title: Modulation of attention-deficit/hyperactivity disorder symptoms by short- and long-acting methylphenidate over the course of a day.
abstract: The purpose of this study was to investigate whether a long-acting methylphenidate formulation (MPH-ret) is as effective as two doses of immediate-release methylphenidate (MPH-IR) in reducing attention-deficit/hyperactivity disorder (ADHD) symptoms including inattention, impulsivity, and hyperactivity during the course of the day. Two groups of children (n=18 each) with ADHD aged between 8 and 12 years completed a continuous performance test in combination with a motion-tracking system four times a day within 8 hours. Inattention (standard deviation of reaction time), impulsivity (commission error rate), and hyperactivity (path length of the headband) were simultaneously measured. We included a control group (n=20) to rule out circadian fluctuations of attentional performance and motor activity. We observed a postlunch dip in attentional performance and an increasing trend of motor activity throughout the day whereas impulsivity remained stable in controls. The MPH-ret and MPH-IR groups had comparable treatment effects on measures of hyperactivity and inattention and normalized participant performance to control levels. In contrast, MPH-IR seems to have an advantage over MPH-ret in impulsivity treatments. Thus, our data suggest that it is crucial to assess the different domains of ADHD symptoms precisely over the course of a day to determine the optimal titration and stimulant formulation for a person with ADHD.
authors.affiliation: Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital of the RWTH Aachen, Aachen, Germany. thomas.guenther2@post.rwth-aachen.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Günther
authors.forename: Berrak
authors.initials: B
authors.lastname: Kahraman-Lanzerath
authors.forename: Eva Lotte
authors.initials: EL
authors.lastname: Knospe
authors.forename: Beate
authors.initials: B
authors.lastname: Herpertz-Dahlmann
authors.forename: Kerstin
authors.initials: K
authors.lastname: Konrad
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002940:Circadian Rhythm; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000188:drug therapy; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use*; D009043:Motor Activity / Q000187:drug effects; D013997:Time Factors
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate