Universität zu Köln

Coghill, David ORCID: 0000-0003-3017-9737, Banaschewski, Tobias ORCID: 0000-0003-4595-1144, Zuddas, Alessandro, Pelaz, Antonio, Gagliano, Antonella ORCID: 0000-0001-9367-7739 and Doepfner, Manfred (2013). Long-acting methylphenidate formulations in the treatment of attention-deficit/hyperactivity disorder: a systematic review of head-to-head studies. BMC Psychiatry, 13. LONDON: BMC. ISSN 1471-244X

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Abstract

Background: The stimulant methylphenidate (MPH) has been a mainstay of treatment for attention-deficit/hyperactivity disorder (ADHD) for many years. Owing to the short half-life and the issues associated with multiple daily dosing of immediate-release MPH formulations, a new generation of long-acting MPH formulations has emerged. Direct head-to-head studies of these long-acting MPH formulations are important to facilitate an evaluation of their comparative pharmacokinetics and efficacy; however, to date, relatively few head-to-head studies have been performed. The objective of this systematic review was to compare the evidence available from head-to-head studies of long-acting MPH formulations and provide information that can guide treatment selection. Methods: A systematic literature search was conducted in MEDLINE and PsycINFO in March 2012 using the MeSH terms: attention deficit disorder with hyperactivity/drug therapy; methylphenidate/therapeutic use and All Fields: Concerta; Ritalin LA; OROS and ADHD; Medikinet; Equasym XL and ADHD; long-acting methylphenidate; Diffucaps and ADHD; SODAS and methylphenidate. No filters were applied and no language, publication date or publication status limitations were imposed. Articles were selected if the title indicated a comparison of two or more long-acting MPH preparations in human subjects of any age; non-systematic review articles and unpublished data were not included. Results: Of 15,295 references returned in the literature search and screened by title, 34 articles were identified for inclusion: nine articles from pharmacokinetic studies (nine studies); nine articles from laboratory school studies (six studies); two articles from randomized controlled trials (two studies); three articles from switching studies (two studies) and three articles from one observational study. Conclusions: Emerging head-to-head studies provide important data on the comparative efficacy of the formulations available. At a group level, efficacy across the day generally follows the pharmacokinetic profile of the MPH formulation. No formulation is clearly superior to another; careful consideration of patient needs and subtle differences between formulations is required to optimize treatment. For patients achieving suboptimal symptom control, switching long-acting MPH formulations may be beneficial. When switching formulations, it is usually appropriate to titrate the immediate-release component of the formulation; a limitation of current studies is a focus on total daily dose rather than equivalent immediate-release components. Further studies are necessary to provide guidance in clinical practice, particularly in the treatment of adults and pre-school children and the impact of comorbidities and symptom severity on treatment response.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Coghill, David UNSPECIFIED orcid.org/0000-0003-3017-9737 UNSPECIFIED Banaschewski, Tobias UNSPECIFIED orcid.org/0000-0003-4595-1144 UNSPECIFIED Zuddas, Alessandro UNSPECIFIED UNSPECIFIED UNSPECIFIED Pelaz, Antonio UNSPECIFIED UNSPECIFIED UNSPECIFIED Gagliano, Antonella UNSPECIFIED orcid.org/0000-0001-9367-7739 UNSPECIFIED Doepfner, Manfred UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-475659
DOI:	10.1186/1471-244X-13-237
Journal or Publication Title:	BMC Psychiatry
Volume:	13
Date:	2013
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-244X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEFICIT-HYPERACTIVITY-DISORDER; MODIFIED-RELEASE METHYLPHENIDATE; MULTIPLE-DOSE PHARMACOKINETICS; DOUBLE-BLIND; TRANSDERMAL SYSTEM; LABORATORY SCHOOL; IMMEDIATE-RELEASE; CHILDREN; EFFICACY; ADHD Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47565