mg/Kg methylphenidate; whereas 2.7 and 5 mg/Kg induced a significant increase in c-fos expression specifically in the medial septum, an area intimately connected to the hippocampus. We analyzed dopaminergic areas such as nucleus accumbens and striatum, and found that only 5mg/Kg induced c-fos levels increase. In these areas tyrosine hydroxylase correlated well with c-fos staining, whereas in the medial septum the sparse tyrosine hydroxylase fibres did not overlap with c-fos positive neurons. Double immunofluorescence of c-fos with neuronal markers in the septal area revealed that co-localization with choline acethyl transferase, parvalbumin, and calbindin with c-fos did not change with MPD treatment; whereas, calretinin and c-fos double labeled neurons increased after MPD administration. Altogether, these results suggest that low and acute doses of methylphenidate primary target specific populations of caltretinin medial septal neurons.

  18. Neuroscience of attention deficit hyperactivity disorder (ADHD- a review

    Haile D.B

    2013-05-01

    Full Text Available Attention Deficit Hyperactivity disorder (ADHD does not have a single underlying pathophysiology which seems it has a multifaceted etiology. There are various contributing factors for ADHD, environmental and genetic being few of them. This neurobiological disorder has been a result of continuous actions of the risk factors. Neuroimaging study has indicated that children suffering from ADHD had immature brains compared to other children. This has pointed towards the fact that the Cerebellum, Basal Ganglia and the Prefrontal cortex parts of the brain are predominantly affected. The pharmacological & neuroimaging studies implicated that the dysregulation of the neuronal pathways of the Neurotransmitters (Dopamine and Norepinephrine being primarily responsible for ADHD. The principal treatment procedure involves Pharmacotherapy (Medication and other effective Psychotherapy (Psychopharmacological methods for ADHD. Presently immediate release Methylphenidate (Ritalin, Coencerta has been clinically approved for the diagnosis of ADHD. The psychotherapy evolves self-consciousness of sensory and cognitive thinking strengths and blind spots deliver some respite and enhanced enactment. The pharmacotherapy should strategize complete treatment plan including behavioural and educational aspects.

  19. A critical appraisal of atomoxetine in the management of ADHD.

    Childress, Ann C

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder beginning in childhood and often continuing into adulthood. A wealth of data shows that ADHD symptoms respond well to pharmacological treatment. Stimulant medications, including amphetamine and methylphenidate, are most commonly used to treat ADHD. However, with the approval of atomoxetine (Strattera(®), [ATX]) by the US Food and Drug Administration in late 2002, an effective non-stimulant option became available. The US Food and Drug Administration approved ATX for the treatment of ADHD in children, adolescents, and adults. Although the effect size of ATX is generally lower than that of stimulants, the American Academy of Child and Adolescent Psychiatry Practice Parameter for the treatment of ADHD lists ATX as a first-line treatment option. ATX is widely prescribed and accounted for 6% of the prescriptions of ADHD visits in the US in 2010. Numerous trials have found that ATX improves quality of life and emotional lability in addition to core ADHD symptoms. Although some improvement may be seen in a patient as early as one week after the initiation of treatment, ATX generally takes longer to have a full effect. The median time to response using 25% improvement in ADHD symptoms in pooled trials was 3.7 weeks. Data from these trials indicate that the probability of symptom improvement may continue to increase up to 52 weeks after treatment is initiated. ATX has been shown to be safe and effective in combination with stimulants. It has also been studied systematically in subjects with ADHD and comorbid oppositional defiant disorder, anxiety, depression, and substance use disorders. The mechanism of action of ATX, its efficacy, and adverse events reported in trials is reviewed. PMID:26730199

  20. A critical appraisal of atomoxetine in the management of ADHD

    Childress AC

    2015-12-01

    Full Text Available Ann C ChildressCenter for Psychiatry and Behavioral Medicine, Inc., Las Vegas, NV, USAAbstract: Attention-deficit/hyperactivity disorder (ADHD is a common neurobehavioral disorder beginning in childhood and often continuing into adulthood. A wealth of data shows that ADHD symptoms respond well to pharmacological treatment. Stimulant medications, including amphetamine and methylphenidate, are most commonly used to treat ADHD. However, with the approval of atomoxetine (Strattera®, [ATX] by the US Food and Drug Administration in late 2002, an effective non-stimulant option became available. The US Food and Drug Administration approved ATX for the treatment of ADHD in children, adolescents, and adults. Although the effect size of ATX is generally lower than that of stimulants, the American Academy of Child and Adolescent Psychiatry Practice Parameter for the treatment of ADHD lists ATX as a first-line treatment option. ATX is widely prescribed and accounted for 6% of the prescriptions of ADHD visits in the US in 2010. Numerous trials have found that ATX improves quality of life and emotional lability in addition to core ADHD symptoms. Although some improvement may be seen in a patient as early as one week after the initiation of treatment, ATX generally takes longer to have a full effect. The median time to response using 25% improvement in ADHD symptoms in pooled trials was 3.7 weeks. Data from these trials indicate that the probability of symptom improvement may continue to increase up to 52 weeks after treatment is initiated. ATX has been shown to be safe and effective in combination with stimulants. It has also been studied systematically in subjects with ADHD and comorbid oppositional defiant disorder, anxiety, depression, and substance use disorders. The mechanism of action of ATX, its efficacy, and adverse events reported in trials is reviewed.Keywords: attention-deficit/hyperactivity disorder, Strattera, non-stimulants, pharmacotherapy

  1. From Clinical Application to Cognitive Enhancement: The Example of Methylphenidate.

    Busardò, Francesco Paolo; Kyriakou, Chrystalla; Cipolloni, Luigi; Zaami, Simona; Frati, Paola

    2016-01-01

    Methylphenidate (MPD) is a central nervous system (CNS) stimulant, which belongs to the phenethylamine group and is mainly used in the treatment of attention deficit hyperactive disorder (ADHD). However, a growing number of young individuals misuse or abuse MPD to sustain attention, enhance intellectual capacity and increase memory. Recently, the use of MPD as a cognitive enhancement substance has received much attention and raised concerns in the literature and academic circles worldwide. The prescribing frequency of the drug has increased sharply as consequence of the more accurate diagnosis of the ADHD and the popularity of the drug itself due to its beneficial short-term effect. However, careful monitoring is required, because of possible abuse. In this review different aspects concerning the use of MPD have been approached. Data showing its abuse among college students are given, when the drug is prescribed short term beneficial effects and side effects are provided; moreover studies on animal-models suggesting long lasting negative effects on healthy brains are discussed. Finally, emphasis is given to the available formulations and pharmacology. PMID:26813119

  2. Mindfulness Based Cognitive Therapy and the Adult ADHD Brain –A Neuropsychotherapeutic Perspective

    Katharina Bachmann

    2016-06-01

    Full Text Available Attention deficit/hyperactivity disorder (ADHD is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD.

  3. Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective

    Bachmann, Katharina; Lam, Alexandra P.; Philipsen, Alexandra

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD. PMID:27445873

  4. Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective.

    Bachmann, Katharina; Lam, Alexandra P; Philipsen, Alexandra

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD. PMID:27445873

  5. ADHD Perspectives: Medicalization and ADHD Connectivity

    Wright, Gloria Sunnie

    2012-01-01

    Today's "ADHDscape" is no longer confined to images of fidgety children falling off classroom chairs. Trans-generational images flood popular culture, from "ADHD creator" with entrepreneurial style, to "ADHD troublemaker". Indeed, ADHD's enigmatic characteristics seem to apply as much to crying babies as to forgetful grannies. With the recent…

  6. Are there any potentially dangerous pharmacological effects of combining ADHD medication with alcohol and drugs of abuse? A systematic review of the literature

    Barkla, Xanthe M.; McArdle, Paul A.; Newbury-Birch, Dorothy

    2015-01-01

    Background Among young people up to 18 years of age, approximately 5 % have attention deficit hyperactivity disorder (ADHD), many of whom have symptoms persisting into adulthood. ADHD is associated with increased risk of co-morbid psychiatric disorders, including substance misuse. Many will be prescribed medication, namely methylphenidate, atomoxetine, dexamphetamine and lisdexamfetamine. If so, it is important to know if interactions exist and if they are potentially toxic. Methods Three dat...

  7. ADHD ja rentoutuminen : Rentoutusopas ADHD-liitolle

    Koskinen, Henna; Miettinen, Outi

    2016-01-01

    Opinnäytetyön tarkoitus oli tuottaa ADHD-liitolle opetuskäyttöön ja jaettavaksi rentoutusopas, jossa on kaikenikäisille rentoutumisvaihtoehtoja. Työ sai alkunsa suunnittelupalaverissa yhdessä ADHD-liiton kanssa. ADHD on aktiivisuuden ja tarkkaavuuden häiriö ja se on neuropsykiatrinen häiriö. ADHD:n ydinoireet ovat tarkkaamattomuus, yliaktiivisuus ja impulsiivisuus ja ne näkyvät sekä painottuvat eri tavoin ja haittaavat usealla elämän osa-alueella. Työssämme perehdytään ADHD:n etiologiaan,...

  8. A candidate gene investigation of methylphenidate response in adult attention-deficit/hyperactivity disorder patients: results from a naturalistic study.

    Hegvik, Tor-Arne; Jacobsen, Kaya Kvarme; Fredriksen, Mats; Zayats, Tetyana; Haavik, Jan

    2016-08-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common childhood onset neuropsychiatric disorder with a complex and heterogeneous symptomatology. Persistence of ADHD symptoms into adulthood is common. Methylphenidate (MPH) is a widely prescribed stimulant compound that may be effective against ADHD symptoms in children and adults. However, MPH does not exert satisfactory effect in all patients. Several genetic variants have been proposed to predict either treatment response or adverse effects of stimulants. We conducted a literature search to identify previously reported variants associated with MPH response and additional variants that were biologically plausible candidates for MPH response. The response to MPH was assessed by the treating clinicians in 564 adult ADHD patients and 20 genetic variants were successfully genotyped. Logistic regression was used to test for association between these polymorphisms and treatment response. Nominal associations (p nominal significance level (OR 0.560, 95 % CI 0.329-0.953, p = 0.033). However, this finding was not affirmed in the meta-analysis. No genetic variants revealed significant associations after correction for multiple testing (p < 0.00125). Our results suggest that none of the studied variants are strong predictors of MPH response in adult ADHD as judged by clinician ratings, potentially except for rs1800544. Consequently, pharmacogenetic testing in routine clinical care is not supported by our analyses. Further studies on the pharmacogenetics of adult ADHD are warranted. PMID:27091191

  9. Efficacy of lisdexamfetamine dimesylate in children with attention-deficit/hyperactivity disorder previously treated with methylphenidate: a post hoc analysis

    Jain Rakesh

    2011-11-01

    Full Text Available Abstract Background Attention-deficit/hyperactivity disorder (ADHD is a common neurobehavioral psychiatric disorder that afflicts children, with a reported prevalence of 2.4% to 19.8% worldwide. Stimulants (methylphenidate [MPH] and amphetamine are considered first-line ADHD pharmacotherapy. MPH is a catecholamine reuptake inhibitor, whereas amphetamines have additional presynaptic activity. Although MPH and amphetamine can effectively manage ADHD symptoms in most pediatric patients, many still fail to respond optimally to either. After administration, the prodrug stimulant lisdexamfetamine dimesylate (LDX is converted to l-lysine and therapeutically active d-amphetamine in the blood. The objective of this study was to evaluate the clinical efficacy of LDX in children with ADHD who remained symptomatic (ie, nonremitters; ADHD Rating Scale IV [ADHD-RS-IV] total score > 18 on MPH therapy prior to enrollment in a 4-week placebo-controlled LDX trial, compared with the overall population. Methods In this post hoc analysis of data from a multicenter, randomized, double-blind, forced-dose titration study, we evaluated the clinical efficacy of LDX in children aged 6-12 years with and without prior MPH treatment at screening. ADHD symptoms were assessed using the ADHD-RS-IV scale, Conners' Parent Rating Scale-Revised short form (CPRS-R, and Clinical Global Impressions-Improvement scale, at screening, baseline, and endpoint. ADHD-RS-IV total and CPRS-R ADHD Index scores were summarized as mean (SD. Clinical response for the subgroup analysis was defined as a ≥ 30% reduction from baseline in ADHD-RS-IV score and a CGI-I score of 1 or 2. Dunnett test was used to compare change from baseline in all groups. Number needed to treat to achieve one clinical responder or one symptomatic remitter was calculated as the reciprocal of the difference in their proportions on active treatment and placebo at endpoint. Results Of 290 randomized participants enrolled, 28

  10. Comparative Efficacy of Iranian and Foreign Methylphenidate in Children with Attention Deficit Hyperactive Disorder

    M Karahmadi

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Methylphenidate is one of the basic drugs in treating ADHD. According to many clinical studies, the foreign form of methylphenidate (ritalin is more efficient than the Iranian form of the drug (stimidate. This study aimed to compare the efficacy of stimidate and Ritalin in the treatment of attention deficit hyperactive disorder. Materials & Methods: In this double blind, randomized clinical trial, 200 children with attention deficit hyperactive disorder who referred to Isfahan psychiatric clinics were studied. For 100 of these patients ritalin was prescribed while others received stimidate. After 4 weeks, changes in severity of symptoms were evaluated with parental form of Conner's questionnaire. Results: After 4 weeks of treatment, the mean decrease of Conner's number in Ritalin group was 19.63±13.5 and in Stimidate group was 3.29±7.2. Ritalin had effectiveness in treatment of 83.3 percent of the patients ( 6 reduction in Conner's number, but Stimidate was only effective in treating 37.5 percent of the patients. Conclusion: This study showed that foreign methylphenidate (ritalin is more effective than the Iranian form of the medicine (stimidate.

  11. The ADHD-susceptibility gene lphn3.1 modulates dopaminergic neuron formation and locomotor activity during zebrafish development.

    Lange, M; Norton, W; Coolen, M; Chaminade, M; Merker, S; Proft, F; Schmitt, A; Vernier, P; Lesch, K-P; Bally-Cuif, L

    2012-09-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, increased impulsivity and emotion dysregulation. Linkage analysis followed by fine-mapping identified variation in the gene coding for Latrophilin 3 (LPHN3), a putative adhesion-G protein-coupled receptor, as a risk factor for ADHD. In order to validate the link between LPHN3 and ADHD, and to understand the function of LPHN3 in the etiology of the disease, we examined its ortholog lphn3.1 during zebrafish development. Loss of lphn3.1 function causes a reduction and misplacement of dopamine-positive neurons in the ventral diencephalon and a hyperactive/impulsive motor phenotype. The behavioral phenotype can be rescued by the ADHD treatment drugs methylphenidate and atomoxetine. Together, our results implicate decreased Lphn3 activity in eliciting ADHD-like behavior, and demonstrate its correlated contribution to the development of the brain dopaminergic circuitry. PMID:22508465

  12. OPTIMIZATION TECHNIQUES IN TRANSDERMAL DRUG DELIVERY SYSTEM

    Shikha Deshwal et al

    2012-08-01

    Full Text Available Transdermal drug technology specialists are continuing to search for new methods that can effectively and painlessly deliver larger molecules in therapeutic quantities to overcome the difficulties associated with the oral route. Transdermal Drug Delivery System (TDDS is the system in which the delivery of the active ingredients of the drug occurs by the means of skin. Skin is an effective medium from which absorption of the drug takes place and enters in to circulatory system. Various types of transdermal patches are used to incorporate the active ingredients into the circulatory system via skin. The patches have been proved effective because of its large advantages over other controlled drug delivery systems. This review article covers a brief outline of various components of transdermal patch, applications of transdermal patch, their advantages, disadvantages, when the transdermal patch are used and when their use should be avoided, types of transdermal patch, recent techniques for enhancing TDDS

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

    Liebrenz Michael

    2012-05-01

    Full Text Available Abstract Introduction Stimulant 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 presentation We 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. Conclusions Symptoms of

  14. Advanced Test of Attention in Children with Attention-Deficit/Hyperactivity Disorder in Japan for Evaluation of Methylphenidate and Atomoxetine Effects

    Fujioka, Toru; Takiguchi, Shinichiro; Yatsuga, Chiho; Hiratani, Michio; Hong, Kang-E M; Shin, Min-Sup; Cho, Sungzoon; Kosaka, Hirotaka; Tomoda, Akemi

    2016-01-01

    Objective This study was conducted to validate the Advanced Test of Attention (ATA) of the visual attention version of Japanese children with attention deficit/hyperactivity disorder (ADHD) and to evaluate the efficacy of methylphenidate (OROS-MPH) and atomoxetine medications. Methods To assess pharmacotherapy efficacy, the visual version of ATA was administered to 42 children with ADHD. Results were assessed using discriminant analysis, ANOVA for indices of ATA before and after medication treatment, and correlation analysis between the improvement of indices of ATA and clinical symptoms during medication treatment. Results Discriminant analysis showed that 69.0% of ADHD children were assigned correctly. The T score of commission errors increased as the trial progressed on the medication-off condition. T scores of commission errors and standard deviation of response times on medication-on condition were low compared to the medication-off condition. A few significant correlations were found between the improvements of indices of ATA and ADHD-Rating Scale (RS) during treatment. Conclusion The performance of the visual version of ATA on medication-off condition reflected the features of ADHD. Furthermore, the medication treatment effects were confirmed sufficiently. In addition, results suggest that indices of ATA reflected aspects of ADHD symptoms that are difficult to elucidate for ADHD-RS. For assessing symptoms and effects of medical treatment in children with ADHD, ATA might be a useful assessment tool. PMID:26792044

  15. No Increases in Biomarkers of Genetic Damage or Pathological Changes in Heart and Brain Tissues in Male Rats Administered Methylphenidate Hydrochloride (Ritalin) for 28 Days

    Witt, Kristine L.; Malarkey, David E; Hobbs, Cheryl A.; Davis, Jeffrey P.; Kissling, Grace E.; Caspary, William; Travlos, Gregory; Recio, Leslie

    2010-01-01

    Following a 2005 report of chromosomal damage in children with attention deficit/hyperactivity disorder (ADHD) who were treated with the commonly prescribed medication methylphenidate (MPH), numerous studies have been conducted to clarify the risk for MPH-induced genetic damage. Although most of these studies reported no changes in genetic damage endpoints associated with exposure to MPH, one recent study (Andreazza et al. 2007) reported an increase in DNA damage detected by the Comet assay i...

  16. A review of the economic burden of ADHD

    Paramore Clark

    2005-06-01

    Full Text Available Abstract Attention-deficit hyperactivity disorder (ADHD is a common disorder that is associated with broad functional impairment among both children and adults. The purpose of this paper is to review and summarize available literature on the economic costs of ADHD, as well as potential economic benefits of treating this condition. A literature search was performed using MEDLINE to identify all published articles on the economic implications of ADHD, and authors were contacted to locate conference abstracts and articles in press that were not yet indexed. In total, 22 relevant items were located including published original studies, economic review articles, conference presentations, and reports available on the Internet. All costs were updated and presented in terms of year 2004 US dollars. A growing body of literature, primarily published in the United States, has demonstrated that ADHD places a substantial economic burden on patients, families, and third-party payers. Results of the medical cost studies consistently indicated that children with ADHD had higher annual medical costs than either matched controls (difference ranged from $503 to $1,343 or non-matched controls (difference ranged from $207 to $1,560 without ADHD. Two studies of adult samples found similar results, with significantly higher annual medical costs among adults with ADHD (ranging from $4,929 to $5,651 than among matched controls (ranging from $1,473 to $2,771. A limited number of studies have examined other economic implications of ADHD including costs to families; costs of criminality among individuals with ADHD; costs related to common psychiatric and medical comorbidities of ADHD; indirect costs associated with work loss among adults with ADHD; and costs of accidents among individuals with ADHD. Treatment cost-effectiveness studies have primarily focused on methylphenidate, which is a cost-effective treatment option with cost-effectiveness ratios ranging from $15

  17. Transdermal innovations in diabetes management.

    Rao, Rekha; Mahant, Sheefali; Chhabra, Lovely; Nanda, Sanju

    2014-01-01

    Diabetes mellitus, an endocrine disorder affecting glucose metabolism, has been crippling mankind for the past two centuries. Despite the advancements in the understanding pertaining to its pathogenesis and treatment, the currently available therapeutic options are far from satisfactory. The growing diabetic population increases the gravity of the situation. The shortcomings of the conventional drug delivery systems necessitate the need to delve into other routes. On account of its merits over other routes, the transdermal approach has drawn the interest of the researchers around the world. The transdermal drug delivery systems are aimed to achieve therapeutic concentrations of the drug through skin. These systems are designed so that the drug can be delivered at a pre-determined and controlled rate. This makes it particularly conducive to treat chronic disorders like diabetes. Correspondingly, the adverse effects and inconvenience concomitant with oral and parentral route are circumvented. This article attempts to outline the development of transdermal drug delivery systems to optimize diabetes pharmacotherapy. It not only covers the transdermal approaches adopted to fine-tune insulin delivery, but also, discusses various transdermal drug delivery systems fabricated to improve the therapeutic performance of oral hypoglycaemic agents. Such formulations include the advanced drug delivery systems, namely, transferosomal gels, microemulsions, self-dissolving micropiles, nanoparticles, insulin pumps, biphasic lipid systems, calcium carbonate nanoparticles, lecithin nanoparticles; physical techniques such as iontophoresis and microneedles and, drugs formulated as transdermal patches. In addition to this, the authors have also shed light on the future prospects and patented and commercial formulations of antidiabetic agents. PMID:25418713

  18. Depressive symptoms as a side effect of the sustained release form of methylphenidate in a 7-year-old boy with attention-deficit hyperactivity disorder

    Lakić Aneta

    2012-01-01

    Full Text Available Introduction. Hyperkinetic disorder or attention-deficit hyperactivity disorder (ADHD is a clinical entity consisting of a cluster of symptoms including hyperactivity, attention disorder and impulse control disorder group. In the context of ADHD etiology we may say that genetic, clinical and imaging studies point out a disruption of the brain dopamine system, which is corroborated by the clinical effectiveness of stimulant drugs, which increase extracellular dopamine in the brain. Basically, it is a biological and not psychological disorder, which is important both for the comprehension and therapeutical approach to this problem. Today, the best recommended approach regarding children with ADHD is a combination of two therapeutic modalities: pharmacotherapy and behavioral treatment. The first-choice drugs for this disorder belong to the group of sympathomimetics - psychostimulants and atomoxetine (more recently. As the firstchoice therapy, methylphenydate in sustained release form has numerous advantages. Like all drugs, methylphenidate has its unwanted side effects. Most common are: loss of appetite, weight loss, sleeping disorders, irritability, headache. These side effects are well-known and documented in the literature. By analysing the available literature we have found cases of psychiatric side effects such as: psychosis, mania, visual hallucinations, agitation, suicidal ideas. We have not found examples of ADHD in children who use increased dosage of sustained release of methylphenidate leading to depressive symptomatology. On the other side, methylphenidate may be prescribed for off-label use in treatmentresistant cases of depression. Case report. The case of a 7- year-old boy diagnosed with ADHD was on a minimal dose of sustained release form of methylphenidate. After initial titration of the drug, i.e. after raising the dose to the next level the boy developed clinical signs of depression. The treatment was ceased and depressive

  19. Safety and tolerability of flexible dosages of prolonged-release OROS methylphenidate in adults with attention-deficit/hyperactivity disorder

    Jan K Buitelaar

    2009-08-01

    Full Text Available Jan K Buitelaar1, J Antoni Ramos-Quiroga2, Miguel Casas2, J J Sandra Kooij3, Asko Niemelä4, Eric Konofal5, Joachim Dejonckheere6, Bradford H Challis7, Rossella Medori81Department of Psychiatry, University Medical Center, St. Radboud and Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands; 2Department of Psychiatry, Hospital Universitari Vall d’Hebron and Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; 3PsyQ, Psycho-Medical Programs, Program Adult ADHD, Den Haag, The Netherlands; 4Oulu University Hospital, Department of Psychiatry, Oulu, Finland; 5Groupe Hospitalier Pitie-Salpetriere, Paris, France; 6SGS Life Sciences, Mechelen, Belgium; 7Johnson & Johnson Pharmaceutical Research and Development, Titusville, NJ, USA; 8Janssen-Cilag EMEA, Neuss, GermanyAbstract: The osmotic release oral system (OROS methylphenidate formulation is a prolonged-release medication for the treatment of attention-deficit/hyperactivity disorder (ADHD in children, adolescents, and adults. We conducted a seven-week open-label extension of a double-blind study to assess the safety and tolerability of OROS methylphenidate in a flexible dose regimen (18–90 mg daily for the treatment of adults diagnosed with ADHD (N = 370. Medication was adjusted to optimize efficacy and tolerability for each patient. Adverse events, vital signs, and laboratory parameters were assessed. Most patients (337; 91% completed the seven-week treatment and the final dispensed dose was 18 mg (8%, 36 mg (29%, 54 mg (34%, 72 mg (20%, or 90 mg (9%. Adverse events were reported in 253 (68% patients and most were mild or moderate in severity; most frequently reported included headache (17%, decreased appetite (13%, and insomnia (11%. Adverse events were rarely serious (<1%; 2/370. Small mean increases in systolic and diastolic blood pressure (both 2.4 mmHg and pulse (3.2 bpm were observed. Body weight decreased

  20. First-Trimester Exposure to Methylphenidate

    Pottegård, Anton; Hallas, Jesper; Andersen, Jon T;

    2014-01-01

    OBJECTIVE: The use of methylphenidate to treat attention-deficit/hyperactivity disorder has risen dramatically in Western countries, and it is increasingly used by adults, including women of childbearing age. Very little is known about potential hazards of in utero exposure to methylphenidate. We...... conducted this study to estimate the risk of major congenital malformations following first-trimester in utero exposure to methylphenidate. METHOD: Data from 2005 to 2012 were extracted from the Danish National Patient Register, the Danish National Prescription Registry, the Medical Birth Registry, and the...... Danish Civil Registration System. Exposure was defined as having redeemed 1 or more prescriptions for methylphenidate within a time window defined as 14 days before the beginning of the first trimester up to the end of the first trimester. Each exposed subject was propensity score-matched to 10 unexposed...

  1. Traditional Oriental Herbal Medicine for Children and Adolescents with ADHD: A Systematic Review.

    Wong, Yuk Wo; Kim, Deog-Gon; Lee, Jin-Yong

    2012-01-01

    Objective. To evaluate the efficacy of traditional Oriental herbal medicines (TOHM) for children and adolescents with ADHD. Methods. Randomized clinical trials published from January 1, 1990, to December 31, 2010, in English, Chinese, Japanese, or Korean language which evaluated the use of TOHM on ADHD subjects of 18 years old or below, diagnosed based on DSM-IV, were searched from MEDLINE, EMBASE, PsyINFO, Cochrane Library, and 10 other databases. Results. Twelve studies involving 1189 subjects met the inclusion criteria. In general, the included studies claimed that TOHM has similar efficacy to methylphenidate and at the same time has fewer side effects compared to methylphenidate. Some studies also suggested that the effect of TOHM sustained better than methylphenidate. However, solid conclusions could not be drawn because the included studies were not of high quality. Risk of bias issues such as randomization, allocation, concealment and blinding were not addressed in most of the studies, and the risk of publication bias could not be ruled out. Conclusion. Currently, there is not strong evidence to say that TOHM is effective in treating the core symptoms of ADHD. PMID:23346205

  2. Methylphenidate facilitates learning-induced amygdala plasticity

    Tye, Kay M.; Tye, Lynne D.; Cone, Jackson J.; Hekkelman, Evelien F; Janak, Patricia H.; Bonci, Antonello

    2010-01-01

    Although methylphenidate (Ritalin) has been used therapeutically for nearly 60 years, the mechanisms by which it acutely modifies behavioral performance are poorly understood. Here we combined intra–lateral amygdala in vivo pharmacology and ex vivo electrophysiology to show that acute administration of methylphenidate, as well as a selective dopamine transporter inhibitor, facilitated learning-induced strengthening of cortico-amygdala synapses through a postsynaptic increase in AMPA receptor–...

  3. Methylphenidate Actively Induces Emergence from General Anesthesia

    Solt, Ken; Cotten, Joseph F.; Cimenser, Aylin; Wong, Kin F.K.; Chemali, Jessica J.; Brown, Emery N.

    2011-01-01

    Background: Although accumulating evidence suggests that arousal pathways in the brain play important roles in emergence from general anesthesia, the roles of monoaminergic arousal circuits are unclear. In this study, the authors tested the hypothesis that methylphenidate (an inhibitor of dopamine and norepinephrine transporters) induces emergence from isoflurane general anesthesia. Methods: Using adult rats, the authors tested the effect of intravenous methylphenidate on time to emergence...

  4. PRIMARY HYPERSOMNIA : RESPONSE TO FLUOXETINE AND METHYLPHENIDATE

    Andrade, Chittaranjan

    1999-01-01

    Primary hypersomnia, a rare clinical syndrome, was diagnosed in a 14-year-old boy. The syndrome showed partial response to high dose fluoxetine therapy (120 mg/day) which recruited insomnia, an adverse effect of the drug, for therapeutic purposes. Response was enhanced with intermittent methylphenidate in association with a lower dose of fluoxetine. A possible pharmacokinetic interaction developed, comprising fluoxetine-induced augmentation of methylphenidate activity; such an interaction has...

  5. Getting Treatment for ADHD

    Full Text Available ... ADHD. Medications can control ADHD symptoms on the day that the pills are taken. For several decades, ... and non-stimulant types—can last throughout the day. A single dose of a long-acting medication ...

  6. Getting Treatment for ADHD

    Full Text Available ... with ADHD can improve their ability to pay attention and control their behavior. The right care can ... with ADHD cope with daily problems, pay better attention, and learn to control aggression. A therapist may ...

  7. Getting Treatment for ADHD

    Full Text Available ... help a child with ADHD gain a better self-image. The therapist can help the child identify ... try to help the child understand ways to change or better cope with ADHD symptoms, such as ...

  8. Getting Treatment for ADHD

    Full Text Available ... a child with ADHD may fall behind in school and continue having trouble with friendships. Family life may also suffer. Untreated ADHD can increase strain between parents and children. Parents often blame themselves when they ...

  9. Getting Treatment for ADHD

    Full Text Available ... a child with ADHD may fall behind in school and continue having trouble with friendships. Family life ... ADHD? Common Signs and Symptoms Getting Treatment Supporting School Success The Teenage Years Working Together Resources Copyright © ...

  10. Getting Treatment for ADHD

    Full Text Available ... speak. Contents What is ADHD? How Common is ADHD? Common Signs and Symptoms Getting Treatment Supporting School Success The Teenage Years Working ... {1} ##LOC[OK]## ##LOC[Cancel]## { ...

  11. Getting Treatment for ADHD

    Full Text Available ... 62nd Annual Meeting 2017 Psychopharmacology Update Institute Annual Review Course Maintenance of Certification and Lifelong Learning Modules ... for your child. Medications Most children with ADHD benefit from taking medication. Medications do not cure ADHD. ...

  12. Getting Treatment for ADHD

    Full Text Available ... medical treatment, children with ADHD can improve their ability to pay attention and control their behavior. The ... become available as alternatives. Scientists are continuing to research and develop new drugs for ADHD. It is ...

  13. Getting Treatment for ADHD

    Full Text Available ... behind in school and continue having trouble with friendships. Family life may also suffer. Untreated ADHD can ... become available as alternatives. Scientists are continuing to research and develop new drugs for ADHD. It is ...

  14. ADHD Medicines (for Kids)

    ... Dictionary of Medical Words En Español What Other Kids Are Reading Movie: Digestive System Winter Sports: Sledding, ... Crushes What's a Booger? ADHD Medicines KidsHealth > For Kids > ADHD Medicines Print A A A Text Size ...

  15. Long-term neurocognitive effects of methylphenidate in patients with attention deficit hyperactivity disorder, even at drug-free status

    Huang Yu-Shu

    2012-11-01

    Full Text Available Abstract Background Methylphenidate (MPH, a psycho-stimulant, is the most widely administered drug for the pharmacological management of patients with attention deficit hyperactivity disorder (ADHD. This study attempts to determine whether sustainable improvements occur in neurocognitive function among ADHD patients following 12-month treatment with MPH, at drug-free status. Whether age groups, gender or ADHD subtypes differ in neurocognitive performance during MPH treatment is also examined. Methods Study participants consisted of 103 ADHD patients (mean age: 9.1 ± 1.9 years old who were drug naïve or drug free for at least 6 months. The patients were prescribed oral short-acting MPH at each dose range of 0.3–1.0 mg/kg daily. During 12 months of the study, the patients underwent the test of variables of attention (TOVA at the baseline, month 6 and month12. Patients were instructed to not intake MPH for one week before the second and the third TOVA. Results Seventy five patients completed the study. Results of this study indicated that although commission errors and response sensitivity (d’ significantly improved during MPH treatment for 12 months, omission errors, response time, response time variability and ADHD score did not. While younger ADHD patients ( Conclusions ADHD patients significantly improved in impulsivity and perceptual sensitivity, determined as TOVA, during MPH treatment for 12 months. Age and gender, yet not ADHD subtypes, appear to influence the MPH treatment effects in some indices of TOVA. A future study containing a comparison group is suggested to confirm whether the neurocognitive improvements are attributed to long-term effects of MPH or natural maturation of patients.

  16. Possible effect of norepinephrine transporter polymorphisms on methylphenidate-induced changes in neuropsychological function in attention-deficit hyperactivity disorder

    Park Subin

    2012-05-01

    Full Text Available Abstract Background Dysregulation of noradrenergic system may play important roles in pathophysiology of attention-deficit/hyperactivity disorder (ADHD. We examined the relationship between polymorphisms in the norepinephrine transporter SLC6A2 gene and attentional performance before and after medication in children with ADHD. Methods Fifty-three medication-naïve children with ADHD were genotyped and evaluated using the continuous performance test (CPT. After 8-weeks of methylphenidate treatment, these children were evaluated by CPT again. We compared the baseline CPT measures and the post-treatment changes in the CPT measures based on the G1287A and the A-3081T polymorphisms of SLC6A2. Results There was no significant difference in the baseline CPT measures associated with the G1287A or A-3081T polymorphisms. After medication, however, ADHD subjects with the G/G genotype at the G1287A polymorphism showed a greater decrease in the mean omission error scores (p = 0.006 than subjects with the G/A or A/A genotypes, and subjects with the T allele at the A-3081T polymorphism (T/T or A/T showed a greater decrease in the mean commission error scores (p = 0.003 than those with the A/A genotypes. Conclusions Our results provide evidence for the possible role of the G1287A and A-3081T genotypes of SLC6A2 in methylphenidate-induced improvement in attentional performance and support the noradrenergic hypothesis for the pathophysiology of ADHD.

  17. [Methylphenidate and secondary Raynaud's phenomenon].

    Iglesias Otero, M; Portela Romero, M; Bugarín González, R; Ventura Victoria, M A

    2013-09-01

    Raynaud's phenomenon is a clinical disease characterized by episodic attacks of vasoconstriction of the arteries and arterioles of the extremities such as fingers and toes, sometimes the ears and nose, in response to cold or emotional stimuli. A classic attack is the pallor of the distal extremity, followed by cyanosis and redness, accompanied by paresthesia, usually as heat. When it occurs without apparent cause is called primary Raynaud's phenomenon. When associated with other disease, is called secondary Raynaud's phenomenon. The secondary table is associated with increased frequency of rheumatic diseases of collagen. They can also present certain drugs that cause vasoconstriction, such as ergotamine, beta-adrenergic antagonists, contraception and sympathomimetic drugs. Regarding the latter, we present a case of Raynaud's phenomenon secondary to methylphenidate in a 14 years. PMID:24034762

  18. Girls and ADHD

    ... other girls, girls with ADHD experience more depression, anxiety, distress, poor teacher relationships, stress, external locus of control (the feeling that “the winds of fate” control their destiny instead of themselves), and impaired academics. Compared with boys with ADHD, girls with ADHD ...

  19. ADHD: Tips to Try

    ... How Can I Help a Friend Who Cuts? ADHD: Tips to Try KidsHealth > For Teens > ADHD: Tips to Try Print A A A Text Size en español TDAH: Consejos que puedes probar ADHD , or attention deficit hyperactivity disorder, is a medical ...

  20. Clinical pharmacokinetics of transdermal opioids: focus on transdermal fentanyl.

    Grond, S; Radbruch, L; Lehmann, K A

    2000-01-01

    Transdermal delivery allows continuous systemic application of opioids through the intact skin. This review analyses the pharmacokinetic properties of transdermal opioid administration in the context of clinical experience, with a focus on fentanyl. A transdermal therapeutic system (TTS) for fentanyl has been developed. The amount of fentanyl released is proportional to the surface area of the TTS, which is available in different sizes. After the first application of a TTS, a fentanyl depot concentrates in the upper skin layers and it takes several hours until clinical effects are observed. The time from application to minimal effective and maximum serum concentrations is 1.2 to 40 hours and 12 to 48 hours, respectively. Steady state is reached on the third day, and can be maintained as long as patches are renewed. Within each 72-hour period, serum concentrations decrease gradually over the second and third days. When a TTS is removed, fentanyl continues to be absorbed into the systemic circulation from the cutaneous depot. The terminal half-life for TTS fentanyl is approximately 13 to 25 hours. The interindividual variability of serum concentrations, partly caused by different clearance rates, is markedly larger than the intraindividual variability. The effectiveness of TTS fentanyl was first demonstrated in acute postoperative pain. However, the slow pharmacokinetics and large variability of TTS fentanyl, together with the relatively short duration of postoperative pain, precluded adequate dose finding and led to inadequate pain relief or, especially, a high incidence of respiratory depression; such use is now contraindicated. Conversely, in cancer pain, TTS fentanyl offers an interesting alternative to oral morphine, and its effectiveness and tolerability in this indication has been demonstrated by a number of trials. Its usefulness in chronic pain of nonmalignant origin remains to be confirmed in controlled trials. In general, TTS fentanyl produces the same

  1. Methylphenidate-induced erections in a prepubertal child.

    Kelly, B D

    2013-02-01

    Methylphenidate is a medication used routinely in the management of attention deficit hyperactivity disorder. We report a case of a prepubertal child who developed unwanted erections after commencing a response-adjusted dosing regimen of sustained release methylphenidate. Despite priapism being a rare adverse reaction associated with methylphenidate, physicians and parents need to be aware as it can have significant long-term complications.

  2. Long lasting complex nocturnal hallucinations during Osmotic Release Oral System (OROS) methylphenidate treatment in a 7-year old girl.

    Goetz, Michal; Prihodova, Iva; Hrdlicka, Michal

    2011-01-01

    We report a case of a girl with Attention deficit hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD) who experienced a 3-hour episode of nocturnal complex bizarre visual hallucinations when treated with 18 mg Osmotic Release Oral System (OROS) methylphenidate (MPH). Nocturnal polysomnography performed two weeks later revealed REM sleep reduction (17%) and fragmentation . Two episodes of confusional arousals were recorded. This finding is typical of parasomnia associated with NREM sleep - disorder of arousal. We hypothesize that this preexisting sleep impairment represents a factor of vulnerability to MPH sleep side effects. In our search of literature, we found no report of nocturnal hallucination alone during treatment with stimulants. PMID:22167138

  3. Methylphenidate improves motor functions in children diagnosed with Hyperkinetic Disorder

    Iversen Synnøve

    2009-05-01

    Full Text Available Abstract Background A previous study showed that a high percentage of children diagnosed with Hyperkinetic Disorder (HKD displayed a consistent pattern of motor function problems. The purpose of this study was to investigate the effect of methylphenidate (MPH on such motor performance in children with HKD Methods 25 drug-naïve boys, aged 8–12 yr with a HKD-F90.0 diagnosis, were randomly assigned into two groups within a double blind cross-over design, and tested with a motor assessment instrument, during MPH and placebo conditions. Results The percentage of MFNU scores in the sample indicating 'severe motor problems' ranged from 44–84%, typically over 60%. Highly significant improvements in motor performance were observed with MPH compared to baseline ratings on all the 17 subtests of the MFNU 1–2 hr after administration of MPH. There were no significant placebo effects. The motor improvement was consistent with improvement of clinical symptoms. Conclusion The study confirmed our prior clinical observations showing that children with ADHD typically demonstrate marked improvements of motor functions after a single dose of 10 mg MPH. The most pronounced positive MPH response was seen in subtests measuring either neuromotor inhibition, or heightened muscular tone in the gross movement muscles involved in maintaining the alignment and balance of the body. Introduction of MPH generally led to improved balance and a generally more coordinated and controlled body movement.

  4. Cost-effectiveness of extended-release methylphenidate in children and adolescents with attention-deficit/hyperactivity disorder sub-optimally treated with immediate release methylphenidate.

    Jurjen van der Schans

    Full Text Available Attention-Deficit/Hyperactivity Disorder (ADHD is a common psychiatric disorder in children and adolescents. Immediate-release methylphenidate (IR-MPH is the medical treatment of first choice. The necessity to use several IR-MPH tablets per day and associated potential social stigma at school often leads to reduced compliance, sub-optimal treatment, and therefore economic loss. Replacement of IR-MPH with a single-dose extended release (ER-MPH formulation may improve drug response and economic efficiency.To evaluate the cost-effectiveness from a societal perspective of a switch from IR-MPH to ER-MPH in patients who are sub-optimally treated.A daily Markov-cycle model covering a time-span of 10 years was developed including four different health states: (1 optimal response, (2 sub-optimal response, (3 discontinued treatment, and (4 natural remission. ER-MPH options included methylphenidate osmotic release oral system (MPH-OROS and Equasym XL/Medikinet CR. Both direct costs and indirect costs were included in the analysis, and effects were expressed as quality-adjusted life years (QALYs. Univariate, multivariate as well as probabilistic sensitivity analysis were conducted and the main outcomes were incremental cost-effectiveness ratios.Switching sub-optimally treated patients from IR-MPH to MPH-OROS or Equasym XL/Medikinet CR led to per-patient cost-savings of €4200 and €5400, respectively, over a 10-year treatment span. Sensitivity analysis with plausible variations of input parameters resulted in cost-savings in the vast majority of estimations.This study lends economic support to switching patients with ADHD with suboptimal response to short-acting IR-MPH to long-acting ER-MPH regimens.

  5. The use of stimulant medications for non-core aspects of ADHD and in other disorders.

    Sinita, Eugenia; Coghill, David

    2014-12-01

    Psychostimulants play a central role in the management of ADHD. Here we review the evidence pertaining to the use of methylphenidate, dexamphetamine and related amphetamine salts, the prodrug lisdexamfetamine and modafinil for the management of comorbid ADHD and non-ADHD indications. There is a growing consensus that stimulant medications are helpful at improving the emotional dysregulation and lability, and oppositional and conduct symptoms that are often associated with ADHD. There is some evidence that psychostimulants may improve outcomes in those with treatment resistant depression, reduce negative symptoms and improve cognitive performance in schizophrenia, and that methylphenidate may reduce binge eating in those with bulimia nervosa. In general medicine, whilst the evidence is at times contradictory, psychostimulants have been shown in some studies to be effective treatments for chronic fatigue and narcolepsy, and to improve outcomes post stroke, post head injury, in dementia and various cancers. It seems likely that these effects often result from a combination of, reduction in fatigue, improvements in concentration and cognitive functioning and a lifting of mood which may be a direct or indirect consequence of the medication. Further studies seem warranted and these should focus on efficacy, effectiveness and long term safety. This article is part of the Special Issue entitled 'CNS Stimulants'. PMID:24951855

  6. Methylphenidate enhances NMDA-receptor response in medial prefrontal cortex via sigma-1 receptor: a novel mechanism for methylphenidate action.

    Chun-Lei Zhang

    Full Text Available Methylphenidate (MPH, commercially called Ritalin or Concerta, has been widely used as a drug for Attention Deficit Hyperactivity Disorder (ADHD. Noteworthily, growing numbers of young people using prescribed MPH improperly for pleasurable enhancement, take high risk of addiction. Thus, understanding the mechanism underlying high level of MPH action in the brain becomes an important goal nowadays. As a blocker of catecholamine transporters, its therapeutic effect is explained as being due to proper modulation of D1 and α2A receptor. Here we showed that higher dose of MPH facilitates NMDA-receptor mediated synaptic transmission via a catecholamine-independent mechanism, in layer V∼VI pyramidal cells of the rat medial prefrontal cortex (PFC. To indicate its postsynaptic action, we next found that MPH facilitates NMDA-induced current and such facilitation could be blocked by σ1 but not D1/5 and α2 receptor antagonists. And this MPH eliciting enhancement of NMDA-receptor activity involves PLC, PKC and IP3 receptor mediated intracellular Ca(2+ increase, but does not require PKA and extracellular Ca(2+ influx. Our additional pharmacological studies confirmed that higher dose of MPH increases locomotor activity via interacting with σ1 receptor. Together, the present study demonstrates for the first time that MPH facilitates NMDA-receptor mediated synaptic transmission via σ1 receptor, and such facilitation requires PLC/IP3/PKC signaling pathway. This novel mechanism possibly explains the underlying mechanism for MPH induced addictive potential and other psychiatric side effects.

  7. Methylphenidate enhances NMDA-receptor response in medial prefrontal cortex via sigma-1 receptor: a novel mechanism for methylphenidate action.

    Zhang, Chun-Lei; Feng, Ze-Jun; Liu, Yue; Ji, Xiao-Hua; Peng, Ji-Yun; Zhang, Xue-Han; Zhen, Xue-Chu; Li, Bao-Ming

    2012-01-01

    Methylphenidate (MPH), commercially called Ritalin or Concerta, has been widely used as a drug for Attention Deficit Hyperactivity Disorder (ADHD). Noteworthily, growing numbers of young people using prescribed MPH improperly for pleasurable enhancement, take high risk of addiction. Thus, understanding the mechanism underlying high level of MPH action in the brain becomes an important goal nowadays. As a blocker of catecholamine transporters, its therapeutic effect is explained as being due to proper modulation of D1 and α2A receptor. Here we showed that higher dose of MPH facilitates NMDA-receptor mediated synaptic transmission via a catecholamine-independent mechanism, in layer V∼VI pyramidal cells of the rat medial prefrontal cortex (PFC). To indicate its postsynaptic action, we next found that MPH facilitates NMDA-induced current and such facilitation could be blocked by σ1 but not D1/5 and α2 receptor antagonists. And this MPH eliciting enhancement of NMDA-receptor activity involves PLC, PKC and IP3 receptor mediated intracellular Ca(2+) increase, but does not require PKA and extracellular Ca(2+) influx. Our additional pharmacological studies confirmed that higher dose of MPH increases locomotor activity via interacting with σ1 receptor. Together, the present study demonstrates for the first time that MPH facilitates NMDA-receptor mediated synaptic transmission via σ1 receptor, and such facilitation requires PLC/IP3/PKC signaling pathway. This novel mechanism possibly explains the underlying mechanism for MPH induced addictive potential and other psychiatric side effects. PMID:23284812

  8. TRANSDERMAL DRUG DELIVERY SYSTEM: REVIEW

    Virendra Yadav

    2012-01-01

    Transdermal drug delivery system (TDDS) are topically administered medicaments in the form of patches that deliver drugs for systemic effects at a predetermined and controlled rate. It works very simply in which drug is applied inside the patch and it is worn on skin for long period of time. By this constant concentration of drug remain in blood for long time. Polymer matrix, drug, permeation enhancers are the main components of TDDS; polymers includes Zein, Shellac (as a natural) to syntheti...

  9. Guanfacine extended release for children and adolescents with attention-deficit/hyperactivity disorder: efficacy following prior methylphenidate treatment

    Huss, Michael; Sikirica, Vanja; Hervas, Amaia; Newcorn, Jeffrey H; Harpin, Valerie; Robertson, Brigitte

    2016-01-01

    Guanfacine extended release (GXR) and atomoxetine (ATX) are nonstimulant treatments for attention-deficit/hyperactivity disorder (ADHD). As nonstimulant treatments are often used after stimulants in ADHD, GXR was assessed relative to prior stimulant treatment in a randomized controlled trial (RCT), in which ATX was included as a reference arm, and in the open-label phase of a randomized-withdrawal study (RWS). Participants were 6–17 years old with ADHD Rating Scale version IV (ADHD-RS-IV) scores ≥32 and Clinical Global Impressions – Severity scores ≥4. RCT participants received dose-optimized GXR (1–7 mg/day), ATX (10–100 mg/day), or placebo for 10–13 weeks. RWS participants received dose-optimized GXR (1–7 mg/day) for 13 weeks. Participants’ last stimulant medication prior to enrolment, and reasons for stopping this medication, were collected at baseline. Change from baseline ADHD-RS-IV score and the proportion of responders were assessed by prior stimulant exposure. Of 163 RCT and 296 RWS participants who had previously received stimulant treatment, 142 and 224, respectively, had received methylphenidate (MPH); due to the low number of participants and the heterogeneity of non-MPH treatments, we only report data for prior MPH treatment. The most frequent reasons for stopping MPH were lack of effectiveness or side effects. Placebo-adjusted ADHD-RS-IV changes from baseline were significant in participants receiving GXR (prior MPH, −9.8, P0.05, ES 0.15) participants. More participants met responder criteria with GXR versus placebo, regardless of prior treatment. GXR response was unaffected by prior stimulant treatment; ATX produced improvement only in stimulant-naïve participants relative to placebo. These findings may be relevant to clinical decision-making regarding sequencing of ADHD treatments. PMID:27226715

  10. Possible association of norepinephrine transporter -3081(A/T polymorphism with methylphenidate response in attention deficit hyperactivity disorder

    Shin Min-Sup

    2010-10-01

    Full Text Available Abstract Background Attention-deficit/hyperactivity disorder (ADHD is a heritable disorder characterized by symptoms of inattention and/or hyperactivity/impulsivity. Methylphenidate (MPH has been shown to block the norepinephrine transporter (NET, and genetic investigations have demonstrated that the norepinephrine transporter gene (SLC6A2 is associated with ADHD. The aims of this study were to examine the association of the SLC6A2 -3081(A/T and G1287A polymorphisms with MPH response in ADHD. Methods This study enrolled 112 children and adolescents with ADHD. A response criterion was defined based on the Clinical Global Impression-Improvement (CGI-I score, and the ADHD Rating Scale-IV (ARS score was also assessed at baseline and 8 weeks after MPH treatment. Results We found that the subjects who had the T allele as one of the alleles (A/T or T/T genotypes at the -3081(A/T polymorphism showed a better response to MPH treatment than those with the A/A genotype as measured by the CGI-I. We also found a trend towards a difference in the change of the total ARS scores and hyperactivity/impulsivity subscores between subjects with and without the T allele. No significant association was found between the genotypes of the SLC6A2 G1287A polymorphism and response to ADHD treatment. Conclusion Our findings provide evidence for the involvement of the -3081(A/T polymorphism of SLC6A2 in the modulation of the effectiveness of MPH treatment in ADHD.

  11. Guanfacine extended release for children and adolescents with attention-deficit/hyperactivity disorder: efficacy following prior methylphenidate treatment.

    Huss, Michael; Sikirica, Vanja; Hervas, Amaia; Newcorn, Jeffrey H; Harpin, Valerie; Robertson, Brigitte

    2016-01-01

    Guanfacine extended release (GXR) and atomoxetine (ATX) are nonstimulant treatments for attention-deficit/hyperactivity disorder (ADHD). As nonstimulant treatments are often used after stimulants in ADHD, GXR was assessed relative to prior stimulant treatment in a randomized controlled trial (RCT), in which ATX was included as a reference arm, and in the open-label phase of a randomized-withdrawal study (RWS). Participants were 6-17 years old with ADHD Rating Scale version IV (ADHD-RS-IV) scores ≥32 and Clinical Global Impressions - Severity scores ≥4. RCT participants received dose-optimized GXR (1-7 mg/day), ATX (10-100 mg/day), or placebo for 10-13 weeks. RWS participants received dose-optimized GXR (1-7 mg/day) for 13 weeks. Participants' last stimulant medication prior to enrolment, and reasons for stopping this medication, were collected at baseline. Change from baseline ADHD-RS-IV score and the proportion of responders were assessed by prior stimulant exposure. Of 163 RCT and 296 RWS participants who had previously received stimulant treatment, 142 and 224, respectively, had received methylphenidate (MPH); due to the low number of participants and the heterogeneity of non-MPH treatments, we only report data for prior MPH treatment. The most frequent reasons for stopping MPH were lack of effectiveness or side effects. Placebo-adjusted ADHD-RS-IV changes from baseline were significant in participants receiving GXR (prior MPH, -9.8, P0.05, ES 0.15) participants. More participants met responder criteria with GXR versus placebo, regardless of prior treatment. GXR response was unaffected by prior stimulant treatment; ATX produced improvement only in stimulant-naïve participants relative to placebo. These findings may be relevant to clinical decision-making regarding sequencing of ADHD treatments. PMID:27226715

  12. Similar and Different? Subjective Effects of Methylphenidate and Cocaine in Opioid-Maintained Patients.

    Vogel, Marc; Bucher, Patricia; Strasser, Johannes; Liechti, Matthias E; Krähenbühl, Stephan; Dürsteler, Kenneth M

    2016-01-01

    Methylphenidate (MPH) is commonly prescribed for attention deficit hyperactivity disorder (ADHD). Recreational nonmedical use has been described and also occurs in patients on opioid maintenance treatment (OMT). MPH has been proposed for use as replacement therapy in cocaine dependence, although evidence for efficacy is inconclusive. We conducted a cross-sectional interview study on patterns of MPH use in a sample of 20 MPH-using patients on OMT with a history of cocaine use. We assessed symptoms of depression, ADHD during childhood, and retrospective subjective-effects profiles of MPH and cocaine. Risky patterns of MPH use were common, in particular illicit acquisition, use of high doses, and parenteral administration. Sixty percent of patients reported having used MPH as a substitute for cocaine. Correspondingly, the subjective-effect profiles of MPH and cocaine showed striking parallels, with overall effects of MPH being rated more positively than those of cocaine. Proportions of patients with elevated scores for depression or childhood ADHD were large, highlighting the importance of treating dual disorders in this population. Clinical studies on MPH substitution in cocaine-dependent patients on opioid maintenance treatment could benefit from consideration of the patterns of application of MPH in this population. Results are preliminary due to small sample size. PMID:26940988

  13. [Summary of the Dutch College of General Practitioners' (NHG) practice guideline 'ADHD in children'].

    van Avendonk, Mariëlle J P; Hassink-Franke, Lieke J A; Stijntjes, Freek; Wiersma, Tjerk; Burgers, Jako S

    2015-01-01

    The diagnosis of ADHD may be considered if a child is hyperactive, impulsive or inattentive, and if this behaviour results in evidently impaired functioning in multiple settings. Children with behavioural problems and slightly impaired functioning may benefit from patient information, education and parenting advice. From the age of 6 years, children can be offered diagnostic testing and professional support within the primary care setting, provided sufficient knowledge and expertise is available and there is collaboration with other health care providers. Management of a child with ADHD but no comorbid psychiatric disorder, consists of a step-by-step plan including education, parent and teacher guidance and, optionally, behavioural therapy for the child. In consultation with parents, child and other therapists, methylphenidate can be prescribed if behavioural interventions are not sufficiently effective. Children taking medication for ADHD should be monitored periodically, including assessment of the effectiveness and side effects. PMID:25654685

  14. Population pharmacokinetics of methylphenidate hydrochloride extended-release multiple-layer beads in pediatric subjects with attention deficit hyperactivity disorder

    Teuscher NS

    2015-05-01

    Full Text Available Nathan S Teuscher,1 Akwete Adjei,2 Robert L Findling,3,4 Laurence L Greenhill,5 Robert J Kupper,2 Sharon Wigal6 1PK/PD Associates, Trophy Club, TX, 2Rhodes Pharmaceuticals L.P., Coventry, RI, 3Department of Psychiatric Services and Research, Kennedy Krieger Institute, Baltimore, MD, 4Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 5Department of Psychiatry, Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, 6AVIDA Inc., Newport Beach, CA, USA Abstract: A new multilayer-bead formulation of extended-release methylphenidate hydrochloride (MPH-MLR has been evaluated in pharmacokinetic studies in healthy adults and in Phase III efficacy/safety studies in children and adolescents with attention deficit hyperactivity disorder (ADHD. Using available data in healthy adults, a two-input, one-compartment, first-order elimination population pharmacokinetic model was developed using nonlinear mixed-effect modeling. The model was then extended to pediatric subjects, and was found to adequately describe plasma concentration–time data for this population. A pharmacokinetic/pharmacodynamic model was also developed using change from baseline in the ADHD Rating Scale (ADHD-RS-IV total scores from a pediatric Phase III trial and simulated plasma concentration–time data. During simulations for each MPH-MLR dose level (10–80 mg, increased body weight resulted in decreased maximum concentration. Additionally, as maximum concentration increased, ADHD-RS-IV total score improved (decreased. Knowledge of the relationship between dose, body weight, and clinical response following the administration of MPH-MLR in children and adolescents may be useful for clinicians selecting initial dosing of MPH-MLR. Additional study is needed to confirm these results. Keywords: population pharmacokinetics, Aptensio XR™, MPH-MLR, methylphenidate

  15. ADHD in idiopathic epilepsy

    Marcos H. C. Duran

    2014-01-01

    Full Text Available Our aim was to clarify the correlation of attention deficit hyperactivity disorder (ADHD with epilepsy and behavior problems. This was a cross-sectional study. Sixty children with idiopathic epilepsy were interviewed using the MTA-SNAP IV Teacher and Parent Rating Scale, Vineland Adaptive Behavior Scales and Conners’ Rating Scales. We used the chi-square test to analyze the correlation of epilepsy variables in patients with and without ADHD with a significance level of 0.05. Eight patients had ADHD symptoms (13%, seven had the inattentive ADHD subtype and only three had behavioral problems. When epileptic patients with and without ADHD symptoms were compared we found no significant difference in regard to epilepsy variables. All patients were controlled and 43% were either without AED or undergoing withdrawal. Our study revealed a low comorbidity of ADHD symptoms and epilepsy due to low interference of seizures and drug treatment on the comorbid condition.

  16. Effectiveness and safety of atomoxetine for ADHD in population between 6 and 19 years: a systematic review

    José Calleja

    2012-09-01

    Full Text Available Introduction: Attention deficit hyperactivity disorder (ADHD is generally treated with pharmacological interventions such as psychostimulants. The most used widely used one is methylphenidate followed by atomoxetine. Purpose: To identify, synthesize and evaluate the best available evidence on the effectiveness and safety of atomoxetine in ADHD treatment in the 6-19 year-old population. Methods: A systematic review of intervention studies that evaluated effectiveness of atomoxetine compared with placebo and methylphenidate was conducted. Outcomes assessed were educational functioning, psychosocial functioning, quality of life and adverse effects. The search was done up to February 2012 in English and Spanish in the following databases: PubMed/MEDLINE, LILACS, Cochrane, DARE and National Guideline Clearinghouse. The articles were independently evaluated by two investigators. Results: Of the 108 studies found initially, 11 were included, among which five systematic reviews, one primary article and 5 clinical guidelines. Conclusions: Atomoxetine is recommended as a second option in ADHD and was found to be superior to placebo. Its use is recommended when methylphenidate fails or comorbidities are present.

  17. Comparison of Two brands of Methylphenidate (Stimdate® vs. Ritalin®) in Children and Adolescents with Attention Deficit Hyperactivity Disorder: A Double-Blind, Randomized Clinical Trial

    Khodadust, Naser; Jalali, Amir-Hossein; Ahmadzad-Asl, Masoud; Khademolreza, Noushin; Shirazi, Elham

    2012-01-01

    Objective: To compare the effectiveness and safety of the methylphenidate produced in Iran (Stimdate®) with its original brand (Ritalin®) in children with Attention deficit hyperactivity disorder (ADHD). Methods: In this double-blinded randomized clinical trial, 30 patients with ADHD who were 6 to 16 years old, were divided into two groups: 15 in Stimdate® and 15 in Ritalin® group. The two groups were compared for side effects profile, Conner’s Parent’s Rating Scale-Persion version (CPRS-R), ...

  18. Psychiatric Comorbidity at the Time of Diagnosis in Adults With ADHD: The CAT Study.

    Piñeiro-Dieguez, Benjamin; Balanzá-Martínez, Vicent; García-García, Pilar; Soler-López, Begoña

    2014-01-24

    Objective: The CAT (Comorbilidad en Adultos con TDAH) study aimed to quantify and characterize the psychiatric comorbidity at the time of diagnosis of ADHD in adult outpatients. Method: Cross-sectional, multicenter, observational register of adults with ADHD diagnosed for the first time. Results: In this large sample of adult ADHD (n = 367), psychiatric comorbidities were present in 66.2% of the sample, and were more prevalent in males and in the hyperactive-impulsive and combined subtypes. The most common comorbidities were substance use disorders (39.2%), anxiety disorders (23%), and mood disorders (18.1%). In all, 88.8% patients were prescribed pharmacological treatment for ADHD (in 93.4% of cases, modified release methylphenidate capsules 50:50). Conclusion: A high proportion of psychiatric comorbidity was observed when adult outpatients received a first-time diagnosis of ADHD. The systematic registering of patients and comorbidities in clinical practice may help to better understand and manage the prognostic determinants in adult ADHD. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24464326

  19. Methylphenidate Enhances Extinction of Contextual Fear

    Abraham, Antony D.; Cunningham, Christopher L.; Lattal, K. Matthew

    2012-01-01

    Methylphenidate (MPH, Ritalin) is a norepinephrine and dopamine transporter blocker that is widely used in humans for treatment of attention deficit disorder and narcolepsy. Although there is some evidence that targeted microinjections of MPH may enhance fear acquisition, little is known about the effect of MPH on fear extinction. Here, we show…

  20. The effect of methylphenidate on oppositional defiant disorder comorbid with attention deficit/hyperactivity disorder O efeito do metilfenidato sobre o transtorno opositivo-desafiador comórbido com transtorno do déficit de atenção e hiperatividade

    Maria Antonia Serra-Pinheiro

    2004-06-01

    Full Text Available OBJECTIVE: To assess the effect of methylphenidate on the diagnosis of oppositional-defiant disorder (ODD comorbid with attention-deficit hyperactivity disorder (ADHD. METHOD: We conducted an open-label study in which 10 children and adolescents with a dual diagnosis of ODD and ADHD were assessed for their ODD symptoms and treated with methylphenidate. At least one month after ADHD symptoms were under control, ODD symptoms were reevaluated with the Parent form of the Children Interview for Psychiatric Syndromes (P-ChIPS. RESULTS: Nine of the 10 patients no longer fulfilled diagnostic criteria for ODD after they were treated with methylphenidate for ADHD. CONCLUSION: Methylphenidate seems to be an effective treatment for ODD, as well as for ADHD itself. The implications for the treatment of patients with ODD not comorbid with ADHD needs further investigation.OBJETIVO: Avaliar o efeito do metilfenidato sobre o diagnóstico de transtorno opositivo-desafiador (TOD comórbido com transtorno do déficit de atenção e Hiperatividade (TDAH. MÉTODO: Conduzimos um estudo aberto em que 10 crianças e adolescentes com diagnóstico de TOD e TDAH foram avaliados para seus sintomas de TOD e tratados com metilfenidato. Pelo menos um mês após os sintomas e TDAH estarem controlados, os sintomas de TOD foram reavaliados com a entrevista P-ChIPS (Children Interview for Psychiatric Syndromes-Parent form. RESULTADOS: Nove dos dez pacientes não preenchiam mais critérios diagnósticos para TOD após serem tratados com metilfenidato para TDAH. CONCLUSÃO: Metilfenidato parece ser um tratamento eficaz para TOD, além de para TDAH. As implicações para o tratamento de pacientes com TOD não comórbido com TDAH necessita mais investigação.

  1. Assessment of daily profiles of ADHD and ODD symptoms, and symptomatology related to ADHD medication, by parent and teacher ratings.

    Breuer, Dieter; Görtz-Dorten, Anja; Rothenberger, Aribert; Döpfner, Manfred

    2011-10-01

    DAYAS is a new two-part rating scale that assesses: (1) ADHD and ODD symptoms (externalising symptom ratings) and (2) symptomatology potentially related to ADHD medication (potentially medication-related symptoms) in real-world settings at different time periods throughout a normal school day. Data from a proof-of-concept study and two observational trials (Medikinet(®) retard [methylphenidate] and the Equasym XL(®) [methylphenidate] OBSEER study) evaluated: (1) validity of weekly externalising symptom ratings using DAYAS, in place of daily ratings; (2) reliability and internal consistency of DAYAS ratings for externalising symptoms and potentially medication-related symptoms; and (3) convergent and divergent validity of the externalising symptom ratings with existing validated scales. From the proof-of-concept study, daily scores by period of day and during the whole day correlated strongly with equivalent weekly scores (r = 0.83-0.92). Internal consistency of externalising symptom rating scales calculated from pooled data were acceptable or good by period of day (Cronbach's alpha = 0.68-0.90) and very high for whole day scores (Cronbach's alpha = 0.88-0.95). Internal consistency of the rating scale for potentially medication-related symptoms was also good for both teacher and parent ratings. From OBSEER data, correlations between FBB-ADHD total symptom scores and ratings on both parent and teacher versions of DAYAS were high (r = 0.73 and r = 0.84, respectively). Correlations between DAYAS and SDQ were highest for the SDQ subscales hyperactivity and conduct problems and substantially lower for pro-social behaviour, peers and emotional problems. The DAYAS rating scale had good internal consistency, and DAYAS scores correlated well with existing validated scales and the SDQ subscales hyperactivity and conduct problems. Weekly DAYAS scores (whole day and by period of day) could be considered a suitable replacement for daily assessment scores. PMID:21901413

  2. Thyrotoropin receptor knockout changes monoaminergic neuronal system and produces methylphenidate-sensitive emotional and cognitive dysfunction.

    Mouri, Akihiro; Hoshino, Yuta; Narusawa, Shiho; Ikegami, Keisuke; Mizoguchi, Hiroyuki; Murata, Yoshiharu; Yoshimura, Takashi; Nabeshima, Toshitaka

    2014-10-01

    Attention deficit/hyperactivity disorder (ADHD) has been reported in association with resistance to thyroid hormone, a disease caused by a mutation in the thyroid hormone receptor β (TRβ) gene. TRβ is a key protein mediating down-regulation of thyrotropin (TSH) expression by 3,3',5-tri-iodothyronine (T3), an active form of thyroid hormone. Dysregulation of TSH and its receptor (TSHR) is implicated in the pathophysiology of ADHD but the role of TSHR remains elusive. Here, we clarified a novel role for TSHR in emotional and cognitive functions related to monoaminergic nervous systems. TSHR knockout mice showed phenotypes of ADHD such as hyperactivity, impulsiveness, a decrease in sociality and increase in aggression, and an impairment of short-term memory and object recognition memory. Administration of methylphenidate (1, 5 and 10mg/kg) reversed impulsiveness, aggression and object recognition memory impairment. In the knockout mice, monoaminergic changes including decrease in the ratio of 3-methoxy-4-hydroxyphenylglycol/noradrenaline and increase in the ratio of homovanillic acid/dopamine were observed in some brain regions, accompanied by increase in the expression of noradrenaline transporter in the frontal cortex. When TSH was completely suppressed by the supraphysiological administration of T3 to the adult mice, some behavioral and neurological changes in TSHR KO mice were also observed, suggesting that these changes were not due to developmental hypothyroidism induced by the inactivation of TSHR but to the loss of the TSH-TSHR pathway itself. Taken together, the present findings suggest a novel role for TSHR in behavioral and neurological phenotypes of ADHD. PMID:25016105

  3. Methylphenidate-induced acute orofacial and extremity dyskinesia.

    Yilmaz, Ayse Esra; Donmez, Ahsen; Orun, Emel; Tas, Tugba; Isik, Bunyamin; Sonmez, Fatma Mujgan

    2013-06-01

    Methylphenidate is a short-acting stimulant. In this article, the authors report a 7-year-old male patient who presented with orofacial and limb dyskinesia after his first dose of methylphenidate treatment for a diagnosis of attention-deficit/hyperactivity disorder; he was also receiving sodium valproate treatment for epilepsy. Orofacial dyskinesia appeared 5 hours after methylphenidate administration, persisted for 10 hours, and had completely resolved within 2 days. Although limb dyskinesia after methylphenidate is a commonly reported side effect, to the authors' knowledge this is only the second reported case to develop both orofacial and limb dyskinesia in the acute period after the first dose of methylphenidate. This case is reported to emphasize the potential side effects of methylphenidate, individual differences in drug sensitivities, and drug-receptor interactions via different mechanisms. PMID:22791547

  4. Getting Treatment for ADHD

    Full Text Available ... of any type of ADHD treatment is to reduce symptoms and help the child function at a normal level. Treatment may include ... build on them. Therapy can also help a child with ADHD cope with daily problems, pay better attention, and learn to control aggression. A therapist may use one or more of ...

  5. ADHD er ikke hysteri

    Lange, Anne-Mette; Sørensen, Anders; Tranæs, Torben

    2014-01-01

    Livsværdi. Mennesker med ADHD bør kunne få et bedre liv, men man ved endnu ikke præcis hvordan.......Livsværdi. Mennesker med ADHD bør kunne få et bedre liv, men man ved endnu ikke præcis hvordan....

  6. ADHD in Young Children

    ... diagnosis and treatment of ADHD in young children. http://bit.ly/1nCUenn , http://bit.ly/1UYugZ8 Discuss with parents the benefits ... the country. Visit this page for more help: http://www.cdc.gov/ncbddd/adhd/finding-therapy.html . ...

  7. Long-acting methylphenidate toxicity: a case report.

    gul eryilmaz

    2014-01-01

    Full Text Available Methylphenidate is a psychostimulant that is used in the treatment of attention deficit hyperactivity disorder and behavior disorders. Neuropsychiatric symptoms like loss of consciousness, lethargy, seizures and psychotic symptoms, and cardiovascular side effects like tachycardia, hypertension and hyperthermia have been reported in methylphenidate toxicity. In this case report, the clinical manifestations of an adolescent having taken 486 mg methylphenidate in a suicide attempt are discussed.

  8. Long-acting methylphenidate toxicity: a case report.

    gul eryilmaz; isil gogcegoz gul; ozgur yorbik; nuket isiten

    2014-01-01

    Methylphenidate is a psychostimulant that is used in the treatment of attention deficit hyperactivity disorder and behavior disorders. Neuropsychiatric symptoms like loss of consciousness, lethargy, seizures and psychotic symptoms, and cardiovascular side effects like tachycardia, hypertension and hyperthermia have been reported in methylphenidate toxicity. In this case report, the clinical manifestations of an adolescent having taken 486 mg methylphenidate in a suicide attempt are discussed.

  9. Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate

    Chemali, Jessica J.; Van Dort, Christa J.; Brown, Emery N.; Solt, Ken

    2011-01-01

    Background: A recent study showed that methylphenidate induces emergence from isoflurane general anesthesia. Isoflurane and propofol are general anesthetics that may have distinct molecular mechanisms of action. The objective of this study was to test the hypothesis that methylphenidate actively induces emergence from propofol general anesthesia. Methods: Using adult rats, the effect of methylphenidate on time to emergence after a single bolus of propofol was determined. The ability of met...

  10. Illicit methylphenidate use among Iranian medical students: prevalence and knowledge

    Habibzadeh, Afshin; Alizadeh, Mahasti; Malek, Ayoub; Maghbooli, Leili; Shoja, Mohammadali M; Ghabili, Kamyar

    2011-01-01

    Background: Methylphenidate, a medication prescribed for individuals suffering from attention-deficit/hyperactivity disorder, is increasingly being misused by students. Objective: The aims of this study were to evaluate the frequency of methylphenidate use among a group of Iranian medical students and to assess their knowledge of methylphenidate. Methods: Anonymous, self-administered questionnaires were completed by all medical students entering the university between 2000 and 2007. Results: ...

  11. Oral methylphenidate establishes a conditioned place preference in rats

    Wooters, Thomas E.; Walton, Matthew T.; Bardo, Michael T.

    2010-01-01

    Emerging data suggest that illicit methylphenidate abuse is a growing problem. Although abuse of the drug typically occurs by the intranasal route, oral (per os; p.o.) methylphenidate also has abuse potential. The present study compared the effects of p.o. and intraperitoneal (i.p.) methylphenidate in rats using the conditioned place preference (CPP) procedure. Young adult male Sprague-Dawley rats were trained to consume oyster crackers injected initially with saline. Next, rats were randomly...

  12. ADHD and temporality

    Nielsen, Mikka

    According to the official diagnostic manual, ADHD is defined by symptoms of inattention, hyperactivity, and impulsivity and patterns of behaviour are characterized as failure to pay attention to details, excessive talking, fidgeting, or inability to remain seated in appropriate situations (DSM-5......). In this paper, however, I will ask if we can understand what we call ADHD in a different way than through the symptom descriptions and will advocate for a complementary, phenomenological understanding of ADHD as a certain being in the world – more specifically as a matter of a phenomenological...... difference in temporal experience and/or rhythm. Inspired by both psychiatry’s experiments with people diagnosed with ADHD and their assessment of time and phenomenological perspectives on mental disorders and temporal disorientation I explore the experience of ADHD as a disruption in the phenomenological...

  13. Timing deficits in attention-deficit/hyperactivity disorder (ADHD): evidence from neurocognitive and neuroimaging studies.

    Noreika, Valdas; Falter, Christine M; Rubia, Katya

    2013-01-01

    measures of impulsiveness and inattention, suggesting that timing problems are key to the clinical behavioural profile of ADHD. Emerging evidence shows that the most common treatment of ADHD with the dopamine agonist and psychostimulant Methylphenidate attenuates most timing deficits in ADHD and normalises the abnormally blunted recruitment of the underlying fronto-striato-cerebellar networks. Timing function deficits in ADHD, therefore, next to executive function deficits, form an independent impairment domain, and should receive more attention in neuropsychological, neuroimaging, and pharmacological basic research as well as in translational research aimed to develop pharmacological or non-pharmacological treatment of abnormal timing behaviour and cognition in ADHD. PMID:23022430

  14. Effect of Methylphenidate on Cardiorespiratory Responses in Hyperactive Children

    Boileau, Richard A.; And Others

    1976-01-01

    Recognition by the physical education teacher that the cardiovascular dynamics of the hyperactive child are augmented during methylphenidate (Ritalin) medication is warranted when planning strenuous physical activity. (JD)

  15. Optimised transdermal delivery of pravastatin.

    Burger, Cornel; Gerber, Minja; du Preez, Jan L; du Plessis, Jeanetta

    2015-12-30

    Wiechers' programme "Formulating for Efficacy" initiated a new strategy to optimise the oil phase of topical formulations in order to achieve optimal transdermal drug delivery. This new approach uses the "Delivery Gap Theory" on any active pharmaceutical ingredients (APIs) to test if it could enhance transdermal drug delivery. The aim of the study was to formulate six different semi-solid formulations (three creams and three emulgels) with 2% pravastatin as the API in order to investigate the "Delivery Gap Principle", by determining which formulation would deliver pravastatin best to the target-site (system circulation). The three cream- and three emulgel formulations had different polarities, i.e. a formulation with polarity equal to that of the stratum corneum (optimised), a non-polar (lipophilic)- and a polar (hydrophilic)-formulation. Franz cell diffusion studies were executed over 12h and the optimised emulgel (2.578μg/cm(2)) had the highest median amount per area obtained. Tape stripping followed the diffusion studies and in the stratum corneum-epidermis, the hydrophilic emulgel (1.448μg/ml) contained the highest median pravastatin concentration and the epidermis-dermis the optimised emulgel (0.849μg/ml) depicted the highest pravastatin concentration. During this study, it was observed that when both emulgel and cream formulations were compared; the emulgels enhanced the delivery of pravastatin more than the creams. PMID:26505148

  16. TRANSDERMAL DRUG DELIVERY SYSTEM: REVIEW

    Virendra Yadav

    2012-01-01

    Full Text Available Transdermal drug delivery system (TDDS are topically administered medicaments in the form of patches that deliver drugs for systemic effects at a predetermined and controlled rate. It works very simply in which drug is applied inside the patch and it is worn on skin for long period of time. By this constant concentration of drug remain in blood for long time. Polymer matrix, drug, permeation enhancers are the main components of TDDS; polymers includes Zein, Shellac (as a natural to synthetic ones (Polybutadiene, Polysiloxane, Polyvinyl chloride, Polyvinyl alcohol etc.. TDDS are of many types varying from single layer drug in adhesive to multi layer drug in adhesive and others are reservoir and the matrix systems. The market value of TDDS products are increasing with rapid rate, more than 35 products have now been approved for sale in US, and approximately 16 active ingredients are approved globally for use as a TDDS. Transdermal drug delivery is a recent technology which promises a great future it has a potential to limit the use of needles for administering wide variety of drugs but cost factor is a important thing to consider since developing nations like INDIA have second highest population, but due to higher cost TDDS are the hidden part of therapy used in general population.

  17. Synthesis of deuterium-labelled methylphenidate, p-hydroxy-methylphenidate, ritalinic acid and p-hydroxyritalinic acid

    The synthesis of threo-dl-methylphenidate (Ritalin 1), threo-dl-p-hydroxy-methylphenidate (3), threo-dl-ritalinic acid (2), and threo-dl-p-hydroxyritalinic acid (4) with deuterium incorporated in the piperidine ring is described. These compounds were synthesized for use as internal standards for mass fragmentographic assays of methylphenidate and its metabolites. The synthetic scheme described resulted in less than 0.05% 2H0 in the piperidine ring in any of the preparations. (author)

  18. Synthesis of deuterium-labelled methylphenidate, p-hydroxy-methylphenidate, ritalinic acid and p-hydroxyritalinic acid

    Patrick, K.; Kilts, C.; Breese, G. (North Carolina Univ., Chapel Hill (USA). School of Medicine)

    1982-04-01

    The synthesis of threo-dl-methylphenidate (Ritalin 1), threo-dl-p-hydroxy-methylphenidate (3), threo-dl-ritalinic acid (2), and threo-dl-p-hydroxyritalinic acid (4) with deuterium incorporated in the piperidine ring is described. These compounds were synthesized for use as internal standards for mass fragmentographic assays of methylphenidate and its metabolites. The synthetic scheme described resulted in less than 0.05% /sup 2/H/sub 0/ in the piperidine ring in any of the preparations.

  19. TRANSDERMAL DRUG DELIVERY: A TECHNICAL WRITEUP

    Vandana Yadav

    2012-02-01

    Full Text Available Transdermal drug delivery is another system which provides controlled and continuous delivery of the drug through the skin into the systemic circulation. Topical application which involves drug transport to viable epidermal and/or dermal tissues of the skin for local therapeutic effect while a very major fraction of drug is transported into the systemic blood circulation. Transdermal route provides many advantages over conventional oral and invasive methods of drug delivery such as avoids first pass metabolism, improve patient compliance, maintance steady state plasma concentration. This article provides an overview of skin permeation pathways, types of transdermal drug delivery system, methods of preparation with different methods of evaluation, and the recent advancement in transdermal drug delivery, which includes Transfersomes, Magnetophoresis, Controlled Heat Aided Drug Delivery System, Laser Radiation, Medicated Tattoos, Laser radiation.

  20. TRANSDERMAL DRUG DELIVERY: A TECHNICAL WRITEUP

    Vandana Yadav; Sipai Altaf Bhai. M; Mamatha Y; Prasanth V.V

    2012-01-01

    Transdermal drug delivery is another system which provides controlled and continuous delivery of the drug through the skin into the systemic circulation. Topical application which involves drug transport to viable epidermal and/or dermal tissues of the skin for local therapeutic effect while a very major fraction of drug is transported into the systemic blood circulation. Transdermal route provides many advantages over conventional oral and invasive methods of drug delivery such as avoids fir...

  1. Percutaneous penetration enhancement in transdermal drug delivery

    Singh Inderjeet; Sri Prasanthi

    2010-01-01

    The transdermal route has numerous advantages over the more traditional drug delivery routes. These include high bioavailability, absence of first pass hepatic metabolism, steady drug plasma concentrations, and the fact that therapy is non-invasive. The main obstacle to permeating drug molecules is the outermost layer of the skin, the stratum corneum. Consequently, research into enhancing transdermal drug delivery (TDD) by overcoming this layer, is an area of prime interest. This review artic...

  2. Essential fatty acids as transdermal penetration enhancers

    Van Zyl, Lindi; du Preez, Jan; Gerber, Minja; Du Plessis, Jeanetta; Viljoen, Joe

    2015-01-01

    The aim of this study was to investigate the effect of different penetration enhancers, containing essential fatty acids (EFAs), on the transdermal delivery of flurbiprofen. Evening primrose oil (EPO), vitamin F and Pheroid™ technology all contain fatty acids and were compared using a cream-based formulation. This selection was to ascertain whether EFAs solely, or EFAs in a Pheroid™ delivery system, would have a significant increase in the transdermal delivery of a compound. Membrane release ...

  3. Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants.

    Weyandt, Lisa L; Oster, Danielle R; Marraccini, Marisa E; Gudmundsdottir, Bergljot Gyda; Munro, Bailey A; Zavras, Brynheld Martinez; Kuhar, Ben

    2014-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. Recent research indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%-4% in the adult population. Although students with ADHD are at greater risk for academic underachievement and psychosocial problems, increasing numbers of students with ADHD are graduating from high school and pursuing higher education. Stimulant medications are considered the first line of pharmacotherapy for individuals with ADHD, including college students. Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted concerning the efficacy of prescription stimulants with college students. In addition, misuse of prescription stimulants has become a serious problem on college campuses across the US and has been recently documented in other countries as well. The purpose of the present systematic review was to investigate the efficacy of prescription stimulants for adolescents and young adults with ADHD and the nonmedical use and misuse of prescription stimulants. Results revealed that both prostimulant and stimulant medications, including lisdexamfetamine dimesylate, methylphenidate, amphetamines, and mixed-amphetamine salts, are effective at reducing ADHD symptoms in adolescents and adults with ADHD. Findings also suggest that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and characteristics such as sex, race, use of illicit drugs, and academic performance are associated with misuse of stimulant medications. Results also indicate that individuals both with and without ADHD are more likely to misuse short-acting agents

  4. Animal models of ADHD.

    Bari, A; Robbins, T W

    2011-01-01

    Studies employing animal models of attention-deficit/hyperactivity disorder (ADHD) present clear inherent advantages over human studies. Animal models are invaluable tools for the study of underlying neurochemical, neuropathological and genetic alterations that cause ADHD, because they allow relatively fast, rigorous hypothesis testing and invasive manipulations as well as selective breeding. Moreover, especially for ADHD, animal models with good predictive validity would allow the assessment of potential new therapeutics. In this chapter, we describe and comment on the most frequently used animal models of ADHD that have been created by genetic, neurochemical and physical alterations in rodents. We then discuss that an emerging and promising direction of the field is the analysis of individual behavioural differences among a normal population of animals. Subjects presenting extreme characteristics related to ADHD can be studied, thereby avoiding some of the problems that are found in other models, such as functional recovery and unnecessary assumptions about aetiology. This approach is justified by the theoretical need to consider human ADHD as the extreme part of a spectrum of characteristics that are distributed normally in the general population, as opposed to the predominant view of ADHD as a separate pathological category. PMID:21287324

  5. Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

    Weyandt LL

    2014-09-01

    Full Text Available Lisa L Weyandt, Danielle R Oster, Marisa E Marraccini, Bergljot Gyda Gudmundsdottir, Bailey A Munro, Brynheld Martinez Zavras, Ben Kuhar Department of Psychology, University of Rhode Island, Kingston, RI, USA Abstract: Attention-deficit/hyperactivity disorder (ADHD is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. Recent research indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. Although students with ADHD are at greater risk for academic underachievement and psychosocial problems, increasing numbers of students with ADHD are graduating from high school and pursuing higher education. Stimulant medications are considered the first line of pharmacotherapy for individuals with ADHD, including college students. Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted concerning the efficacy of prescription stimulants with college students. In addition, misuse of prescription stimulants has become a serious problem on college campuses across the US and has been recently documented in other countries as well. The purpose of the present systematic review was to investigate the efficacy of prescription stimulants for adolescents and young adults with ADHD and the nonmedical use and misuse of prescription stimulants. Results revealed that both prostimulant and stimulant medications, including lisdexamfetamine dimesylate, methylphenidate, amphetamines, and mixed-amphetamine salts, are effective at reducing ADHD symptoms in adolescents and adults with ADHD. Findings also suggest that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and

  6. Increased glutamate-stimulated release of dopamine in substantia nigra of a rat model for attention-deficit/hyperactivity disorder--lack of effect of methylphenidate.

    Warton, Fleur L; Howells, Fleur M; Russell, Vivienne A

    2009-12-01

    Attention-deficit/hyperactivity disorder (ADHD) is a behavioural disorder that has been associated with dysfunction of the dopaminergic system. Abnormal dopamine function could be the result of a primary defect in dopamine neurons (neuronal firing, dopamine transporter, synthesis, receptor function) or an indirect result of impaired glutamate and/or noradrenergic regulation of dopamine neurons. There is considerable evidence to suggest that dopamine release is impaired at mesolimbic and nigrostriatal dopaminergic terminals. However, it is not known whether dysregulation occurs at the level of the cell bodies in the ventral tegmental area of the midbrain (VTA) and substantia nigra (SN). An in vitro superfusion technique was used to measure dopamine release in a widely used model of ADHD, the spontaneously hypertensive rat (SHR), and its normotensive Wistar-Kyoto (WKY) control. At approximately 30 days of age, rats were analysed for behavioural differences in the open field in response to acute treatment with methylphenidate (0.5 to 2 mg/kg in condensed milk, oral self-administration). In addition, rats were treated chronically with methylphenidate (2 mg/kg, oral self-administration, twice daily for 14 days from postnatal day 21 to 34) before the VTA and the SN were analysed for glutamate-stimulated and depolarization-evoked release of dopamine in these areas. In support of its use as an animal model for ADHD, SHR were more active in the open field and displayed less anxiety-like behaviour than WKY. Neither strain showed any effect of treatment with methylphenidate. A significant difference was observed in glutamate-stimulated release of dopamine in the SN of SHR and WKY, with SHR releasing more dopamine, consistent with the hypothesis of altered glutamate regulation of dopamine neurons in SHR. PMID:19821016

  7. Neurotrophin 3 genotype and emotional adverse effects of osmotic-release oral system methylphenidate (OROS-MPH) in children with attention-deficit/hyperactivity disorder.

    Park, Subin; Kim, Bung-Nyun; Kim, Jae-Won; Shin, Min-Sup; Cho, Soo-Churl; Kim, Ji-Hoon; Son, Jung-Woo; Shin, Yun-Mi; Chung, Un-Sun; Han, Doug-Hyun

    2014-03-01

    Neurotrophin 3 (NTF3) has been studied in relation to the pathophysiology of attention-deficit/hyperactivity disorder (ADHD) and mood disorders as well as psychostimulant action. We hypothesized that the risk of an emotional side effect to methylphenidate (MPH) treatment may be associated with NTF3 genotypes. Ninety-six medication-naïve children with ADHD (mean age 8.70, standard deviation 1.41 years, 79 males) were genotyped and treated with MPH. At baseline, which was prior to MPH treatment, and after two weeks of medication, investigators asked children and their parents or caregivers about adverse events using a symptom rating scale. ADHD subjects with the A/A genotype at the NTF3 rs6332 polymorphism showed the highest 'Emotionality' and 'Over-focus/euphoria' factor scores, followed by those with the G/A genotype and those with the G/G genotype (p=0.042 and p=0.045, respectively). ADHD subjects with the A/A genotype at the NTF3 rs6332 polymorphism showed the highest 'Proneness to crying' and 'Nail biting' item scores, followed by those with the G/A genotype and those with the G/G genotype (p=0.047 and p=0.017, respectively). These data provide preliminary evidence that genetic variation in the NTF3 gene is related to susceptibility to emotional side effects in response to MPH treatment in Korean children with ADHD. PMID:23471121

  8. Prescription, dispensation and marketing patterns of methylphenidate

    Edson Perini

    2014-12-01

    Full Text Available OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales – psychoactive and others – subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines.

  9. Methylphenidate enhances extinction of contextual fear

    Abraham, Antony D.; Cunningham, Christopher L.; Lattal, K. Matthew

    2012-01-01

    Methylphenidate (MPH, Ritalin) is a norepinephrine and dopamine transporter blocker that is widely used in humans for treatment of attention deficit disorder and narcolepsy. Although there is some evidence that targeted microinjections of MPH may enhance fear acquisition, little is known about the effect of MPH on fear extinction. Here, we show that MPH, administered before or immediately following extinction of contextual fear, will enhance extinction retention in C57BL/6 mice. Animals that ...

  10. Methylphenidate Abuse and Psychiatric Side Effects

    Morton, W. Alexander; Stockton, Gwendolyn G.

    2000-01-01

    Methylphenidate is a central nervous system stimulant drug that has become the primary drug of choice in treating attention-deficit/hyperactivity disorder in children. Side effects are usually mild and are generally well tolerated by patients. Along with increases in prescribing frequency, the potential for abuse has increased. Intranasal abuse produces effects rapidly that are similar to the effects of cocaine in both onset and type. The clinical picture of stimulant abuse produces a wide ar...

  11. Pharmacokinetic and pharmacodynamic effects of methylphenidate and MDMA administered alone or in combination

    Hysek, C M; Simmler, L. D.; Schillinger, N.; De Meyer, N.; Schmid, Y; Donzelli, M; Grouzmann, E.; Liechti, M. E.

    2014-01-01

    Methylphenidate and 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') are widely misused psychoactive drugs. Methylphenidate increases brain dopamine and norepinephrine levels by blocking the presynaptic reuptake transporters. MDMA releases serotonin, dopamine and norepinephrine through the same transporters. Pharmacodynamic interactions of methylphenidate and MDMA are likely. This study compared the pharmacodynamic and pharmacokinetic effects of methylphenidate and MDMA administered alone ...

  12. Transdermic absorption of Melagenina II

    The transdermic absorption of Melagenina II (MII) was evaluated. MII was a labelled with 125I by the yodogen method and purified by column chromatography with Sephadex LH-20 in ethanol: water (7:3). In vitro absorption of (125I) - MII thought human skin was carried out in Keshary-Chien modified diffusion cells. Tape stripping method was applied after 24 hours to evaluate the accumulated activity in dermis and epidermis. In vivo assays were performed in Sprague Dawley rats to analyze absorption of MII until 24 hours after a single application and for five days a low penetrability of the drug while in vivo there were not found blood levels significantly greater than zero , nevertheless and important amount of radioactivity was found in feces and urine. The activity was concentrated mainly in the application site in both models

  13. Factors Associated with Response to Methylphenidate in Advanced Cancer Patients

    Yennurajalingam, Sriram; Palmer, J. Lynn; Chacko, Ray; Bruera, Eduardo

    2011-01-01

    The objective of this study was to identify the specific patient characteristics associated with response to methylphenidate and to compare day 1 response with day 8 response. Response to methylphenidate is associated with higher baseline fatigue but not with higher baseline depression or sedation. Additionally, day 1 improvement is highly sensitive as a predictor of long-term improvement.

  14. [Use of methylphenidate in palliative patients with asthenia: a review].

    Saralegui, A; Palacio, P; Royo, P

    2013-01-01

    Asthenia (or fatigue) is one of the most common symptoms in palliative patients. Methylphenidate is currently being assessed for treating this condition. A review of related literature published to date was performed, revealing methylphenidate to be a safe drug which could decrease fatigue in palliative patients with a tolerable side-effects profile. PMID:24008532

  15. Determinants of physicians' prescribing behaviour of methylphenidate for cognitive enhancement.

    Ponnet, Koen; Wouters, Edwin; Van Hal, Guido; Heirman, Wannes; Walrave, Michel

    2014-01-01

    The non-medical use of methylphenidate for cognitive enhancement becomes a more and more common practice among college and university students. Although physicians are a source of access, little is known about the underlying mechanisms that might lead to physicians' intention and behaviour of prescribing methylphenidate to improve students' academic performance. Applying Ajzen's theory of planned behaviour (TPB), we tested whether attitudes, subjective norms (controllability and self-efficacy) and perceived behavioural control predicted the intention and the prescribing behaviour of physicians. Participants were 130 physicians (62.3% males). Structural equation modelling was used to test the ability of TPB to predict physicians' behaviour. Overall, the present study provides support for the TPB in predicting physicians' prescribing behaviour of methylphenidate for cognitive enhancement. Subjective norms, followed by attitudes, are the strongest predictors of physicians' intention to prescribe methylphenidate. To a lesser extent, controllability predicts the intention of physicians, and self-efficacy predicts the self-reported behaviour. Compared to their male colleagues, female physicians seem to have more negative attitudes towards prescribing methylphenidate for cognitive enhancement, feel less social pressure and perceive more control over their behaviour. Intervention programmes that want to decrease physicians' intention to prescribe methylphenidate for improving academic performance should primarily focus on alleviating the perceived social pressure to prescribe methylphenidate and on converting physician neutral or positive attitudes towards prescribing methylphenidate into negative attitudes. PMID:23713799

  16. Association of Norepinephrine Transporter Gene with Methylphenidate Response.

    Yang, Li; Wang, Yu-Feng; Li, Jun; Faraone, Stephen V.

    2004-01-01

    Objective: This study aimed to explore the association between alleles of the norepinephrine transporter gene and the methylphenidate response. Method: Chinese Han youths with attention-deficit/hyperactivity disorder recruited in the Outpatient Department of the Institute of Mental Health from 2001 to 2004 were treated with methylphenidate in…

  17. Getting Treatment for ADHD

    Full Text Available ... Resources Early Career Psychiatrists Become a Member Advocacy Life Members International Maintenance of Certification Clinical Practice Center ... school and continue having trouble with friendships. Family life may also suffer. Untreated ADHD can increase strain ...

  18. Getting Treatment for ADHD

    Full Text Available ... level. Treatment may include medication, therapy, family support, educational support, or a combination of these. A major ... become available as alternatives. Scientists are continuing to research and develop new drugs for ADHD. It is ...

  19. Getting Treatment for ADHD

    Full Text Available ... AACAP Medical Students and Residents Medical Student Resources Child Psychiatry Residents (Fellows) Early Career Psychiatrists Member Resources ... Resources ADHD Resource Center Resource Centers Youth Resources Child and Adolescent Psychiatrist Finder Without treatment, a child ...

  20. ADHD & Down Syndrome

    ... at an accredited sleep center. What Types of Communication Difficulties Can Look Like ADHD? People with Down ... Down syndrome have a wide range of learning styles. A child's educational team may need to try ...

  1. Learning Disabilities and ADHD

    ... Illness & disability Drugs, alcohol & smoking Your feelings Relationships Bullying Safety Your future Environmental health Skip section navigation ( ... stimulates you, but these medicines have the opposite effect on kids with ADHD. If you take medication ...

  2. Getting Treatment for ADHD

    Full Text Available ... and Reimbursement Job Source Assembly of Regional Organizations Education Center Resources for Primary Care Become a Member ... become available as alternatives. Scientists are continuing to research and develop new drugs for ADHD. It is ...

  3. Getting Treatment for ADHD

    Full Text Available ... children to share their experiences and concerns. Support groups may also share information and referrals to specialists, and invite experts to speak. Contents What is ADHD? How ... Copyright ©2016 - American Academy of Child ...

  4. Getting Treatment for ADHD

    Full Text Available ... Assembly of Regional Organizations Education Center Resources for Primary Care Become a Member Practice Parameters and Resource ... Without treatment, a child with ADHD may fall behind in school and continue having trouble with friendships. Family life ...

  5. What Is ADHD?

    ... disability. The most common learning problems affect reading ( dyslexia ) and handwriting . Although ADHD isn't categorized as ... child does well — whether it's sports, art, or music — can boost social skills and self-esteem. previous ...

  6. Getting Treatment for ADHD

    Full Text Available ... and Reimbursement Job Source Assembly of Regional Organizations Education Center Resources for Primary Care Become a Member ... ADHD. They know that biological substances in the brain, such as dopamine and norepinephrine, play a role ...

  7. Getting Treatment for ADHD

    Full Text Available ... help a child with ADHD cope with daily problems, pay better attention, and learn to control aggression. A therapist may use one or more of the following approaches : Behavior therapy helps the family develop a plan to ...

  8. Chromosomal Abnormalities in ADHD

    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  9. Getting Treatment for ADHD

    Full Text Available ... They also have higher rates of cigarette and drug addiction, and more driving infractions. The good news ... Scientists are continuing to research and develop new drugs for ADHD. It is important to confer with ...

  10. Getting Treatment for ADHD

    Full Text Available ... Clinical Practice Center Award Opportunities CPT and Reimbursement Job Source Assembly of Regional Organizations Education Center Resources ... untreated ADHD have higher rates of divorce and job loss. They also have higher rates of cigarette ...

  11. Getting Treatment for ADHD

    Full Text Available ... child after each step is completed. Family support groups allow groups of parents with ADHD children to share their experiences and concerns. Support groups may also share information and referrals to specialists, ...

  12. Sleep Problems and ADHD

    J Gordon Millichap

    2008-01-01

    The prevalence of sleep problems and their associations with quality of life (QOL), school attendance, and family impacts in children with ADHD were determined in a study at Royal Children's Hospital, University of Melbourne, Australia.

  13. Getting Treatment for ADHD

    Full Text Available ... is that effective treatment is available . With the right medical treatment, children with ADHD can improve their ... to pay attention and control their behavior. The right care can help them grow, learn, and feel ...

  14. Getting Treatment for ADHD

    Full Text Available ... Family life may also suffer. Untreated ADHD can increase strain between parents and children. Parents often blame ... and control their behavior. The right care can help them grow, learn, and feel better about themselves. ...

  15. Getting Treatment for ADHD

    Full Text Available ... Resource Center Resource Centers Youth Resources Child and Adolescent Psychiatrist Finder Without treatment, a child with ADHD ... Together Resources Copyright ©2016 - American Academy of Child Adolescent Psychiatry. All Rights Reserved. Contact Us | Disclaimer | Privacy ...

  16. Getting Treatment for ADHD

    Full Text Available ... grow, learn, and feel better about themselves. The goal of any type of ADHD treatment is to ... Us | Disclaimer | Privacy Statement Developed by Armstrong Enterprise Communication {1} ##LOC[OK]## {1} ##LOC[OK]## ##LOC[Cancel]## { ...

  17. Getting Treatment for ADHD

    Full Text Available ... communicate with their child. The sense of losing control can be very frustrating. Untreated ADHD can have ... can improve their ability to pay attention and control their behavior. The right care can help them ...

  18. Getting Treatment for ADHD

    Full Text Available ... is to reduce symptoms and help the child function at a normal level. Treatment may include medication, ... become available as alternatives. Scientists are continuing to research and develop new drugs for ADHD. It is ...

  19. 盐酸哌甲酯控释片治疗注意缺陷多动障碍不同临床亚型患儿疗效的对比研究%To Compare the Effects of Methylphenidate Extended-release Tablets(OROS MPH ) in Treating Different Clinical Type of attention Deficit Hyperactivity Disorder (ADHD)

    杨思渊; 麦坚凝; 杜志宏

    2007-01-01

    目的 比较盐酸哌甲酯控释片(专注达)治疗注意缺陷多动障碍(ADHD)的不同临床亚型儿童的疗效.方法 采用自身前后对照试验设计.按照ADHD的DSM-Ⅳ诊断标准,分别收集注意缺陷为主型(IT)患儿、冲动为主型(HT)患儿以及混合型(CT)患儿各20例,分成三组,分别接受治疗各7天,并于治疗期末评定主要疗效评定指标:家长评定的Conners量表、教师评定的Conners量表.次要疗效指标:儿童行为量表.结果 疗效:哌甲酯控释片治疗7天后,不同临床亚型患儿的主要疗效评定指标和次要疗效指标均出现明显改善,其中注意缺陷为主型(IT)患儿在学习问题、不注意-被动以及注意力的改善程度等方面明显优于其他两组儿童(P<0.05);冲动-多动为主型(HT)患儿在品行问题、心身障碍、冲动-多动以及多动指数的改善明显优于其他两组儿童(P<0.05),同时对于CBCL中的交往不良、多动、攻击性和违纪的改善也明显优于其他两组儿童(P<0.05);混合型主要在多动指数和焦虑方面呈现较大改善.结论 盐酸哌甲酯控释片对于不同亚型的注意力缺陷多动障碍儿童的疗效存在差异.

  20. Factors related to methylphenidate response in children with attention deficit/ hyperactivity disorder: a retrospective study

    gokce nur say

    2015-01-01

    Full Text Available Objective: We aimed to explore the predictive value of clinical features and self-concept on methylphenidate (MPH response in children with attention deficit/hyperactivity disorder (ADHD. Methods: The study had a naturalistic design where the results were analyzed retrospectively. ADHD and comorbidity were diagnosed by Schedule for Affective Disorders and Schizophrenia for School-Age Children Present Lifetime Version (K-SADS-PL. At the baseline assessment, parents completed Turgay DSM-IV Disruptive Disorders Rating Scale (T-DSM-IV-S and Child Behavior Check List (CBCL; teachers were given T-DSM-IV-S, CBCL. The children completed Piers-Harris Children’s Self-Concept Scale (PHSCS, Children’s Depression Inventory (CDI, and Screen for Child Anxiety Related Emotional Disorders (SCARED. Following 4-8 weeks of MPH treatment, the parents completed T-DSM-IV-S and the clinician completed Clinical Global Impression-Improvement scale (CGI-I. This study included 54 children (18 girls, 36 boys; mean age 9.32±0.21 years old. The sample was divided in “good responders” (GR and “poor responders” (PR regarding the response criteria defined by authors. Results: The PR group had significantly higher rates of anxiety disorders, higher internalizing scores and lower PHSCS scores compared to GR. Comorbid anxiety disorders, elimination disorders and negative self-concept were found to predict poor MPH response by multiple regression analysis. Conclusions: The results point to the need for additional interventions in the presence of comorbid anxiety, incontinence or poor self-concept in children with ADHD.

  1. Effects of developmental methylphenidate (MPH) treatment on monoamine neurochemistry of male and female rats.

    Panos, John J; O'Callaghan, James P; Miller, Diane B; Ferguson, Sherry A

    2014-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) is estimated to affect 4-5% of the adult human population (Kessler et al., 2006; Willcutt, 2012). Often prescribed to attenuate ADHD symptoms (Nair and Moss, 2009), methylphenidate hydrochloride (MPH) can have substantial positive effects. However, there is a paucity of literature regarding its use during pregnancy. Thus, adult women with ADHD face a difficult decision when contemplating pregnancy. In this study, pregnant Sprague-Dawley rats were orally treated a total of 0 (water), 6 (low), 18 (medium), or 42 (high) mg MPH/kg body weight/day (divided into three doses) on gestational days 6-21 (i.e., the low dose received 2 mg MPH/kg body weight 3×/day). Offspring were orally treated with the same daily dose as their dam (divided into two doses) on postnatal days (PNDs) 1-21. One offspring/sex/litter was sacrificed at PND 22 or PND 104 (n=6-7/age/sex/treatment group) and the striatum was quickly dissected and frozen. High Performance Liquid Chromatography (HPLC) coupled to a Photo Diode Array detector (PDA) was used to analyze monoamine content in the striatum of one side while a sandwich ELISA was used to analyze tyrosine hydroxylase (TH) from the other side. Age significantly affected monoamine and metabolite content as well as turnover ratios (i.e., DA, DOPAC, HVA, DOPAC/DA, HVA/DA, 5-HT and 5-HIAA); however, there were no significant effects of sex. Adult rats of the low MPH group had higher DA levels than control adults (peffect (i.e., higher DA or TH levels) exhibited an apparent dose-response. PND 22 subjects of the high MPH treatment group had higher ratios of HVA/DA and DOPAC/DA than same-age control subjects (peffects on monoamine system development, further studies are required to determine if these alterations manifest as functional changes in behavior. PMID:25132048

  2. Effects of methylphenidate on executive functioning in attention-deficit/hyperactivity disorder across the lifespan: a meta-regression analysis.

    Tamminga, H G H; Reneman, L; Huizenga, H M; Geurts, H M

    2016-07-01

    Attention-deficit/hyperactivity disorder (ADHD) in childhood and adulthood is often treated with the psychostimulant methylphenidate (MPH). However, it is unknown whether cognitive effects of MPH depend on age in individuals with ADHD, while animal studies have suggested age-related effects. In this meta-analysis, we first determined the effects of MPH on response inhibition, working memory and sustained attention, but our main goal was to examine whether these effects are moderated by age. A systematic literature search using PubMed, PsycINFO, Web of Science and MEDLINE for double-blind, placebo-controlled studies with MPH resulted in 25 studies on response inhibition (n = 775), 13 studies on working memory (n = 559) and 29 studies on sustained attention (n = 956) (mean age range 4.8-50.1 years). The effects of MPH on response inhibition [effect size (ES) = 0.40, p attention (ES = 0.42, p children and adults with ADHD. However, adolescent studies are lacking and needed to conclude a lack of an age-dependency across the lifespan. PMID:27019103

  3. The acute effect of methylphenidate on cerebral blood flow in boys with attention-deficit/hyperactivity disorder

    Szobot, Claudia M.; Ketzer, Carla; Kapczinski, Flavio [Department of Psychiatry, Federal University of Rio Grande do Sul (Brazil); Cunha, Renato D. [Service of Nuclear Medicine, Hospital de Clinicas de Porto Alegre (Brazil); Parente, Maria A. [Department of Psychology, Federal University of Rio Grande do Sul (Brazil); Langleben, Daniel D. [Department of Psychiatry, University of Pennsylvania (United States); Acton, Paul D. [Department of Radiology, University of Pennsylvania (United States); Rohde, Luis A.P. [Department of Psychiatry, Federal University of Rio Grande do Sul (Brazil); Servico de Psiquiatria da Infancia e Adolescencia, Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos 2350, CEP 90035-003, RS Porto Alegre (Brazil)

    2003-03-01

    Methylphenidate (MPH) is the most commonly prescribed treatment for attention-deficit/hyperactivity disorder (ADHD). The therapeutic mechanisms of MPH are not, however, fully understood. We studied the effects of MPH on brain activity in male children and adolescents with ADHD, using the blood flow radiotracer technetium-99m ethyl cysteinate dimer ({sup 99m}Tc-ECD) and single-photon emission tomography (SPET). The study was randomized, double blind, and placebo controlled (MPH group, n=19; placebo group, n=17), Radiotracer was administered during the performance of the Continuous Performance Test and before and after 4 days of MPH treatment. Statistical parametric mapping (SPM99) analysis showed a significant reduction in regional cerebral blood flow in the left parietal region in the MPH group compared with the placebo group (P<0.05, corrected for multiple comparisons). Our findings suggest that the posterior attentional system, which includes the parietal cortex, may have a role in the mediation of the therapeutic effects of MPH in ADHD. (orig.)

  4. The acute effect of methylphenidate on cerebral blood flow in boys with attention-deficit/hyperactivity disorder

    Methylphenidate (MPH) is the most commonly prescribed treatment for attention-deficit/hyperactivity disorder (ADHD). The therapeutic mechanisms of MPH are not, however, fully understood. We studied the effects of MPH on brain activity in male children and adolescents with ADHD, using the blood flow radiotracer technetium-99m ethyl cysteinate dimer (99mTc-ECD) and single-photon emission tomography (SPET). The study was randomized, double blind, and placebo controlled (MPH group, n=19; placebo group, n=17), Radiotracer was administered during the performance of the Continuous Performance Test and before and after 4 days of MPH treatment. Statistical parametric mapping (SPM99) analysis showed a significant reduction in regional cerebral blood flow in the left parietal region in the MPH group compared with the placebo group (P<0.05, corrected for multiple comparisons). Our findings suggest that the posterior attentional system, which includes the parietal cortex, may have a role in the mediation of the therapeutic effects of MPH in ADHD. (orig.)

  5. Transdermal drug delivery system: An overview

    Vaibhav Rastogi

    2012-01-01

    Full Text Available Transdermal drug delivery system (TDDS is one of the systems lying under the category of controlled drug delivery, in which the aim is to deliver the drug through the skin in a predetermined and controlled rate. It has various advantages, like prolonged therapeutic effect, reduced side-effects, improved bioavailability, better patient compliance and easy termination of drug therapy. The stratum corneum is considered as the rate limiting barrier in transdermal permeation of most molecules. There are three main routes of drug penetration, which include the appendageal, transcellular and intercellular routes. Skin age, condition, physicochemical factors and environmental factors are some factors that are to be considered while delivering drug through this route. Basic components of TDDS include polymer matrix, membrane, drug, penetration enhancers, pressure-sensitive adhesives, backing laminates, release liner, etc. Transdermal patches can be divided into various systems like reservoir system, matrix system and micro-reservoir system, which are used to incorporate the active ingredients into the circulatory system via the skin. After preparation of transdermal patches, consistent methodology are adopted to test the adhesion properties, physicochemical properties, in vitro drug release studies, in vitro skin permeation studies, skin irritation studies and stability studies. According to the duration of therapy, various drugs are commercially available in the form of transdermal patches.

  6. Permeation enhancer strategies in transdermal drug delivery.

    Marwah, Harneet; Garg, Tarun; Goyal, Amit K; Rath, Goutam

    2016-01-01

    Today, ∼74% of drugs are taken orally and are not found to be as effective as desired. To improve such characteristics, transdermal drug delivery was brought to existence. This delivery system is capable of transporting the drug or macromolecules painlessly through skin into the blood circulation at fixed rate. Topical administration of therapeutic agents offers many advantages over conventional oral and invasive techniques of drug delivery. Several important advantages of transdermal drug delivery are prevention from hepatic first pass metabolism, enhancement of therapeutic efficiency and maintenance of steady plasma level of the drug. Human skin surface, as a site of drug application for both local and systemic effects, is the most eligible candidate available. New controlled transdermal drug delivery systems (TDDS) technologies (electrically-based, structure-based and velocity-based) have been developed and commercialized for the transdermal delivery of troublesome drugs. This review article covers most of the new active transport technologies involved in enhancing the transdermal permeation via effective drug delivery system. PMID:25006687

  7. Transdermal Photopolymerization for Minimally Invasive Implantation

    Elisseeff, J.; Anseth, K.; Sims, D.; McIntosh, W.; Randolph, M.; Langer, R.

    1999-03-01

    Photopolymerizations are widely used in medicine to create polymer networks for use in applications such as bone restorations and coatings for artificial implants. These photopolymerizations occur by directly exposing materials to light in "open" environments such as the oral cavity or during invasive procedures such as surgery. We hypothesized that light, which penetrates tissue including skin, could cause a photopolymerization indirectly. Liquid materials then could be injected s.c. and solidified by exposing the exterior surface of the skin to light. To test this hypothesis, the penetration of UVA and visible light through skin was studied. Modeling predicted the feasibility of transdermal polymerization with only 2 min of light exposure required to photopolymerize an implant underneath human skin. To establish the validity of these modeling studies, transdermal photopolymerization first was applied to tissue engineering by using "injectable" cartilage as a model system. Polymer/chondrocyte constructs were injected s.c. and transdermally photopolymerized. Implants harvested at 2, 4, and 7 weeks demonstrated collagen and proteoglycan production and histology with tissue structure comparable to native neocartilage. To further examine this phenomenon and test the applicability of transdermal photopolymerization for drug release devices, albumin, a model protein, was released for 1 week from photopolymerized hydrogels. With further study, transdermal photpolymerization potentially could be used to create a variety of new, minimally invasive surgical procedures in applications ranging from plastic and orthopedic surgery to tissue engineering and drug delivery.

  8. Update on optimal use of lisdexamfetamine in the treatment of ADHD

    Madaan V

    2013-07-01

    Full Text Available Vishal Madaan, Venkata Kolli, Durga P Bestha, Manan J ShahDepartment of Psychiatry and Neurobehavioral Sciences, Division of Child and Family Psychiatry, University of Virginia Health System, Charlottesville, VA, USAAbstract: Lisdexamfetamine (LDX has been a recent addition to the treatment armamentarium for Attention Deficit Hyperactivity Disorder (ADHD. It is unique among stimulants as it is a prodrug, and has been found to be safe and well-tolerated medication in children older than 6 years, adolescents and adults. It has a smooth onset of action, exerts its action up to 13 hours and may have less rebound symptoms. LDX has proven to be effective in the treatment of ADHD in placebo controlled trials, and improved performance in simulated academic and work environments have been noticed. Both stimulant naïve and stimulant-exposed patients with ADHD appear to benefit from LDX. It has also shown some promise in improving emotional expression and executive function of patients with ADHD. Adverse effects such as decrease in sleep, loss of appetite and others have been reported with LDX use, just as with other stimulant formulations. Since most such studies exclude subjects with preexisting cardiac morbidity, prescribing precautions should be taken with LDX in such subjects, as with any other stimulant. Study subjects on LDX have been reported to have low scores on drug likability scales, even with intravenous use; as a result, LDX may have somewhat less potential for abuse and diversion. There is a need for future studies comparing other long acting stimulants with LDX in ADHD; in fact clinical trials comparing LDX with OROS (osmotic controlled-release oral delivery system methylphenidate are currently underway. Furthermore, the utility of this medication in other psychiatric disorders and beyond ADHD is being investigated.Keywords: lisdexamfetamine, ADHD, functional impairment, pharmacotherapy

  9. ADHD-problematikkens sociale aspekter

    Høgsbro, Kjeld; Eskelinen, Leena; Andersen, Maja Lundemark;

    Denne forskningsrapport sammenfatter resultaterne fra en undersøgelse af den sociale indsats overfor mennesker med en ADHD-problematik. Den bidrager til en øget forståelse for, hvordan ADHD-problematikken påvirker familiers og individers relationer til arbejdsmarkedet og samfundet, samtidig med at...... indsats over for mennesker med ADHD....

  10. Metabolism of methylphenidate in dog and rat

    The urinary metabolites of methylphenidate in the dog and rat were investigated. After oral administration of 14C-labeled methylphenidate, approximately 86% and 63% of the dose was recovered in the urine of the dog and rat, respectively. Less than 1% of the dose was excreted as unchanged drug. Metabolism involved oxidation, hydrolysis, and conjugation processes. The primary hydrolytic product was alpha-phenyl-2-piperidineacetic acid (24%, dog; 35-40%, rat). The primary metabolites of oxidation were methyl 6-oxo-alpha-phenyl-2-piperidineacetate (3%, dog; 1.5%, rat) and the glucuronide of alpha-(p-hydroxyphenyl)-2-piperidineacetic acid (10%, rat). The former also underwent extensive biotransformation, including: 1) hydrolysis to the lactam acid (27%, dog; 7-10%, rat) and subsequent carboxylic acid O-glucuronidation (15%, dog); or 2) hydroxylation at the 5-position (1%, dog; 2%, rat) and subsequent hydrolysis (4%, dog; 15-17%, rat); or 3) 5-O-glucuronidation (12%, dog). Additional minor metabolites from methyl-6-oxo-alpha-phenyl-2-piperidineacetate were the phenolic O-glucuronide of methyl alpha-(p-hydroxyphenyl)-6-oxo-2-piperidineacetate (1%, dog), and the 4-O-glucuronide of methyl 4-hydroxy-6-oxo-alpha-phenyl-2-piperidineacetate (1%, dog), and the taurine amide conjugate of alpha-(p-hydroxyphenyl)-6-oxo-2-piperidineacetic acid (1%, dog). Additional products from methylphenidate conjugation included methyl 1-carbamoyl-alpha-phenyl-2-piperidineacetate (1%, dog or rat) and its carboxylic acid hydrolysis product (1%, rat). The chirality of the major metabolites isolated from dog urine showed that metabolism was partially stereoselective in all investigated cases, except in the formation of alpha-phenyl-2-piperidineacetic acid

  11. Summarization of Treating ADHD by Using MPH with Neuro - feedback%哌甲酯联合神经反馈治疗儿童注意力缺陷多动障碍(综述)

    陈桂芳; 谢维爵; 钟昆

    2015-01-01

    Methylphenidate(MPH)is a key drug to treat children with attention deficit / hyperactivity disor-der(ADHD),and neuro - feedback(NF)is a new technique for the treatment of ADHD,MPH and NF have their own advantages and limitations in treating ADHD. In recent years,in order to explore the better treatment effect for the ADHD,clinical doctors and researchers have reported the present situations of application and re-searches relating to MPH combined with NF in the treatment of ADHD. The paper summarizes the documents a-bout ADHD treatment in use of MPH combined NF,analyzes and comments on several factors which influence the effect,aiming at offering some references for combination therapy research about ADHD.%哌甲酯(Methylphenidate,MPH)是目前治疗儿童注意力缺陷多动障碍(Attention - deficit/ hyperactivity disorder,ADHD)的一线药物,神经反馈(Neuro - feedback,NF)是治疗 ADHD 的新技术。两种方法在治疗 ADHD 方面具有不同优势和局限性。近年来,为了探讨更好的 ADHD 治疗效果,临床工作者和研究者报道了 MPH 联合 NF治疗 ADHD 的临床应用与研究情况。文章综述了 MPH 联合 NF 治疗 ADHD 的相关文献,分析和评述了影响其疗效的各种可能因素。旨在为不断完善 ADHD 综合治疗研究提供一定的参考。

  12. Percutaneous penetration enhancement in transdermal drug delivery

    Singh Inderjeet

    2010-01-01

    Full Text Available The transdermal route has numerous advantages over the more traditional drug delivery routes. These include high bioavailability, absence of first pass hepatic metabolism, steady drug plasma concentrations, and the fact that therapy is non-invasive. The main obstacle to permeating drug molecules is the outermost layer of the skin, the stratum corneum. Consequently, research into enhancing transdermal drug delivery (TDD by overcoming this layer, is an area of prime interest. This review article is written to provide a coverage commentary of the recent advancements in TDD enhancement techniques.

  13. Transdermal clonidine in patients with swallowing dysfunction.

    Goldenberg, Gregory; Bharathan, Thayyullathil; Shifrin, Inna

    2014-09-01

    Patients with swallowing dysfunction are usually very ill and have a constellation of challenging issues requiring palliation. Accumulation of oropharyngeal secretions leads to a substantial effort of medical teams including doctors, nurses, respiratory therapists, and ancillary staff. We present 10 patients successfully treated with application of transdermal clonidine film. It was well tolerated, provided quick control of secretions, and reduced staff labor. We suggest that transdermal clonidine can be used as antisialogogue in patients with swallowing dysfunction. Clonidine pharmacology is physiologic grounds for this clinical application. PMID:24813023

  14. A REVIEW: TRANSDERMAL DRUG DELIVERY OF NICOTINE

    Saurabh Ravi

    2011-06-01

    Full Text Available Cigarette smoking has been the leading cause of premature death and illness in many industrialized country in the world, while the U.S. alone registers more than 4,00,000 deaths each year. The nicotine patch serves to deliver a constant dose of nicotine across the skin that helps to relieve the symptoms which are associated with tobacco withdrawal. Further, the use of carbon nanotube membranes and micro needle based transdermal drug delivery has lead to the great advancements. Some of the main advantages of transdermal drug delivery are bypassing of hepatic first pass metabolism, maintenance of steady plasma level of the drug and enhancement of therapeutic efficiency.

  15. Comparison of Sensorimotor Rhythm (SMR and Beta Training on Selective Attention and Symptoms in Children with Attention Deficit/Hyperactivity Disorder (ADHD: A Trend Report

    Mohammad Reza Mohammadi

    2015-11-01

    Full Text Available  Objective: The aim of this study was to assess and compare the effect of two neurofeedback protocols (SMR/theta and beta/theta on ADHD symptoms, selective attention and EEG (electroencephalogram parameters in children with ADHD.  Method:The sample consisted of 16 children (9-15 year old: 13 boys; 3 girls with ADHD-combined type (ADHD-C. All of children used methylphenidate (MPH during the study. The neurofeedback training consisted of two phases of 15 sessions, each lasting 45 minutes. In the first phase, participants were trained to enhance sensorimotor rhythm (12-15 Hz and reduce theta activity (4-8 Hz at C4 and in the second phase; they had to increase beta (15-18 Hz and reduce theta activity at C3. Assessments consisted of d2 attention endurance test, ADHD rating scale (parent form at three time periods: before, middle and the end of the training. EEG signals were recorded just before and after the training . Result:Based on parents’ reports, inattention after beta/theta training, and hyperactivity/impulsivity were improved after the end of the training. All subscales of d2 test were improved except for the difference between maximum and minimum responses. However, EEG analysis showed no significant differences . Conclusion:Neurofeedback in conjunction with Methylphenidate may cause further improvement in ADHD symptoms reported by parents and selective attention without long-term impact on EEG patterns. However, determining the exact relationship between EEG parameters, neurofeedback protocols and ADHD symptoms remain unclear.

  16. Nuorten ADHD : Nuorisonetti

    Heinänen, Pirkko; Sjöman, Jutta

    2011-01-01

    ADHD (attention deficit hyperactivity disorder) on lievä aivotoiminnan häiriö, joka aiheuttaa ylivilkkautta tarkkaavaisuus häiriöitä sekä impulssikontrollin puuttumista. Suomalaisista lapsista noin 4-10%:lla esiintyy ADHD:ta ja se on yleisempää pojilla kuin tytöillä. Nuoruudessa häiriön luonne muuttuu ja ylivilkkausoireet vähenevät. Sisäinen levottomuus ja sääntöjä vastaan kapinointi on tyypillistä nuoruuden käytöshäiriöissä. Nuori tarvitsee tukea selvitäkseen yhteiskunnan haasteista ADHD dia...

  17. 哌甲酯治疗不同亚型注意缺陷多动障碍患儿的疗效及影响因素%Efficacy and Factors of Methylphenidate on Children with Different Subtypes of Attention Deficit Hyperactivity Disorder

    韩颖; 秦炯; 姜玉武; 边旸; 侯绍荣; 李明

    2011-01-01

    Objective To examine the efficacy and safety of methylphenidate on children with different subtypes of attention deficit hy-peractivity disorder( ADHD) ,and further explore potential factors which may contribute to the prognosis of ADHD. Methods The diagnostic assessment of ADHD was performed according to the recommendations of the diagnosis and treatment of ADHD for Chinese children. Efficacy of medication on ADHD was evaluated by means of ADHD parent rating scale scores, Conners' parent rating scale, and continuous performance test(CPT). ADHD children were given methylphenidate dose titration systematically and followed up for 6 months. Factors were collected including symptom severity, intelligence quotient, learning achievement, which may contribute to the prognosis of ADHD. Results 1. The differences between before and after treatment were statistically significant, including the results of ADHD parent rating scale scores, Conners' parent rating scale, and CPT. 2. Comparison of efficacy in different subtypes; (1) Reduction rate of ADHD parent rating scale scores:The differences between combined type (ADHD - CT) and predominantly inattentive type ( ADHD - PI) had no statistical significance; compared with ADHD - CT or ADHD - PI, hyperactive - impulsive type (ADHD - HI) had lower reduction rate; (2 ) Reduction rate of Conners' parent rating scale;the differences between ADHD - CT, ADHD - PI or ADHD - HI had no statistical significance; (3) Reduction rate of CPT:the differences between ADHD - CT, ADHD - PI or ADHD - HI had no statistical significance; (4) Effective rate and effectual rate:effectual rate of ADHD - CT was 68. 25% , while effectual rate of ADHD - CT was 55. 56% ; effectual rate of ADHD - PI was 75. 82% , while effectual rate of ADHD - PI was 56.04% ; effectual rate of ADHD - HI was 63. 64% , while effectual rate of ADHD - HI was 45.45%. 3. Factors influencing the efficacy: the severity of symptoms and intelligence quotient were related to the

  18. ADHD : from childhood into adulthood

    Camilleri, Nigel; Makhoul, Samer

    2013-01-01

    This is an overview of the some of the most recent and seminal research done on Attention Deficit Hyperactivity Disorders (ADHD). ADHD is currently one of the most common reasons for referral to child mental health services and still is under-recognised both in children (5.29%) and adults (2.5%). ADHD is a highly heritable disorder with a mulitifactorial pattern of inheritance. Parents, siblings and parents of a child with ADHD are 4-5 times more likely to have ADHD. Environmental factors als...

  19. Effectiveness and safety of amphetamine for ADHD in population between 6 and 19 years: a systematic review

    José Calleja

    2012-09-01

    Full Text Available Introduction: Attention deficit hyperactivity disorder (ADHD drug treatment is based on psychostimulants, and methylphenidate is still the most widely used one. Other psychostimulants used include amphetamines, hence the importance of knowing both its effectiveness and safety. Purpose: To identify, synthesize and evaluate the best available evidence on the effectiveness and safety of amphetamine in ADHD in the 6-19 year-old population. Methods: A systematic review of studies that evaluated the effectiveness of interventions comparing amphetamine to methylphenidate was conducted. The outcomes measured were educational performance, psychosocial functioning, quality of life and adverse effects. The following databases were searched up to February 2012 in English and Spanish: PubMed/MEDLINE, LILACS, Cochrane, DARE and National Guideline Clearinghouse. The articles that met inclusion criteria were assessed by two researchers independently. Results: Of the 114 studies found initially, four were included, among which a systematic review, a primary article and two clinical guidelines. Conclusions: The evidence on amphetamine for ADHD treatment recommends its use as an alternative to MPH. Further good-quality studies are needed.

  20. ADHD stigma among college students.

    Thompson, Amanda Chi; Lefler, Elizabeth K

    2016-03-01

    The current study examined ADHD stigma within a college-enrolled young adult population, including the debate regarding the cause of stigma: label or behavior. In Phase 1, 135 college students rated stigma toward one of the four fictitious partners described as having either: the label of ADHD alone, the behaviors associated with ADHD alone, the label of ADHD and a set of behaviors associated with ADHD, or neither the label nor behaviors. In Phase 2, 48 college students rated stigma toward one of the two assigned fictitious partners described as having either: the label of ADHD and a set of behaviors associated with ADHD, or the label of Depression and a set of behaviors associated with Depression. It was hypothesized that the interaction between the label and the behaviors would cause the highest levels of ADHD stigma and that ADHD would elicit more stigma than Depression. In Phase 1, stigma was associated with the behaviors of ADHD, but not the label. In Phase 2, ADHD and Depression were found to be equally stigmatized. Implications, limitations, and future directions are discussed. PMID:26135022

  1. The potential for misuse and abuse of medications in ADHD: a review.

    Clemow, David B; Walker, Daniel J

    2014-09-01

    This article reviews the literature concerning attention-deficit/hyperactivity disorder (ADHD) medication misuse, abuse, dependence, diversion, and malingering. The review covers nonmedical use (NMU) of both stimulant (methylphenidate and amphetamine) and nonstimulant (α-adrenergic agonists and atomoxetine) prescription medications, and provides a discussion on the relevance for ADHD treatment today. The neural basis for ADHD medication mechanisms of action (increased norepinephrine and dopamine signaling) and their neurobiochemical relationship to the abuse potential is explored. Regionally-specific, stimulant-induced elevations in brain dopamine appear to be integral to both efficacy in ADHD and potential for abuse. In addition to the prevalence of misuse and diversion, additional topics discussed include the potential safety concerns associated with NMU of prescription ADHD medications and the cost to payers of prescription drug diversion (eg, increased emergency department visits associated with misuse). The evidence describing the difficulty in detecting malingering for the purpose of illicit access to ADHD medications for subsequent misuse or diversion is also summarized. Moreover, the effect of ADHD medications in patients with comorbid substance use disorder and the controversial potential linkage of stimulant prescription use with subsequent substance use disorder are explored. Overall, the data suggest that ADHD medication misuse and diversion are common health care problems for stimulant medications, with the prevalence believed to be approximately 5% to 10% of high school students and 5% to 35% of college students, depending on the study. Stimulant effectiveness and speed of action are deemed desirable to enhance attention and focus performance for activities like studying, but stimulants are also misused recreationally. Conversely, the data suggest a lack of abuse potential and lack of actual medication misuse for the nonstimulant medications

  2. Functional MRI in ADHD: a systematic literature review.

    Paloyelis, Yannis; Mehta, Mitul A; Kuntsi, Jonna; Asherson, Philip

    2007-10-01

    Functional MRI (fMRI) research in attention-deficit/hyperactivity disorder (ADHD) is a fast developing and very complex field. Every study appears to show differences in patterns of brain activation between cases and controls, but the interpretation of such differences is not as straightforward as it may seem. We present here a systematic review of the fMRI literature in ADHD; areas covered include executive functions, reward processing, the effects of methylphenidate, comorbidity and spontaneous brain activity in the resting state. To facilitate the interpretation of research in this area, we discuss important conceptual issues, such as the need to take group differences in performance into account or to consider the role of errors. We present common themes that emerge from these studies and we discuss possible reasons for the many discrepancies that were observed. Finally, based on existing literature and current advancements in fMRI research, we discuss the role that fMRI could play in the future as a diagnostic tool or in treatment outcome predictions, and we make predictions for the future directions of research in this field. PMID:17939771

  3. College Students' Attitudes toward Their ADHD Peers

    Chew, Brandi L.; Jensen, Scott A.; Rosen, Lee A.

    2009-01-01

    Objective: The attitudes of college students with and without ADHD toward peers with ADHD were examined. Method: A total of 196 college students (30 diagnosed with ADHD) anonymously completed four attitude measures. General analyses of attitudes toward peers with ADHD as well as comparisons between those with and without ADHD are made. Results:…

  4. Affect Recognition in Adults with ADHD

    Miller, Meghan; Hanford, Russell B.; Fassbender, Catherine; Duke, Marshall; Schweitzer, Julie B.

    2011-01-01

    Objective: This study compared affect recognition abilities between adults with and without ADHD. Method: The sample consisted of 51 participants (34 men, 17 women) divided into 3 groups: ADHD-combined type (ADHD-C; n = 17), ADHD-predominantly inattentive type (ADHD-I; n = 16), and controls (n = 18). The mean age was 34 years. Affect recognition…

  5. Assessment of outcome of an ADHD treatment program using parent feedback

    Hemamali Perera

    2010-12-01

    Full Text Available Background Attention deficit hyperactivity disorder (ADHD is a common behaviour disorder in children where the associated aggressive tendencies, learning difficulties and poor social skills pose a substantial burden of care on the parents. However, in traditional clinical practice, parental expectation of outcome of treatment is rarely considered. Aims This study prospectively analysed an outpatient treatment programme for children with ADHD, where parents provided feedback on the outcome of treatment. Methods Parents completed structured formats to provide information on presenting complaints, outcome at 3 months and 6 months after commencing treatment and side effects of the drug methylphenidate. Parents also attended psycho-educational and support groups. Results Of the 102 patients, parents reported a positive outcome in the majority. There was significantly better improvement in symptoms of ADHD at 6 months when compared to 3 months of treatment (p<0.005. Also, hyperactivity improved more than attention deficit and impulsiveness at the end of 6 months, though persistence of learning difficulties (50% and disruptive behaviour were causes for dissatisfaction about treatment. The commonest side effect was poor appetite (49%, though none of the children had identifiable weight loss. Conclusions Close involvement of parents in monitoring outcome of treatment of ADHD helps to focus on aspects of care relevant to them.

  6. Comparative Study of Multimodal and Pharmacological Therapy in Treating School Aged Children with ADHD

    Susana Bogdana MILEA

    2012-09-01

    Full Text Available The attention deficit hyperactivity disorder (ADHD, one of the most commonly diagnosed psychiatric disorders among school aged children, continues to create disputes between specialists, upon the best treatment to be used. The herby study aims to bring forward some differences that may exist between the efficacy of the multimodal treatment compared to the drug treatment of ADHD. The novelty component of this study, unfolded February 2010-July 2012, is that the children, their parents and also their teachers were included in the multimodality treatment. The children included in this research (n=63, aged 6-14 and ADHD diagnosed, were randomly assigned in two groups. In the medication (Med group (n=32 the children only received the specific pharmacological treatment (Atomoxetine or Methylphenidate, and for the multimodality (MM group (n=31 the therapy included psychosocial interventions besides the drug therapy. All children were evaluated, both pre and post intervention, with the Achenbach System of Empirically Based Assessment – ASEBA, for the 6-18 aged category. We have compared the influence of therapy on the core symptoms, on the adaptive functionality and academic performance and on the competences and social functioning of the children in the two groups. The multimodal intervention proved to be more effective (p<0.05 than medication alone, firstly in ameliorating the child’s social behavior in both family and school environment, than in what concerns the main ADHD symptoms. The children’s academic performance was little impacted by either of the two therapies.

  7. Relationship between quality of life and psychopathological profile: data from an observational study in children with ADHD.

    Becker, Andreas; Roessner, Veit; Breuer, Dieter; Döpfner, Manfred; Rothenberger, Aribert

    2011-10-01

    Although ADHD significantly affects the quality of life (QoL) of patients and their families, QoL in children with ADHD has rarely been investigated in association with psychopathological profile, and the relationship remains unclear. The open-label OBSEER study evaluated the effectiveness and tolerability of Equasym XL(®), a modified-release methylphenidate, in routine care of children and adolescents (aged 6-17 years) with ADHD. At baseline, questionnaires assessing psychopathological profile (Strengths and Difficulties Questionnaire, SDQ; parental ratings) and QoL (KINDL; parent, child or adolescent versions) were completed; QoL was reassessed at final visit. We analysed the relationship between psychopathology and parent/patient-rated QoL in ADHD at baseline. Data from 721 consecutively referred children and adolescents were analysed. QoL was similarly low from parent and self-ratings and independent of severity on the SDQ subscale hyperactivity/inattention. Self-ratings indicated that additional conduct disorder was associated with further reduction in QoL. Similarly, children with high scores from parent and adolescent ratings on the SDQ subscale conduct problems had reduced QoL on some KINDL subscales. Adolescents with ADHD not receiving medication at baseline reported lower QoL than those already on medication. Results show that children and adolescents with ADHD have low QoL, independent of core symptom severity. Additional conduct problems may further impact QoL negatively, while ADHD medication use may show a trend towards improved QoL. Not all psychopathological problems associated with ADHD affect QoL similarly. As parents appear to have a less critical view of QoL compared with children's self-ratings, both parent and child ratings should be included in clinical assessments. PMID:21901415

  8. Music and Sound Elements in Time Estimation and Production of Children with Attention Deficit/Hyperactivity Disorder (ADHD

    Luiz Rogerio Jorgensen Carrer

    2015-09-01

    Full Text Available ADHD involves cognitive and behavioral aspects with impairments in many environments of children and their families’ lives. Music, with its playful, spontaneous, affective, motivational, temporal and rhythmic dimensions can be of great help for studying the aspects of time processing in ADHD. In this article we studied time processing with simple sounds and music in children with ADHD with the hypothesis that children with ADHD have a different performance when compared with children with normal development in tasks of time estimation and production. The main objective was to develop sound and musical tasks to evaluate and correlate the performance of children with ADHD, with and without methylphenidate, compared to a control group with typical development. The study involved 36 participants age 6 to 14 years, recruited at NANI-Unifesp/SP, sub-divided into three groups with 12 children in each. Data was collected through a musical keyboard using Logic Audio Software 9.0 on the computer that recorded the participant's performance in the tasks. Tasks were divided into sections: spontaneous time production, time estimation with simple sounds and time estimation with music. Results: 1. Performance of ADHD groups in temporal estimation of simple sounds in short time intervals (30 ms were statistically lower than control group (p<0,05; 2. In the task comparing musical excerpts of the same duration (7s, ADHD groups considered the tracks longer when the musical notes had longer durations, while in the control group, the duration was related to the density of musical notes in the track. The positive average performance observed in the three groups in most tasks perhaps indicates the possibility that music can, in some way, positively modulate the symptoms of inattention in ADHD.

  9. Dopamine D4 receptors modulate brain metabolic activity in the prefrontal cortex and cerebellum at rest and in response to methylphenidate

    Michaelides, M.; Wang, G.; Michaelides, M.; Pascau, J.; Gispert, J.-D.; Delis, F.; Grandy, D.K.; Wang, G.-J.; Desco, M.; Rubinstein, M.; Volkow, N.D.; Thanos, P.K.

    2010-07-16

    Methylphenidate (MP) is widely used to treat attention deficit hyperactivity disorder (ADHD). Variable number of tandem repeats polymorphisms in the dopamine D4 receptor (D{sub 4}) gene have been implicated in vulnerability to ADHD and the response to MP. Here we examined the contribution of dopamine D4 receptors (D4Rs) to baseline brain glucose metabolism and to the regional metabolic responses to MP. We compared brain glucose metabolism (measured with micro-positron emission tomography and [{sup 18}F]2-fluoro-2-deoxy-D-glucose) at baseline and after MP (10 mg/kg, i.p.) administration in mice with genetic deletion of the D{sub 4}. Images were analyzed using a novel automated image registration procedure. Baseline D{sub 4}{sup -/-} mice had lower metabolism in the prefrontal cortex (PFC) and greater metabolism in the cerebellar vermis (CBV) than D{sub 4}{sup +/+} and D{sub 4}{sup +/-} mice; when given MP, D{sub 4}{sup -/-} mice increased metabolism in the PFC and decreased it in the CBV, whereas in D{sub 4}{sup +/+} and D{sub 4}{sup +/-} mice, MP decreased metabolism in the PFC and increased it in the CBV. These findings provide evidence that D4Rs modulate not only the PFC, which may reflect the activation by dopamine of D4Rs located in this region, but also the CBV, which may reflect an indirect modulation as D4Rs are minimally expressed in this region. As individuals with ADHD show structural and/or functional abnormalities in these brain regions, the association of ADHD with D4Rs may reflect its modulation of these brain regions. The differential response to MP as a function of genotype could explain differences in brain functional responses to MP between patients with ADHD and healthy controls and between patients with ADHD with different D{sub 4} polymorphisms.

  10. Attention in Hyperactive Children and the Effect of Methylphenidate (Ritalin)

    Sykes, Donald H.; And Others

    1971-01-01

    Hyperactive children treated with methylphenidate (ritalin) showed a significant improvement in all aspects of performance in an experimenter-paced task when compared to a control group of hyperactive children given a placebo. (Author/WY)

  11. Immune modulation using transdermal photodynamic therapy

    Levy, Julia G.; Chowdhary, R. K.; Ratkay, Leslie G.; Waterfield, Douglas; Obochi, Modestus; Leong, Simon; Hunt, David W. C.; Chan, Agnes H.

    1995-01-01

    The photosensitizer benzoporphyrin derivative monoacid ring A (VerteporfinR or BPD) has maximum absorption characteristics (690 nm) and biodistribution characteristics which permit activation of the drug in capillaries of the skin without causing skin photosensitivity (transdermal PDT). This permits targeting of cells in the circulation for selective ablation. Since BPD has been shown to accumulate preferentially in activated lymphocytes and monocytes, studies have been undertaken to determine the effect of transdermal PDT on murine models for rheumatoid arthritis (the MRL/lpr adjuvant enhanced model) and multiple sclerosis (the experimental allergic encephalomyelitis (EAE) model in PL mice). Localized transdermal PDT with BPD was found to be completely successful in preventing the development of adjuvant enhanced arthritis in the MRL/lpr mouse as well as improving the underlying arthritic condition of these animals. In the EAE model, in which an adoptive transfer system was used, it was found that transdermal PDT of recipients was effective in preventing EAE if treatments were implemented up to 24 hours after cell transfer but was not effective if given later, indicating the requirement for circulating T cells for effective treatment.

  12. Navigating sticky areas in transdermal product development.

    Strasinger, Caroline; Raney, Sam G; Tran, Doanh C; Ghosh, Priyanka; Newman, Bryan; Bashaw, Edward D; Ghosh, Tapash; Shukla, Chinmay G

    2016-07-10

    The benefits of transdermal delivery over the oral route to combat such issues of low bioavailability and limited controlled release opportunities are well known and have been previously discussed by many in the field (Prausnitz et al. (2004) [1]; Hadgraft and Lane (2006) [2]). However, significant challenges faced by developers as a product moves from the purely theoretical to commercial production have hampered full capitalization of the dosage forms vast benefits. While different technical aspects of transdermal system development have been discussed at various industry meetings and scientific workshops, uncertainties have persisted regarding the pharmaceutical industry's conventionally accepted approach for the development and manufacturing of transdermal systems. This review provides an overview of the challenges frequently faced and the industry's best practices for assuring the quality and performance of transdermal delivery systems and topical patches (collectively, TDS). The topics discussed are broadly divided into the evaluation of product quality and the evaluation of product performance; with the overall goal of the discussion to improve, advance and accelerate commercial development in the area of this complex controlled release dosage form. PMID:27117457

  13. Response to methylphenidate by adult and pediatric patients with attention-deficit/hyperactivity disorder: the Spanish multicenter DIHANA study

    Valdizán-Usón JR

    2013-02-01

    Full Text Available JR Valdizán-Usón,1 A Cánovas-Martínez,2 MT De Lucas-Taracena,3 F Díaz-Atienza,4 LS Eddy-Ives,5 A Fernández-Jaén,6 M Fernández-Pérez,7 M García-Giral,8 P García-Magán,9 M Garraus-Oneca,10 MA Idiazábal-Alecha,11 M López-Benito,12 G Lorenzo-Sanz,13 J Martínez-Antón,14 MA Martínez-Granero,15 F Montañés-Rada,16 F Mulas-Delgado,17 G Ochando-Perales,18 E Ortega-García,19 A Pelaz-Antolín,20 JA Ramos-Quiroga,21 FC Ruiz-Sanz,22 J Vaquerizo-Madrid,23 A Yusta-Izquierdo241Unidad Trastornos Neurofuncionales, Clínica Montpellier, Zaragoza, 2Hospital Dr Peset, Valencia, 3Hospital 12 de Octubre, Madrid, 4Hospital Virgen de las Nieves, Granada, 5Centre Mèdic Sant Ramon, Santa Coloma de Gramenet, Barcelona, 6Hospital Universitario Quirón, Madrid, 7Centro de Salud La Felguera, Langreo, Asturias, 8Hospital Clínic, Barcelona, 9Unidad Salud Mental, Talavera de la Reina, 10Clínica Universitaria de Navarra, Pamplona, 11Hospital Ntra. Sra. del Pilar, Barcelona, 12Centro Salud Contrueces, Gijón, 13Hospital Ramón y Cajal, Madrid, 14Complejo Hospitalario Carlos Haya, Málaga, 15Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, 16Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, 17Hospital Universitario La Fe, Valencia, 18Hospital Universitario La Fe, Valencia, 19Complejo Asistencial Universitario de León, 20Centro Salud Mental, Alcalá de Henares, 21Hospital Universitari Vall d'Hebron. CIBERSAM. Department of Psychiatry and Legal Medicine. Universitat Autònoma de Barcelona, 22Hospital General Rio Carrión, Palencia, 23Hospital Materno-Infantil, Badajoz, 24Hospital Universitario, Guadalajara, SpainBackground: The purpose of this multicenter Spanish study was to evaluate the response to immediate-release methylphenidate by children and adults diagnosed with attention-deficit/hyperactivity disorder (ADHD, as well as to obtain information on current therapy patterns and safety characteristics.Methods: This multicenter

  14. Working Memory Capacity Predicts Effects of Methylphenidate on Reversal Learning

    van der Schaaf, Marieke E; Fallon, Sean J.; ter Huurne, Niels; Buitelaar, Jan; Cools, Roshan

    2013-01-01

    Increased use of stimulant medication, such as methylphenidate, by healthy college students has raised questions about its cognitive-enhancing effects. Methylphenidate acts by increasing extracellular catecholamine levels and is generally accepted to remediate cognitive and reward deficits in patients with attention deficit hyperactivity disorder. However, the cognitive-enhancing effects of such ‘smart drugs' in the healthy population are still unclear. Here, we investigated effects of methyl...

  15. Perioperative Outcome of Dyssomnia Patients on Chronic Methylphenidate Use

    Stoicea, Nicoleta; Ellis, Thomas; Moran, Kenneth; Ackermann, Wiebke; Wilson, Thomas; Quevedo, Eduardo; Bergese, Sergio

    2014-01-01

    Methylphenidate is frequently prescribed for attention deficit hyperactivity disorder, narcolepsy, and other sleep disorders requiring psychostimulants. Our report is based on 2 different clinical experiences of patients with chronic methylphenidate use, undergoing general anesthesia. These cases contrast different strategies of taking versus withholding the drug treatment on the day of surgery. From the standpoint of anesthetic management and patient safety, the concerns for perioperative me...

  16. Differential effects of MDMA and methylphenidate on social cognition

    Schmid, Yasmin; Hysek, Cédric M.; Simmler, Linda D.; Crockett, Molly J.; Quednow, Boris B.; Liechti, Matthias E

    2014-01-01

    Social cognition is important in everyday-life social interactions. The social cognitive effects of 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') and methylphenidate (both used for neuroenhancement and as party drugs) are largely unknown. We investigated the acute effects of MDMA (75 mg), methylphenidate (40 mg) and placebo using the Facial Emotion Recognition Task, Multifaceted Empathy Test, Movie for the Assessment of Social Cognition, Social Value Orientation Test and the Moral Judgm...

  17. Getting Treatment for ADHD

    Full Text Available ... also suffer. Untreated ADHD can increase strain between parents and children. Parents often blame themselves when they can’t communicate ... plan to improve a child’s behavior. For example, parents can learn to use point systems or charts ...

  18. Getting Treatment for ADHD

    Full Text Available ... or feelings and learn alternative ways of handling emotions. The therapist will try to help the child understand ways to change or better cope with ADHD symptoms, such as organizing schoolwork or dealing with emotional experiences. Social skills training can help ...

  19. Getting Treatment for ADHD

    ... or feelings and learn alternative ways of handling emotions. The therapist will try to help the child understand ways to change or better cope with ADHD symptoms, such as organizing schoolwork or dealing with emotional experiences. Social skills training can help ...

  20. Getting Treatment for ADHD

    Full Text Available ... use point systems or charts to reward good behavior. When a child becomes too unruly or loses control, families can ... find opportunities to praise their child for appropriate behavior. Talk therapy can help children with ADHD feel better about themselves. The child ...

  1. Motor Incoordination in ADHD

    J Gordon Millichap

    2004-01-01

    The relationship between motor performance, attention deficit, impulsiveness, and hyperactivity in 42 school-aged children with ADHD (36 males, 6 females; mean age 8 years 2 months; range 6-11 years) was studied at National Taiwan University, Taipei, Taiwan.

  2. Getting Treatment for ADHD

    Full Text Available ... They also have higher rates of cigarette and drug addiction, and more driving infractions. The good news is that effective treatment is available . With the right medical treatment, children ... and develop new drugs for ADHD. It is important to confer with ...

  3. The presence of ADHD

    Breining, Sanni Nørgaard

    2014-01-01

    This paper uses high quality register-data to study the spillover effects on firstborns from having a younger sibling suffering from ADHD. Using OLS and cousin fixed effects analyses it is found that the educational outcomes of healthy firstborn children are significantly reduced by the presence of...

  4. Getting Treatment for ADHD

    Full Text Available ... more effective than receiving only medication or only behavior therapy. Since individual needs vary, however, you should work with your child’s doctor to help find most effective treatment for your child. Medications Most children with ADHD benefit from taking medication. Medications do not cure ...

  5. Getting Treatment for ADHD

    Full Text Available ... Annual Review Course Maintenance of Certification and Lifelong Learning Modules Online CME Learning on Demand Sign In My Profile Publications Donate ... a child with ADHD gain a better self-image. The therapist can help the child identify his ...

  6. Getting Treatment for ADHD

    Full Text Available ... Annual Review Course Maintenance of Certification and Lifelong Learning Modules Online CME Learning on Demand Sign In My Profile Publications Donate ... help a child with ADHD cope with daily problems, pay better attention, and learn to control aggression. ...

  7. Kids' Quest: ADHD

    ... they are doing at school and at home. Matt Morgan Matt is a pro wrestler. Matt talks about how he has been diagnosed with ... or not supported in this browser The Blueprint Matt Morgan On ADHD Â Return to Steps Movies ...

  8. The NICE ADHD health technology assessment: A review and critique

    Schlander Michael

    2008-01-01

    Full Text Available Abstract Background Health technology assessments (HTAs by the National Institute for Health and Clinical Excellence (NICE enjoy high levels of international attention. The present analysis addresses NICE's appraisal of methylphenidate, atomoxetine and dexamphetamine for attention-deficit/hyperactivity disorder (ADHD in children and adolescents, published in March 2006. Methods A qualitative study of NICE Technology Appraisal No. 98 was done focusing on the >600-page technology assessment report, which aimed at evaluating ADHD treatment strategies by a clinical effectiveness review and an economic analysis using meta-analytical techniques and a cost-effectiveness model. Results The technology assessment was unable to differentiate between the various drugs in terms of efficacy, and its economic model was ultimately driven by cost differences. While the assessment concluded that the economic model "clearly identified an optimal treatment strategy" with first-line dexamphetamine, the NICE appraisal committee subsequently found it impossible to distinguish between the different strategies on grounds of cost-effectiveness. Analyzing the assessment reveals gaps and inconsistencies concerning data selection (ultimately relying on a small number of short-term studies only, data synthesis (pooling of heterogeneous study designs and clinical endpoints, and economic model structure (identifying double-counting of nonresponders as a likely source of bias, alongside further methodological anomalies. Conclusion Many conclusions of the NICE technology assessment rest on shaky grounds. There remains a need for a new, state-of-the-art systematic review of ADHD treatment strategies including economic evaluation, which ideally should address outcomes beyond children's health-related quality of life, such as long-term sequelae of the disorder and caregiver burden.

  9. Focusing on ADHD - Attention Deficit Hyperactivity Disorder

    ... review our exit disclaimer . Subscribe Focusing on ADHD Attention Deficit Hyperactivity Disorder Most children get restless, rowdy, or distracted at ... might be signs of a developmental disorder called attention deficit hyperactivity disorder, or ADHD. ADHD is a common brain condition ...

  10. A Post Hoc Analysis of D-Threo-Methylphenidate Hydrochloride (Focalin) Versus D,l-Threo-Methylphenidate Hydrochloride (Ritalin)

    Weiss, Margaret; Wasdell, Michael; Patin, John

    2004-01-01

    Objective: To evaluate clinical measures of the benefit/risk ratio in a post hoc analysis of a clinical trial of d-threo-methylphenidate hydrochloride (d-MPH) and d,l-threo-methylphenidate hydrochloride (d,l-MPH). Method: Data from a phase III clinical trial was used to compare equimolar doses of d-MPH and d,l-MPH treatment for…

  11. Effetti del Metilfenidato sulla crescita in bambini e adolescenti ADHD. Revisione sistematica e monitoraggio prospettico a lungo termine dei parametri auxologici: analisi preliminari dei risultati dello studio europeo di farmacovigilanza ADDUCE

    Carucci, Sara

    2016-01-01

    Stimulant medications represent the main effective treatment in improving the core symptoms of ADHD. However, in the last 30 years, there has been increasing concern about the risks associated with these medications in particular with respect to possible growth deficits, due to their impact on weight, height and BMI. The aim of this work was to provide an extensive update of the literature on methylphenidate (MPH) long-term adverse effects on growth and pubertal maturation in A...

  12. A Comprehensive Review on: Transdermal drug delivery systems.

    Kharat, Rekha; Bathe, Ritesh Suresh

    2016-01-01

    Transdermal drug delivery system was introduced to overcome the difficulties of drug delivery through oral route. Despite their relatively higher costs, transdermal delivery systems have proved advantageous for delivery of selected drugs, such as estrogens, testosterone, clonidine and nitro-glycerine. Transdermal delivery provides a leading edge over injectable and oral routes by increasing patient compliance and avoiding first pass metabolism respectively. Topical  administration  of  therap...

  13. Transferosomes - A vesicular transdermal delivery system for enhanced drug permeation

    Reshmy Rajan; Shoma Jose; V P Biju Mukund; Deepa T Vasudevan

    2011-01-01

    Transdermal administration of drugs is generally limited by the barrier function of the skin. Vesicular systems are one of the most controversial methods for transdermal delivery of active substances. The interest in designing transdermal delivery systems was relaunched after the discovery of elastic vesicles like transferosomes, ethosomes, cubosomes, phytosomes, etc. This paper presents the composition, mechanisms of penetration, manufacturing and characterization methods of transferosomes a...

  14. Impaired visuomotor adaptation in adults with ADHD

    Kurdziel, Laura B. F.; Dempsey, Katherine; Zahara, Mackenzie; Valera, Eve; Rebecca M.C. Spencer

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in children that often continues into adulthood. It has been suggested that motor impairments in ADHD are associated with underlying cerebellar pathology. If such is the case, individuals with ADHD should be impaired on motor tasks requiring healthy cerebellar function. To test this, we compared performance of individuals with ADHD and ADHD-like symptoms with non-ADHD controls on a visuomotor adaptation task k...

  15. Novel chemical permeation enhancers for transdermal drug delivery

    Yang Chen

    2014-04-01

    Full Text Available Transdermal drug delivery has been accepted as a potential non-invasive route of drug administration, with advantages of prolonged therapeutic action, decreased side effect, easy use and better patient compliance. However, development of transdermal products is primarily hindered by the low permeability of the skin. To overcome this barrier effect, numerous new chemicals have been synthesized as potential permeation enhancers for transdermal drug delivery. In this review, we presented an overview of the investigations in this field, and further implications on selection or design of suitable permeation enhancers for transdermal drug delivery were also discussed.

  16. ADHD: does parenting style matter?

    Modesto-Lowe, Vania; Danforth, Jeffrey S; Brooks, Donna

    2008-11-01

    Attention deficit hyperactivity disorder (ADHD) is a condition typically arising in childhood, which untreated, can have consequences reaching into adolescence and beyond. Effective pharmacological treatment is available and has become widespread in the West. Outcomes for both the child with ADHD and the parent may be influenced by the nature of interaction between them. The authors of this article aim to review published research examining the interaction between parents and their children with ADHD. A PubMed search was conducted of studies written in English between 2000 and 2007 with the keywords ADHD and parenting. Child ADHD elicits high levels of parental stress and maladaptive parenting. The presence of parental psychopathology is common and influences the parent's response to the child's ADHD symptoms. Optimizing parent-child interaction and parental psychiatric status may improve outcomes for both parent and child. PMID:18559885

  17. Chronic Administration of Methylphenidate Induces Lipid Peroxidation in the Striatum of Young Rats

    KORKMAZ, Ahmet; ÇAYCI, Tuncer; Ayhan CÖNGÖLOĞLU; Bülent UYSAL; Turgut TOPAL; Tümer TÜRKBAY

    2009-01-01

    Objective: Methylphenidate is the most commonly prescribed psychostimulant and is indicated in the treatment of attention-deficit hyperactivity disorder. There have been concerns about potential adverse effects of long-term methylphenidate administration on the brain. The purpose of this study is to investigate antioxidant system and lipid peroxidation in order to evaluate the potential adverse effects of methylphenidate on the brain. Methods: Methylphenidate at doses of 2 mg/kg (n=10) and 10...

  18. Neonatal handling causes impulsive behavior and decreased pharmacological response to methylphenidate in male adult wistar rats.

    Lazzaretti, Camilla; Kincheski, Grasielle Clotildes; Pandolfo, Pablo; Krolow, Rachel; Toniazzo, Ana Paula; Arcego, Danusa Mar; Couto-Pereira, Natividade de Sá; Zeidán-Chuliá, Fares; Galvalisi, Martin; Costa, Gustavo; Scorza, Cecilia; Souza, Tadeu Mello E; Dalmaz, Carla

    2016-03-01

    Neonatal handling has an impact on adult behavior of experimental animals and is associated with rapid and increased palatable food ingestion, impaired behavioral flexibility, and fearless behavior to novel environments. These symptoms are characteristic features of impulsive trait, being controlled by the medial prefrontal cortex (mPFC). Impulsive behavior is a key component of many psychiatric disorders such as attention deficit hyperactivity disorder (ADHD), manic behavior, and schizophrenia. Others have reported a methylphenidate (MPH)-induced enhancement of mPFC functioning and improvements in behavioral core symptoms of ADHD patients. The aims of the present study were: (i) to find in vivo evidence for an association between neonatal handling and the development of impulsive behavior in adult Wistar rats and (ii) to test whether neonatal handling could have an impact on monoamine levels in the mPFC and the pharmacological response to MPH in vivo. Therefore, experimental animals (litters) were classified as: "non-handled" and "handled" (10[Formula: see text]min/day, postnatal days 1-10). After puberty, they were exposed to either a larger and delayed or smaller and immediate reward (tolerance to delay of reward task). Acute MPH (3[Formula: see text]mg/Kg. i.p.) was used to suppress and/or regulate impulsive behavior. Our results show that only neonatally handled male adult Wistar rats exhibit impulsive behavior with no significant differences in monoamine levels in the medial prefrontal cortex, together with a decreased response to MPH. On this basis, we postulate that early life interventions may have long-term effects on inhibitory control mechanisms and affect the later response to pharmacological agents during adulthood. PMID:26620193

  19. Understanding ADHD through entification

    Nielsen, Mikka

    2014-01-01

    How do we perceive ourselves and what explanations are we drawing upon in order to understand ourselves as morally acting individuals? In this presentation, I focus on how we live with, accept, and work on parts of ourselves that we find less desirable or even pathological. Based on interviews with adults diagnosed with ADHD, I illustrate how the process of entification (transforming a trait, temperament, emotion, or some other psychological phenomenon into a thing or agent) can be a way to u...

  20. Environmental enrichment has no effect on the development of dopaminergic and GABAergic fibers during methylphenidate treatment of early traumatized gerbils

    Teuchert-Noodt Gertraud

    2008-05-01

    Full Text Available Abstract It is widely believed, that environmental factors play a crucial role in the etiology and outcome of psychiatric diseases such as Attention-Deficit/Hyperactivity Disorder (ADHD. A former study from our laboratory has shown that both methylphenidate (MP and handling have a positive effect on the dopaminergic fiber density in the prefrontal cortex (PFC of early traumatized gerbils (Meriones unguiculatus. The current study was performed to investigate if enriched environment during MP application has an additional influence on the dopaminergic and GABAergic fiber densities in the PFC and amygdala in this animal model. Animals received a single early dose of methamphetamine (MA; 50 mg/kg; i.p. on postnatal day (PD 14, which is known to cause multiple changes in the subsequent development of several neurotransmitter systems including the dopaminergic systems, and were then treated with oral daily applications of MP (5 mg/kg from PD30–60. Animals treated this way were either transferred to an enriched environment after weaning (on PD30 or were kept under impoverished rearing conditions. There was no effect of an enriched environment on the dopaminergic or GABAergic fiber density neither in the PFC nor in the amygdala. With regard to former studies these results underline the particular impact of MP in the treatment of ADHD.

  1. The effects of clinically relevant doses of amphetamine and methylphenidate on signal detection and DRL in rats

    Andrzejewski, Matthew E.; Spencer, Robert C.; Harris, Rachel L.; Feit, Elizabeth C.; McKee, Brenda L.; Berridge, Craig W.

    2014-01-01

    Low dose amphetamine (AMPH) and methylphenidate (MPH, Ritalin®) are the most widely prescribed and most effective pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD). Certain low, clinically relevant doses of MPH improve sustained attention and working memory in normal rats, in contrast to higher doses that impair cognitive ability and induce locomotor activity. However, the effects of AMPH of MPH on sustained attention and behavioral inhibition remain poorly characterized. The present experiments examined the actions of AMPH (0.1 and 0.25 mg/kg) and MPH (0.5 and 1.0 mg/kg) in a rat model of 1) sustained attention, where signal and blank trials were interspersed randomly and occurred at unpredictable times, and 2) behavioral inhibition, using a differential reinforcement of low rate (DRL) schedule. In a signal detection paradigm, both 0.5 mg/kg and 1.0 mg/kg MPH and 0.25 mg/kg AMPH improve sustained attention, however neither AMPH nor MPH improve behavioral inhibition on DRL. Taken together with other recent studies, it appears that clinically-relevant doses of AMPH and MPH may preferentially improve attention-related behavior while having little effect on behavioral inhibition. These observations provide additional insight into the basic behavioral actions of low-dose psychostimulants and further suggest that the use of sustained attention tasks may be important in the development of novel pharmacological treatments for ADHD. PMID:24467844

  2. Effects of methylphenidate during emotional processing in amphetamine users: preliminary findings.

    Bottelier, M A; Schouw, M L J; de Ruiter, M B; Ruhe, H G; Lindauer, R J L; Reneman, L

    2015-12-01

    D-amphetamine (dAMPH) and methylphenidate (MPH) are stimulants used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Preclinical studies have shown that in healthy animals, dAMPH induces dopamine (DA) dysfunction, as evidenced for instance by loss of DA levels and its transporters. It has also been suggested that DA plays an important role in emotional processing, and that altered DA-ergic intervention may modulate amygdala function. To explore the role of the DA system in emotional processing we examined emotional processing using functional magnetic resonance imaging (fMRI) in eight male recreational users of dAMPH and eight male healthy controls. We compared brain activation between both groups during an emotional face-processing task with and without an oral MPH challenge. All subjects were abstinent for at least 2 weeks during the baseline scan. The second scan was performed on the same day 1½ hours after receiving an oral dose of 35 mg MPH. A significant Valence*Group interaction (p = .037) indicated amygdala hyperreactivity to fearful facial expressions in dAMPH users that was robust against adjustment for age (p = .015). Furthermore, duration of amphetamine use in years was positively correlated with amygdala reactivity in dAMPH users (r = .76; p = .029). These exploratory findings are in line with previous findings suggesting that DA plays a role in emotional processing. PMID:25563230

  3. Topical and transdermal delivery of caffeine.

    Luo, L.; Lane, M. E.

    2015-01-01

    Caffeine is administered topically and transdermally for a variety of pharmaceutical and cosmetic applications and it is also used as a model hydrophilic compound in dermal risk assessment studies. This review considers the physicochemical and permeation properties of caffeine with reference to its delivery to and through the skin. Since it has been used as a model compound the findings have implications for the delivery of many hydrophilic compounds having similar properties. Various passive...

  4. Transdermal drug delivery: approaches and significance

    Murthy, SATHYANARAYANA

    2012-01-01

    S Narasimha MurthyDepartment of Pharmaceutics, The University of Mississippi, USATransdermal drug delivery systems deliver drugs through the skin as an alternative to oral, intravascular, subcutaneous, and transmucosal routes. Potential advantages of transdermal delivery include, but are not limited to, elimination of first-pass metabolism, steady delivery/blood levels, better patient compliance, reduced systemic drug interactions, possible dose intervention, avoidance of medically assisted d...

  5. Microneedle Coating Techniques for Transdermal Drug Delivery

    Rita Haj-Ahmad; Hashim Khan; Muhammad Sohail Arshad; Manoochehr Rasekh; Amjad Hussain; Susannah Walsh; Xiang Li; Ming-Wei Chang; Zeeshan Ahmad

    2015-01-01

    Drug administration via the transdermal route is an evolving field that provides an alternative to oral and parenteral routes of therapy. Several microneedle (MN) based approaches have been developed. Among these, coated MNs (typically where drug is deposited on MN tips) are a minimally invasive method to deliver drugs and vaccines through the skin. In this review, we describe several processes to coat MNs. These include dip coating, gas jet drying, spray coating, electrohydrodynamic atomisat...

  6. Proniosomes for Penetration Enhancement in Transdermal System

    Samita Singla; S. L. Harikumar; Geeta Aggarwal

    2012-01-01

    Over the last few years an inclusive research has been done over provesicular approach for transdermal drug delivery. Skin has a very tough diffusion barrier inhibiting penetration of drug moiety which is rate limiting barrier for penetration of drugs. There are several approaches that deal with penetration enhancement across the skin. Vesicular and provesicular systems are promising amongst them. Vesicular systems including (niosomes, ethosomes, transfersomes and liposomes) are promising sys...

  7. Transdermal electrical stimulation in sensorineural tinnitus

    S Maini; Deoganonkar, S. C.

    1999-01-01

    In 73 patients, comprising of 84 ears, with persistent decompensated tinnitus and sensorineu-ral deafness, tinnitus suppression was attempted with low frequency, low ampere transdermal electrical stimula-tion (TDES). The causes of tinnitus were presbyacusis, unknown aetiology, noise exposure, otosclerosis, ototoxic drugs, endolymphatic hydrops, labyrinthitis and post head injury. Reduction of tinnitus was achieved in 38 of 84 ears. Results i.e. improvement were achieved in patients in the fol...

  8. Modeling of Ethanol Metabolism and Transdermal Transport

    Webster, Gregory Daniel

    2008-01-01

    Approximately 14,500 people were killed in traffic crashes where the driver was legally intoxicated in 2005, constituting 33% of all traffic fatalities that year. While social efforts to reduce the number of traffic fatalities have shown to be moderately successful, alcohol has remained a factor in 40% of all traffic deaths over the past decade. Transdermal ethanol detection is a promising method that could prevent drunk driving if integrated into an ignition interlock system; potentially ...

  9. A randomized crossover clinical study showing that methylphenidate-SODAS improves attention-deficit/hyperactivity disorder symptoms in adolescents with substance use disorder

    C.M. Szobot

    2008-03-01

    Full Text Available Our objective was to evaluate the effectiveness of a long-acting formulation of methylphenidate (MPH-SODAS on attention-deficit/hyperactivity disorder (ADHD symptoms in an outpatient sample of adolescents with ADHD and substance use disorders (SUD. Secondary goals were to evaluate the tolerability and impact on drug use of MPH-SODAS. This was a 6-week, single-blind, placebo-controlled crossover study assessing efficacy of escalated doses of MPH-SODAS on ADHD symptoms in 16 adolescents with ADHD/SUD. Participants were randomly allocated to either group A (weeks 1-3 on MPH-SODAS, weeks 4-6 on placebo or group B (reverse order. The primary outcome measures were the Swanson, Nolan and Pelham Scale, version IV (SNAP-IV and the Clinical Global Impression Scale (CGI. We also evaluated the adverse effects of MPH-SODAS using the Barkley Side Effect Rating Scale and subject reports of drug use during the study. The sample consisted of marijuana (N = 16; 100% and cocaine users (N = 7; 43.8%. Subjects had a significantly greater reduction in SNAP-IV and CGI scores (P < 0.001 for all analyses during MPH-SODAS treatment compared to placebo. No significant effects for period or sequence were found in analyses with the SNAP-IV and CGI scales. There was no significant effect on drug use. MPH-SODAS was well tolerated but was associated with more severe appetite reduction than placebo (P < 0.001. MPH-SODAS was more effective than placebo in reducing ADHD symptoms in a non-abstinent outpatient sample of adolescents with comorbid SUD. Randomized clinical trials, with larger samples and SUD intervention, are recommended.

  10. The use of methylphenidate among students: the future of enhancement?

    Outram, Simon M

    2010-04-01

    During the past few years considerable debate has arisen within academic journals with respect to the use of smart drugs or cognitive enhancement pharmaceuticals. The following paper seeks to examine the foundations of this cognitive enhancement debate using the example of methylphenidate use among college students. The argument taken is that much of the enhancement debate rests upon inflated assumptions about the ability of such drugs to enhance and over-estimations of either the size of the current market for such drugs or the rise in popularity as drugs for enhancing cognitive abilities. This article provides an overview of the empirical evidence that methylphenidate has the ability to significantly improve cognitive abilities in healthy individuals, and examines whether the presumed uptake of the drug is either as socially significant as implied or growing to the extent that it requires urgent regulatory attention. In addition, it reviews the evidence of side-effects for the use of methylphenidate which may be an influential factor in whether an individual decides to use such drugs. The primary conclusions are that neither drug efficacy, nor the benefit-to-risk balance, nor indicators of current or growing demand provide sufficient evidence that methylphenidate is a suitable example of a cognitive enhancer with mass appeal. In light of these empirically based conclusions, the article discusses why methylphenidate might have become seen as a smart drug or cognitive enhancer. PMID:20338928

  11. [Paradoxical effect of methylphenidate in the treatment of a patient with severe traumatic brain injury].

    Grønborg, Pia; Liljegren, Jeanette; Jansen, Jette

    2009-06-22

    Methylphenidate is a central nervous system (CNS)-stimulating agent. During recent years methylphenidate has been shown to increase arousal in patients with traumatic brain injury. We describe a patient with a severe traumatic injury in whom arousal was increased when methylphenidate was given, and the level of arousal decreased when the amount was diminished after some months. Due to possible side effects, methylphenidate treatment was reduced over several weeks 2 years after the trauma. Surprisingly, the cognitive level was then dramatically improved. To our knowledge, such paradoxical effect of methylphenidate has not previously been described. PMID:19671403

  12. TRANSFEROSOMES: A NOVEL APPROACH FOR TRANSDERMAL DRUG DELIVERY

    Kumar Ravi; Manvir Singh; Rajni bala; Nimrata seth; A C Rana

    2012-01-01

    Transdermal drug delivery system appears to be most promising delivery system due to their merits over conventional delivery systems. Recently, various strategies have been used to augment the transdermal delivery of bioactives. Mainly, they include iontophoresis, electrophoresis, sonophoresis, chemical permeation enhancers, microneedles, and vesicular system (liposomes, niosomes, elastic liposomes such as ethosomes and transfersomes). Among these strategies transferosomes appear promising. T...

  13. Transdermal fentanyl matrix patches Matrifen and Durogesic DTrans are bioequivalent

    Kress, Hans G; Boss, Hildegard; Delvin, Thomas;

    2010-01-01

    AIM: The pharmacokinetic profiles of the two commercially available transdermal fentanyl patches Matrifen (100 microg/h) and Durogesic DTrans (100 microg/h), used to manage severe chronic pain, were compared regarding their systemic exposure, rate of absorption, and safety. METHODS: Transdermal m...

  14. ADHD: Implications for School Counselors

    Branscome, Jennifer; Cunningham, Teddi; Kelley, Heather; Brown, Caitlyn

    2014-01-01

    The focus of this article is to provide an overview of the current state of knowledge of ADHD and to provide evidence-based training interventions for school counselors. An overview of basic information about ADHD will be provided, including diagnosis, presentation, causes, prevalence, and common misconceptions. Evidence-based training…

  15. ADHD: From Intervention to Implementation

    Chaban, Peter

    2010-01-01

    Attention deficit/hyperactivity disorder (ADHD), a chronic neurological disorder, is not formally recognized in the educational systems across Canada. As a result, there is little opportunity for collaboration or sharing of information between the medical/research community and the educational system. Because ADHD is not formally identified,…

  16. Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents

    Bello NT

    2015-06-01

    Full Text Available Nicholas T Bello Department of Animal Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA Abstract: Attention deficit hyperactivity disorder (ADHD is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate and amphetamine derivatives, are available to treat ADHD in pediatric patients. Nonstimulant medications are more preferred by some parents, other caregivers, and patients because they lack the abuse potential of stimulant medications. In the US, one available nonstimulant option is guanfacine extended release (XR. As a selective α2A adrenergic receptor, guanfacine acts on the central noradrenergic pathways and cortical noradrenergic targets to improve working memory and attention. The XR formulation of guanfacine, compared with the immediate-release formulation, is more effective for the long-term management of ADHD and is associated with fewer adverse effects. Available data also indicate that guanfacine XR is superior to atomoxetine and is as effective as the nonselective α2 adrenergic receptor agonist, clonidine XR. The most common adverse effects associated with guanfacine XR are somnolence, fatigue, bradycardia, and hypotension. Somnolence is the most often cited reason for discontinuation. Guanfacine XR is also labeled for use as an adjuvant to stimulant treatment for ADHD. A similar profile of adverse effects as reported with monotherapy is reported when guanfacine XR is “added on” to stimulant therapy with somnolence as the most commonly reported adverse event. This review discusses the clinical efficacy and patient preference of guanfacine XR based on available published data on the safety, relative effectiveness, and tolerance of this medication to treat ADHD. Keywords: Intuniv, norepinephrine, prefrontal cortex, locus coeruleus, impulsivity, inattentive

  17. Control study on methylphenidate treatment in epilepsy comorbid attention deficit hyperactivity disorder%癫痫共患注意缺陷多动障碍儿童哌甲酯治疗对照研究

    刘玲; 陈燕惠; 林桂秀

    2013-01-01

    [目的]研究癫痫共患注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童应用哌甲酯治疗的意义. [方法]从本院小儿神经专科门诊中收集癫痫共患ADHD患儿58例,根据癫痫类型以及是否服用哌甲酯进行分组,治疗3个月以后,比较同一癫痫发作类型服用哌甲酯与未服用哌甲酯组之间脑电图异常变化值、癫痫发作次数变化情况以及ADHD症状改善情况. [结果]同一癫痫发作类型服用哌甲酯与未服用哌甲酯组之间脑电图异常变化值、癫痫发作次数减少值比较,差异无统计学意义(P>0.05);各癫痫发作类型未服用哌甲酯组3个月治疗前、后SNAP-Ⅳ评分比较差异均无统计学意义(P>0.05),而服用哌甲酯组3个月治疗后SNAP-Ⅳ评分较前明显下降,差异有统计学意义(P<0.05). [结论]哌甲酯对脑电图异常评分以及发作减少次数没有影响,未发现该药加重癫痫病情现象.%[Objective] To investigate the clinical significance of methylphenidate treatment in epilepsy comorbid attention deficit hyperactivity disorder (ADHD) children in the disorder in children medication.[Methods] From our hospital specialist outpatients pediatric neurologist,58 cases of children epilepsy comorbid ADHD were collected and divided groups according to the type of epilepsy and whether taking methylphenidate.After 3 months of treatment.Electroencephalogram (EEG) abnormality rate change value,changes in seizure frequency and improvement of ADHD symptoms among the groups.[Results] After three months’ treatment,between the groups of the same type of seizures were compared,EEG abnormality rate and the reduced value of seizure frequency were no statistical differenees(P>0.05).Comparison of SNAPⅣ scale scores in not taking methylphenidate groups before and after treatment was no statistical difference (P>0.05),while taking methylphenidate groups’ SNAP-Ⅳ score was significantly decreased after

  18. Evaluation of the Dopamine Hypothesis of ADHD with PET Brain Imaging

    Swanson, James (University of California, Irvine)

    2010-04-28

    The Dopamine (DA) Hypothesis of ADHD (Wender, 1971; Levy, 1990) suggests that abnormalities in the synaptic mechanisms of DA transmission may be disrupted, and specific abnormalities in DA receptors and DA transporters (DAT) have been proposed (see Swanson et al, 1998). Early studies with small samples (e.g., n = 6, Dougherty et al, 1999) used single photon emission tomography (SPECT) and the radioligand (123I Altropane) to test a theory that ADHD may be caused by an over expression of DAT and reported 'a 70% increase in age-corrected dopamine transporter density in patients with attention deficit hyperactivity disorder compared with healthy controls' and suggested that treatment with stimulant medication decreased DAT density in ADHD patients and corrected an underlying abnormality (Krause et al, 2000). The potential importance of these findings was noted by Swanson (1999): 'If true, this is a major finding and points the way for new investigations of the primary pharmacological treatment for ADHD (with the stimulant drugs - e.g., methylphenidate), for which the dopamine transporter is the primary site of action. The potential importance of this finding demands special scrutiny'. This has been provided over the past decade using Positron Emission Tomography (PET). Brain imaging studies were conducted at Brookhaven National Laboratory (BNL) in a relatively large sample of stimulant-naive adults assessed for DAT (11C cocaine) density and DA receptors (11C raclopride) availability. These studies (Volkow et al, 2007; Volkow et al, 2009) do not confirm the hypothesis of increased DAT density and suggest the opposite (i.e., decreased rather than increased DAT density), and follow-up after treatment (Wang et al, 2010) does not confirm the hypothesis that therapeutic doses of methylphenidate decrease DAT density and suggests the opposite (i.e., increased rather than decreased DAT density). The brain regions implicated by these PET imaging studies also

  19. Evaluation of the Dopamine Hypothesis of ADHD with PET Brain Imaging

    The Dopamine (DA) Hypothesis of ADHD (Wender, 1971; Levy, 1990) suggests that abnormalities in the synaptic mechanisms of DA transmission may be disrupted, and specific abnormalities in DA receptors and DA transporters (DAT) have been proposed (see Swanson et al, 1998). Early studies with small samples (e.g., n = 6, Dougherty et al, 1999) used single photon emission tomography (SPECT) and the radioligand (123I Altropane) to test a theory that ADHD may be caused by an over expression of DAT and reported 'a 70% increase in age-corrected dopamine transporter density in patients with attention deficit hyperactivity disorder compared with healthy controls' and suggested that treatment with stimulant medication decreased DAT density in ADHD patients and corrected an underlying abnormality (Krause et al, 2000). The potential importance of these findings was noted by Swanson (1999): 'If true, this is a major finding and points the way for new investigations of the primary pharmacological treatment for ADHD (with the stimulant drugs - e.g., methylphenidate), for which the dopamine transporter is the primary site of action. The potential importance of this finding demands special scrutiny'. This has been provided over the past decade using Positron Emission Tomography (PET). Brain imaging studies were conducted at Brookhaven National Laboratory (BNL) in a relatively large sample of stimulant-naive adults assessed for DAT (11C cocaine) density and DA receptors (11C raclopride) availability. These studies (Volkow et al, 2007; Volkow et al, 2009) do not confirm the hypothesis of increased DAT density and suggest the opposite (i.e., decreased rather than increased DAT density), and follow-up after treatment (Wang et al, 2010) does not confirm the hypothesis that therapeutic doses of methylphenidate decrease DAT density and suggests the opposite (i.e., increased rather than decreased DAT density). The brain regions implicated by these PET imaging studies also suggest that a

  20. Familier og ADHD-problematikker

    Andersen, Maja Lundemark

    Denne rapport henvender sig til alle – borgere, professionelle i det sociale og sundhedsfaglige arbejde, forskere og politikere – som interesserer sig for forståelsen og betydningen af ADHD-problematikker i familiers daglige liv. Rapporten har særligt fokus på brugernes egne perspektiver på ADHD......-problematikker, og der er lagt vægt på en ressourceorienteret tilgang. Rapporten viser, på baggrund af observationer og interview med familier, hvor ADHD-problematikker er en del af de daglige udfordringer, at ADHD opleves meget differentieret af de forskellige individer, hvilket tyder på, at det kan være en idé, at...... familiernes oplevelser af samarbejde med de professionelle inden for det sociale og pædagogiske arbejde en diskussion af muligheder for at øge kvaliteten i mødet mellem velfærdssystemer og familier med ADHD-problematikker....

  1. Screening af voksne for ADHD

    Obel, Carsten; Dalsgaard, Søren; Arngrim, Torben;

    2009-01-01

    ADHD is a well established condition in childhood, but much less attention has been given to this diagnosis among adults. It is estimated that 2-4% of the adult population has this condition. Adults with ADHD present symptoms that differ somewhat from those presenting in childhood and they are...... typically characterized by problems with planning of work and daily life activities as well as social persistence. The Adult ADHD Self-report Scale (ASRS) can be used in general practice as an introduction to the diagnostic process of ADHD in a psychiatry setting and to evaluate the effect of treatment....... ASRS is now available in Danish and is recommended as a screener for adult ADHD. Udgivelsesdato: 2009-Jan-19...

  2. Screening af voksne for ADHD

    Obel, Carsten; Dalsgaard, Søren; Arngrim, Torben;

    2009-01-01

    ADHD is a well established condition in childhood, but much less attention has been given to this diagnosis among adults. It is estimated that 2-4% of the adult population has this condition. Adults with ADHD present symptoms that differ somewhat from those presenting in childhood and they are...... typically characterized by problems with planning of work and daily life activities as well as social persistence. The Adult ADHD Self-report Scale (ASRS) can be used in general practice as an introduction to the diagnostic process of ADHD in a psychiatry setting and to evaluate the effect of treatment....... ASRS is now available in Danish and is recommended as a screener for adult ADHD. Udgivelsesdato: 2009-Jan-12...

  3. [Study on preparation of testosterone undecanoate ethosomes and its in vitro transdermal penetration].

    Meng, Shu; Yang, Li-Qun; Ma, Li-Ying; Guo, Jing; Li, Miao; Yang, Dan

    2013-05-01

    Ethosomes, as a new vector for transdermal drug delivery, could obviously improve the transdermal penetration of drugs. In this study, we prepared testosterone undecanoate ethosomes, with TU ethosomes as the basic remedy, to determine its appearance, particle size, entrapment efficiency (EE) and membrane fluidity. Meanwhile, a transdermal test was conducted in mice, in order to determine the permeability characteristics of ethosomes as a vector for transdermal drug delivery, and compare transdermal behaviors of TU ethosomes, liposomes and their ethanol solutions. PMID:23944071

  4. Association of a carboxylesterase 1 polymorphism with appetite reduction in children and adolescents with attention-deficit/hyperactivity disorder treated with methylphenidate.

    Bruxel, E M; Salatino-Oliveira, A; Genro, J P; Zeni, C P; Polanczyk, G V; Chazan, R; Rohde, L A; Hutz, M H

    2013-10-01

    Carboxylesterase 1 is the enzyme involved in methylphenidate (MPH) metabolism. The aim of this study was to evaluate the association between a -75 T>G polymorphism and appetite reduction in children with attention-deficit/hyperactivity disorder (ADHD). A sample of 213 children with ADHD was investigated. The primary outcome was appetite reduction measured by the Barkley Stimulant Side Effect Rating Scale applied at baseline, at 1 and 3 months of treatment. MPH doses were augmented until no further clinical improvement or significant adverse events occurred. The G allele presented a trend for association with appetite reduction scores (P=0.05). A significant interaction between the G allele and treatment over time for appetite reduction scores was also observed (P=0.03). The G allele carriers presented a higher risk for appetite reduction worsening when compared with T allele homozygotes (odds ratio=3.47, P=0.01). The present results suggest an influence of carboxylesterase 1 -75 T>G polymorphism on the worsening of appetite reduction with MPH treatment in youths with ADHD. PMID:22688218

  5. Long Withdrawal of Methylphenidate Induces a Differential Response of the Dopaminergic System and Increases Sensitivity to Cocaine in the Prefrontal Cortex of Spontaneously Hypertensive Rats.

    dos Santos Pereira, Maurício; Sathler, Matheus Figueiredo; Valli, Thais da Rosa; Marques, Richard Souza; Ventura, Ana Lucia Marques; Peccinalli, Ney Ronner; Fraga, Mabel Carneiro; Manhães, Alex C; Kubrusly, Regina

    2015-01-01

    Methylphenidate (MPD) is one of the most prescribed drugs for alleviating the symptoms of Attention Deficit/Hyperactivity Disorder (ADHD). However, changes in the molecular mechanisms related to MPD withdrawal and susceptibility to consumption of other psychostimulants in normal individuals or individuals with ADHD phenotype are not completely understood. The aims of the present study were: (i) to characterize the molecular differences in the prefrontal dopaminergic system of SHR and Wistar strains, (ii) to establish the neurochemical consequences of short- (24 hours) and long-term (10 days) MPD withdrawal after a subchronic treatment (30 days) with Ritalin® (Methylphenidate Hydrochloride; 2.5 mg/kg orally), (iii) to investigate the dopaminergic synaptic functionality after a cocaine challenge in adult MPD-withdrawn SHR and Wistar rats. Our results indicate that SHR rats present reduced [3H]-Dopamine uptake and cAMP accumulation in the prefrontal cortex (PFC) and are not responsive to dopaminergic stimuli in when compared to Wistar rats. After a 24-hour withdrawal of MPD, SHR did not present any alterations in [3H]-Dopamine Uptake, [3H]-SCH 23390 binding and cAMP production; nonetheless, after a 10-day MPD withdrawal, the results showed a significant increase of [3H]-Dopamine uptake, of the quantity of [3H]-SCH 23390 binding sites and of cAMP levels in these animals. Finally, SHR that underwent a 10-day MPD withdrawal and were challenged with cocaine (10 mg/kg i.p.) presented reduced [3H]-Dopamine uptake and increased cAMP production. Wistar rats were affected by the 10-day withdrawal of MPD in [3H]-dopamine uptake but not in cAMP accumulation; in addition, cocaine was unable to induce significant modifications in [3H]-dopamine uptake and in cAMP levels after the 10-day withdrawal of MPD. These results indicate a mechanism that could explain the high comorbidity between ADHD adolescent patients under methylphenidate treatment and substance abuse in adult life

  6. Long Withdrawal of Methylphenidate Induces a Differential Response of the Dopaminergic System and Increases Sensitivity to Cocaine in the Prefrontal Cortex of Spontaneously Hypertensive Rats.

    Maurício dos Santos Pereira

    Full Text Available Methylphenidate (MPD is one of the most prescribed drugs for alleviating the symptoms of Attention Deficit/Hyperactivity Disorder (ADHD. However, changes in the molecular mechanisms related to MPD withdrawal and susceptibility to consumption of other psychostimulants in normal individuals or individuals with ADHD phenotype are not completely understood. The aims of the present study were: (i to characterize the molecular differences in the prefrontal dopaminergic system of SHR and Wistar strains, (ii to establish the neurochemical consequences of short- (24 hours and long-term (10 days MPD withdrawal after a subchronic treatment (30 days with Ritalin® (Methylphenidate Hydrochloride; 2.5 mg/kg orally, (iii to investigate the dopaminergic synaptic functionality after a cocaine challenge in adult MPD-withdrawn SHR and Wistar rats. Our results indicate that SHR rats present reduced [3H]-Dopamine uptake and cAMP accumulation in the prefrontal cortex (PFC and are not responsive to dopaminergic stimuli in when compared to Wistar rats. After a 24-hour withdrawal of MPD, SHR did not present any alterations in [3H]-Dopamine Uptake, [3H]-SCH 23390 binding and cAMP production; nonetheless, after a 10-day MPD withdrawal, the results showed a significant increase of [3H]-Dopamine uptake, of the quantity of [3H]-SCH 23390 binding sites and of cAMP levels in these animals. Finally, SHR that underwent a 10-day MPD withdrawal and were challenged with cocaine (10 mg/kg i.p. presented reduced [3H]-Dopamine uptake and increased cAMP production. Wistar rats were affected by the 10-day withdrawal of MPD in [3H]-dopamine uptake but not in cAMP accumulation; in addition, cocaine was unable to induce significant modifications in [3H]-dopamine uptake and in cAMP levels after the 10-day withdrawal of MPD. These results indicate a mechanism that could explain the high comorbidity between ADHD adolescent patients under methylphenidate treatment and substance abuse in adult

  7. Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: A double blind and randomized trial [ISRCTN64132371

    Mohammadi Mohammad-Reza

    2004-04-01

    Full Text Available Abstract Background Attention-deficit hyperactivity disorder is an early-onset, clinically heterogenous disorder of inattention, hyperactivity, and impulsiveness. The diagnosis and treatment of attention-deficit hyperactivity disorder continues to raise controversy, and, there is also an increase in treatment options. In this 6-week double blind, placebo controlled-trial, we assessed the effects of zinc plus methylphenidate in the treatment of children with attention deficit hyperactivity disorder. To the best of our knowledge, this study is the first double blind and placebo controlled clinical trial assessing the adjunctive role of zinc in ADHD. Methods Our subjects were 44 outpatient children (26 boys and 18 girls between the ages of 5–11 (mean ± SD was 7.88 ± 1.67 who clearly met the DSM IV diagnostic criteria for attention-deficit hyperactivity disorder and they were randomized to methylphenidate 1 mg/kg/day + zinc sulfate 55 mg/day (with approximately 15 mg zinc element (group 1 and methylphenidate 1 mg/kg/day + placebo (sucrose 55 mg (group 2 for a 6 week double blind clinical trial. The principal measure of the outcome was the Teacher and Parent ADHD Rating Scale. Patients were assessed by a child psychiatrist at baseline, 14, 28 and 42 days after the medication started. Results The present study shows the Parent and Teacher Rating Scale scores improved with zinc sulfate over this 6-week, double blind and placebo controlled trial. The behavior of the two treatments was not homogeneous across the time. The difference between the two protocols was significant as indicated by the effect on the group, the between-subjects factor (F = 4.15, d.f. = 1, P = 0.04; F = 4.50, d.f. = 1, P = 0.04 respectively. The difference between the two groups in the frequency of side effects was not significant. Conclusions This double-blind, placebo-controlled study demonstrated that zinc as a supplementary medication might be beneficial in the treatment of

  8. Analysis on the use of methylphenidate hydrochloride based on the prescription for outpatients%盐酸哌甲酯门诊处方应用分析

    窦克莹; 刘雪飞; 凌科; 张建民

    2011-01-01

    目的 分析盐酸哌甲酯的门诊使用情况,评价其使用的合理性.方法 采用回顾性调查方法,收集我院门诊药房2010年1~5月盐酸哌甲酯处方336张,按姓名、年龄、性别、药名、数量、服用方法、处方编号等处方内容进行统计;以限定日剂量(DDD)、药物利用指数(DUI)为指标进行分析、评价,判断其使用的合理性.结果 336张处方共涉及患儿168例,男138例,女30例,男女比例为4.6:1;8~9岁患儿最多;盐酸哌甲酯片的处方36张,DUI为0.94,盐酸哌甲酯控释片的处方300张,DUI为0.76.结论 我院门诊患儿盐酸哌甲酯的使用基本合理,处方质量及处方调配有不足之处,医师和药师需注意改进.%Objective To analyze the use of methylphenidate hydrochloride for outpatient in our hospital and evaluate the rational drug administration. Methods 336 prescriptions from outpatients during January to May in 2010 were collected, analyzed retrospectively for the prescriptions by name, age, sex, dose, way of administration, and code of prescriptions. Using the indicators of DDD and DUI, the rational drug administration for outpatients was evaluated. Results In 336 prescriptions, 138 of them were prescribed for males and 30 for females, the sex ratio was 4.6:1. Most of patients were 8~9 years old. Among the 336 prescriptions, 300 prescriptions were methylphenidate hydrochloride extended-release tablets for ADHD, the DUI of methylphenidate hydruchloride tablets was 0.94, and the DUI of methylphenidate hydrochloride extended-release tablets was 0.76. Conclusion The use of methylphenidate hydrochloride for outpatients is rational in the Children's Hospital Affiliated to Capital Institute of Pediatrics, however, there is necessity for improvement in quality of prescriptions and preparation.

  9. Caffeine improves attention deficit in neonatal 6-OHDA lesioned rats, an animal model of attention deficit hyperactivity disorder (ADHD).

    Caballero, Miguel; Núñez, Fabiana; Ahern, Siobhán; Cuffí, Maria L; Carbonell, Lourdes; Sánchez, Silvia; Fernández-Dueñas, Víctor; Ciruela, Francisco

    2011-04-20

    Nowadays the pharmacological treatment of the attention deficit hyperactivity disorder (ADHD) is based on amphetamine derivatives (i.e. methylphenidate). However, these drugs induce a large array of adverse side effects, thus less aggressive psychostimulant drugs (i.e. caffeine) are being proposed in the management of ADHD. Following this tendency, we decided to study the possible therapeutic use of caffeine in an animal model of ADHD, namely the neonatal 6-hydroxy-dopamine (6-OHDA)-lesioned rat. Therefore, at postnatal day 7 rats were lesioned at the left striatum with 6-OHDA or with saline. Thereafter, at postnatal day 25 their activity and attention were measured with the Olton maze before caffeine was administered ad libitum in the drinking water. Next, after 14 days of caffeine treatment, we repeated these measurements to assess the effect of caffeine on motor activity and attention deficit. Interestingly, while no changes in the motor activity measurements were observed before and after caffeine administration, a significant improvement in the attention deficit of the 6-OHDA lesioned rats was achieved after caffeine treatment. Thus, our results led us to hypothesize that caffeine might be useful to manage the attention deficit during the prepubertal period of ADHD. PMID:21362462

  10. The epidemiology of pharmacologically treated attention deficit hyperactivity disorder (ADHD) in children, adolescents and adults in UK primary care

    McCarthy, Suzanne

    2012-06-19

    AbstractBackgroundAttention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterised by the symptoms of inattention, impulsivity and hyperactivity. ADHD was once perceived as a condition of childhood only; however increasing evidence has highlighted the existence of ADHD in older adolescents and adults. Estimates for the prevalence of ADHD in adults range from 2.5–4%. Few data exist on the prescribing trends of the stimulants methylphenidate and dexamfetamine, and the non-stimulant atomoxetine in the UK. The aim of this study was to investigate the annual prevalence and incidence of pharmacologically treated ADHD in children, adolescents and adults in UK primary care.MethodsThe Health Improvement Network (THIN) database was used to identify all patients aged over 6 years with a diagnosis of ADHD\\/hyperkinetic disorder and a prescription for methylphenidate, dexamfetamine or atomoxetine from 2003–2008. Annual prevalence and incidence of pharmacologically treated ADHD were calculated by age category and sex.ResultsThe source population comprised 3,529,615 patients (48.9% male). A total of 118,929 prescriptions were recorded for the 4,530 patients in the pharmacologically treated ADHD cohort during the 6-year study. Prevalence (per 1000 persons in the mid-year THIN population) increased within each age category from 2003 to 2008 [6–12 years: from 4.8 (95% CI: 4.5–5.1) to 9.2 (95% CI: 8.8–9.6); 13–17 years: from 3.6 (95% CI: 3.3–3.9) to 7.4 (95% CI: 7.0–7.8); 18–24 years: from 0.3 (95% CI: 0.2–0.3) to 1.1 (95% CI: 1.0–1.3); 25–45 years: from 0.02 (95% CI: 0.01–0.03) to 0.08 (95% CI: 0.06–0.10); >45 years: from 0.01 (95% CI: 0.00–0.01) to 0.02 (95% CI: 0.01–0.03). Whilst male patients aged 6-12 years had the highest prevalence; the relative increase in prescribing was higher amongst female patients of the same age - the increase in prevalence in females aged 6–12 years was 2.1 fold

  11. The epidemiology of pharmacologically treated attention deficit hyperactivity disorder (ADHD in children, adolescents and adults in UK primary care

    McCarthy Suzanne

    2012-06-01

    Full Text Available Abstract Background Attention Deficit Hyperactivity Disorder (ADHD is a common neurodevelopmental disorder characterised by the symptoms of inattention, impulsivity and hyperactivity. ADHD was once perceived as a condition of childhood only; however increasing evidence has highlighted the existence of ADHD in older adolescents and adults. Estimates for the prevalence of ADHD in adults range from 2.5–4%. Few data exist on the prescribing trends of the stimulants methylphenidate and dexamfetamine, and the non-stimulant atomoxetine in the UK. The aim of this study was to investigate the annual prevalence and incidence of pharmacologically treated ADHD in children, adolescents and adults in UK primary care. Methods The Health Improvement Network (THIN database was used to identify all patients aged over 6 years with a diagnosis of ADHD/hyperkinetic disorder and a prescription for methylphenidate, dexamfetamine or atomoxetine from 2003–2008. Annual prevalence and incidence of pharmacologically treated ADHD were calculated by age category and sex. Results The source population comprised 3,529,615 patients (48.9% male. A total of 118,929 prescriptions were recorded for the 4,530 patients in the pharmacologically treated ADHD cohort during the 6-year study. Prevalence (per 1000 persons in the mid-year THIN population increased within each age category from 2003 to 2008 [6–12 years: from 4.8 (95% CI: 4.5–5.1 to 9.2 (95% CI: 8.8–9.6; 13–17 years: from 3.6 (95% CI: 3.3–3.9 to 7.4 (95% CI: 7.0–7.8; 18–24 years: from 0.3 (95% CI: 0.2–0.3 to 1.1 (95% CI: 1.0–1.3; 25–45 years: from 0.02 (95% CI: 0.01–0.03 to 0.08 (95% CI: 0.06–0.10; >45 years: from 0.01 (95% CI: 0.00–0.01 to 0.02 (95% CI: 0.01–0.03. Whilst male patients aged 6-12 years had the highest prevalence; the relative increase in prescribing was higher amongst female patients of the same age - the increase in prevalence in females aged 6–12 years was 2

  12. Adolescent atomoxetine treatment in a rodent model of ADHD: effects on cocaine self-administration and dopamine transporters in frontostriatal regions.

    Somkuwar, Sucharita S; Jordan, Chloe J; Kantak, Kathleen M; Dwoskin, Linda P

    2013-12-01

    Cocaine abuse and attention deficit/hyperactivity disorder (ADHD) are often comorbid. Preclinical research indicates that medial prefrontal (mPFC) and orbitofrontal (OFC) cortices are important neural substrates for both disorders. Using the spontaneously hypertensive rat (SHR) model of ADHD, we reported that adolescent treatment with the stimulant methylphenidate, a dopamine (DAT) and norepinephrine (NET) transporter inhibitor, enhanced cocaine self-administration during adulthood, and was associated with increased DAT function in mPFC. This study investigates the effects of atomoxetine ((R)-N-methyl-γ-(2-methylphenoxy)-benzenepropanamine hydrochloride) treatment, a selective NET inhibitor, during adolescence on cocaine self-administration and on DAT function and cell-surface expression in mPFC and OFC during adulthood. SHR acquired cocaine self-administration faster than Wistar-Kyoto and Wistar. Across cocaine doses, SHR earned more cocaine infusions and had higher progressive-ratio breakpoints than Wistar-Kyoto and Wistar, demonstrating that the SHR phenotype models comorbid ADHD and cocaine abuse. Prior atomoxetine treatment did not augment cocaine self-administration in SHR, but acquisition was enhanced in Wistar-Kyoto. No strain differences were found for DAT kinetic parameters or cellular localization in the vehicle controls. Atomoxetine did not alter DAT kinetic parameters or localization in SHR mPFC. Rather, atomoxetine decreased V(max) and DAT cell surface expression in SHR OFC, indicating that inhibition of NET by atomoxetine treatment during adolescence indirectly reduced DAT function and trafficking to the cell surface in OFC, specifically in the ADHD model. Thus, atomoxetine, unlike methylphenidate, does not enhance vulnerability to cocaine abuse in SHR and may represent an important alternative for teens with ADHD when drug addiction is a concern. PMID:23822950

  13. Effectiveness of pharmaceutical therapy of ADHD (Attention-Deficit/Hyperactivity Disorder in adults – health technology assessment

    Wasem, Jürgen

    2010-01-01

    Full Text Available Background: Attention-Deficit/Hyperactivity Disorder (ADHD is a mental disorder. Symptoms include hyperactivity, lack of attentiveness, and frivolousness. This disorder always begins in childhood, but can remain through adulthood. ADHD affects all areas of life and limits the quality of life due to its symptoms and the high rate of associated disorders that can develop. An established form of therapy is using stimulant medications, most commonly, containing Methylphenidate as the active ingredient. However, in Germany this ingredient is not approved for adults suffering from ADHD. Therefore, many adults cannot obtain appropriate medication to treat this disorder. Objective: The following report (Health Technology Assessment [HTA] examines the effectiveness and cost-effectiveness of the medical treatment of ADHD in adults as well as the ethical, social and legal aspects thereof. Methods: In August 2009, a systematic literature search is performed in all relevant scientific databases. The selected citations fulfill predetermined inclusion criteria. The data in the publications is then systematically extracted, reviewed and assessed. A manual search of citations is conducted as well. Results: Nineteen studies fulfill the inclusion criteria: nine randomised controlled studies (RCT, five meta-analyses, three economic studies and two studies relevant to the legal aspects of the HTA.All RCT reveal that adult patients who receive medication containing a stimulant (Methylphenidate and Amphetamine and Atomoxetine, see a reduction of ADHD symptoms compared to the placebo-treated patients. The drug response rate among the control group ranges from 7 to 42%; in the treatment group from 17 to 59.6%. The meta-analyses confirm the findings of the RCT. In light of the control group, it can be ascertained that there are higher annual costs (both direct and indirect for patients with ADHD. The average annual medical expenses for an adult with ADHD were 1,262 $ in

  14. Causative Factors for ADHD: Role of Copy Number Variants in ADHD

    J Gordon Millichap; John J Millichap

    2014-01-01

    Investigators from Brazil determined if copy number variants (CNVs) in glutamate metabotropic receptor genes (GRM) were overrepresented in 1038 individuals with ADHD compared to 1057 subjects without ADHD.

  15. The effect of alpha-linolenic acid supplementation on ADHD symptoms in children: a randomized controlled double-blind study

    Gal Dubnov-Raz

    2014-10-01

    Full Text Available Background: Attention Deficit-Hyperactivity Disorder (ADHD is the most common neuro-developmental disorder in childhood. Its pharmacologic treatment mostly includes methylphenidate, yet many parents seek alternative, "natural", therapeutic options, commonly omega-3 fatty acids. Previous studies of supplementation with fish oil or long-chain omega-3 fatty acids to children with ADHD yielded mixed results. The use of alpha-linolenic acid, a medium-chained, plant-based omega-3 fatty acid (18:3 n-3, has not been sufficiently examined in this population. Methods: Forty untreated children with ADHD, aged 6-16 years, were randomized to receive either 2gr/day of oil containing 1gr alpha-linolenic acid or placebo, for 8 weeks. Before and after supplementation, the children underwent a physician assessment of ADHD symptoms and a computerized continuous performance functions test. The children's parents and teachers filled out Conners' and DSM questionnaires. Results: Seventeen (42.5% children completed the study, 8 in the supplementation group, 9 in the placebo group. Main drop-out reasons were capsule size, poor compliance, and a sense of lack of effect. No significant difference was found in any of the measured variables tested before and after supplementation, in both study groups. No between-group difference was found in the changes of the various measures of ADHD symptoms throughout the study period. Conclusion: Supplementation of 2gr/day of oil containing 1gr alpha-linolenic acid did not significantly reduce symptoms in children with ADHD. Future studies in this field should consider an alternative method to deliver the oil, a higher dose, and a larger sample size.

  16. ADHD - en risikofaktor i trafikken?

    Møller, Mette

    2014-01-01

    Tidligere undersøgelser tyder på, at personer med ADHD har større risiko for at blive involveret i et færdselsuheld, når de kører bil, end personer, der ikke har ADHD. Tidligere undersøgelsesresultater har dog været meget forskellige, ikke mindst fordi man har benyttet forskellige metoder og...... inddraget forskellige aspekter. En ny metaanalyse viser, at personer med ADHD har øget uheldsrisiko, men at risikoen er mindre end hidtil antaget....

  17. Influence of monoolein on progesterone transdermal delivery

    Wanessa de Souza Cardoso Quintão

    2015-12-01

    Full Text Available abstract This work aimed to investigate in vitro the influence of monoolein (MO on progesterone (PG transdermal delivery and skin retention. Information about the role of MO as an absorption enhancer for lipophilic molecules can help on innovative product development capable of delivering the hormone through the skin in a consistent manner, improving transdermal therapy of hormonal replacement. MO was dispersed in propylene glycol under heat at concentrations of 0% (control, 5% w/w, 10% w/w and 20% w/w. Then, 0.6% of PG (w/w was added to each formulation. Permeation profile of the hormone was determined in vitro for 48 h using porcine skin in Franz diffusion cells. PG permeation doubled when 5% (w/w of MO was present in formulation in comparison to both the control and higher MO concentrations (10% and 20% w/w. An equal trend was observed for PG retention in stratum corneum (SC and reminiscent skin (E+D. PG release rates from the MO formulations, investigated using cellulose membranes, revealed that concentrations of MO higher than 5% (w/w hindered PG release, which indeed negatively reflected on the hormone permeation through the skin. In conclusion, this work demonstrated the feasibility of MO addition (at 5% w/w in formulations as a simple method to increase transdermal PG delivery for therapies of hormonal replacement. In contrast, higher MO concentrations (from 10% to 20% w/w can control active release, and this approach could be extrapolated to other lipophilic, low-molecular-weight molecules.

  18. Methylphenidate exposure induces dopamine neuron loss and activation of microglia in the basal ganglia of mice.

    Shankar Sadasivan

    Full Text Available BACKGROUND: Methylphenidate (MPH is a psychostimulant that exerts its pharmacological effects via preferential blockade of the dopamine transporter (DAT and the norepinephrine transporter (NET, resulting in increased monoamine levels in the synapse. Clinically, methylphenidate is prescribed for the symptomatic treatment of ADHD and narcolepsy; although lately, there has been an increased incidence of its use in individuals not meeting the criteria for these disorders. MPH has also been misused as a "cognitive enhancer" and as an alternative to other psychostimulants. Here, we investigate whether chronic or acute administration of MPH in mice at either 1 mg/kg or 10 mg/kg, affects cell number and gene expression in the basal ganglia. METHODOLOGY/PRINCIPAL FINDINGS: Through the use of stereological counting methods, we observed a significant reduction (∼20% in dopamine neuron numbers in the substantia nigra pars compacta (SNpc following chronic administration of 10 mg/kg MPH. This dosage of MPH also induced a significant increase in the number of activated microglia in the SNpc. Additionally, exposure to either 1 mg/kg or 10 mg/kg MPH increased the sensitivity of SNpc dopaminergic neurons to the parkinsonian agent 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP. Unbiased gene screening employing Affymetrix GeneChip® HT MG-430 PM revealed changes in 115 and 54 genes in the substantia nigra (SN of mice exposed to 1 mg/kg and 10 mg/kg MPH doses, respectively. Decreases in the mRNA levels of gdnf, dat1, vmat2, and th in the substantia nigra (SN were observed with both acute and chronic dosing of 10 mg/kg MPH. We also found an increase in mRNA levels of the pro-inflammatory genes il-6 and tnf-α in the striatum, although these were seen only at an acute dose of 10 mg/kg and not following chronic dosing. CONCLUSION: Collectively, our results suggest that chronic MPH usage in mice at doses spanning the therapeutic range in humans, especially at

  19. A REVIEW: TRANSDERMAL DRUG DELIVERY OF NICOTINE

    Saurabh Ravi; Sharma P. K; Bansal M

    2011-01-01

    Cigarette smoking has been the leading cause of premature death and illness in many industrialized country in the world, while the U.S. alone registers more than 4,00,000 deaths each year. The nicotine patch serves to deliver a constant dose of nicotine across the skin that helps to relieve the symptoms which are associated with tobacco withdrawal. Further, the use of carbon nanotube membranes and micro needle based transdermal drug delivery has lead to the great advancements. Some of the mai...

  20. Transdermal administration of morphine to healthy subjects.

    Westerling, D; Höglund, P; Lundin, S.; Svedman, P

    1994-01-01

    1. Twelve healthy subjects received 10 mg morphine HCl delivered transdermally from an occlusive reservoir applied to a small area of skin, painlessly de-epithelialised by vacuum suction. On a separate occasion, 10 mg morphine HCl was given as an i.v. infusion over 20 min. 2. Venous blood samples were collected serially for 72 h and assayed for morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) by h.p.l.c. Pupil size, salivation, and central nervous effects (nausea, fatig...