A pharmacokinetic/pharmacodynamic study comparing a single morning dose of adderall to twice-daily dosing in children with ADHD.
OBJECTIVE
To determine the pharmacokinetic and pharmacodynamic properties of once-daily versus twice-daily doses of Adderall.


METHODS
Following a 1-week wash-out, 12 subjects with attention-deficit/hyperactivity disorder (ADHD) entered a double-blind crossover study comparing two conditions: QD (10 mg of Adderall at 7:30 a.m. and placebo at noon) or BID (10 mg of Adderall at 7:30 a.m. and at noon). At two sites, cohorts of six subjects each were assessed on two different days by a 12-hour laboratory school protocol. Plasma concentrations of d- and l-amphetamine, vital signs, teacher ratings of classroom behavior on the SKAMP, and 10-minute Math Test performance were measured repeatedly over 12 hours. An analysis of variance used center, subject-within-center, condition, and time-after-second-dose as independent variables.


RESULTS
The pharmacokinetic profiles revealed similar morning concentrations of d- and l-amphetamine. However, concentrations were twice as high in the afternoon for BID as QD. The two conditions showed similar pharmacodynamic profiles in the morning, although improvement in math performance and behavior was maintained into the afternoon only in the BID condition (p <.05).


CONCLUSIONS
This study suggests that twice-daily dosing of Adderall may be an effective strategy for afternoon control of attention and deportment for children with ADHD.
Greenhill
Laurence L
LL
Attention Deficit Disorder Research Program, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA. LarryLGreenhill@cs.com
Swanson
James M
JM
Steinhoff
Ken
K
Fried
Jane
J
Posner
Kelly
K
Lerner
Marc
M
Wigal
Sharon
S
Clausen
Susan B
SB
Zhang
Yuxin
Y
Tulloch
Simon
S
D000284:Administration, Oral; D000662:Amphetamines / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male
C090411:Adderall; D000662:Amphetamines; D000697:Central Nervous System Stimulants