Effect of methylphenidate formulation for attention deficit hyperactivity disorder on patterns and outcomes of
1HealthMetrics Outcomes Research, Groton, Connecticut, USA.
Objectives:
The aim of this study was to assess whether once-daily Concerta extended-release (XR) methylphenidate (MPH) is associated with: (1) better compliance; (2) decreased likelihood of accidents/injuries; and (3) lower health-care resource use over a 1-year period than 3-times-daily immediate-release (IR) MPH in children with attention deficit hyperactivity disorder (ADHD).
Methods:
Multivariate regression analyses were performed using an administrative database. Inclusion criteria were: (1) an age of 6-12 years at the date of first prescription for XR/IR MPH (index date); (2) patient-level data available for least 6 months before and 12 months after the index date; (3) no ADHD medications in the 6-month prior period; and (4) no XR MPH use by the IR MPH group.
Results:
IR MPH: n=344, mean age 9.55 years, 76% male; XR MPH: n=1431, mean age 9.78 years, 75% male. XR MPH patients were less likely to discontinue, less likely to switch, and more likely to persist (i.e., no gaps >14 days) with therapy (p <0.0001). Children receiving XR MPH were less likely to experience an accident or injury (OR=0.58, 95% CI 0.353-0.945). Use of XR MPH was associated with significantly fewer emergency room visits and general practitioner visits per patient, on average, over 1 year.
Conclusions:
These data support the use of XR MPH with its simplified dosing regimen for children with ADHD.
More Related Videos
Related Concept Videos
Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
Adrenergic Agonists: Mixed-Action Agents
Ephedrine and pseudoephedrine lack a catecholamine group, making them less susceptible to degradation by metabolic enzymes. They have increased oral bioavailability and lipophilicity, resulting in a longer duration of action. Their response is reduced by...
Adrenergic Agonists: Chemistry and Structure-Activity Relationship
Aromatic ring substitutions: Substituting the aromatic ring with –OH groups at positions 3 and 4 yields catecholamines (e.g., epinephrine), which have a high affinity for adrenoceptors. Hydrogen bonding between –OH groups and receptors enhances adrenergic activity.
Separation of the aromatic...
Drug Therapy
Antianxiety Medications
Drugs Affecting Neurotransmitter Synthesis
Antiasthma Drugs: Methylxanthines
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...


