title: Long-acting methylphenidate reduces collision rates of young adult drivers with attention-deficit/hyperactivity disorder.
abstract: This study investigated whether methylphenidate delivered through a long-acting transdermal system (MTS) would reduce collision rates of young adult drivers with attention-deficit/hyperactivity disorder (ADHD).Seventeen young adults completing the study (mean [SD] age, 20.82 [2.40] years; 14 men and 13 white) met the following inclusion criteria: ADHD diagnoses but not routinely taking ADHD medication, previously responsive to ADHD medication, active drivers with more than 1 collision or citation in the past 2 years, and no significant comorbidities. In this open-labeled, crossover design drivers were randomly assigned either to the no-medication condition for 3 months and then MTS for 3 months or to the reverse sequence. In-car video monitoring of routine driving occurred during these 6 months. At baseline and after each condition, participants completed the Conners Adult ADHD Rating Scale and the Cox Assessment of Risky Driving Scale, and their blood pressure, heart rate, and body weight were monitored.Compared with the no-medication condition, participants in the MTS condition self-reported fewer total ADHD (P < 0.04) and inattentive symptoms (P = 0.014) and a trend for risky driving behaviors (P = 0.059) and had fewer video-recorded collisions (P < 0.005) and other problematic driving events. There were no significant changes in blood pressure, heart rate, or body weight across conditions or any significant skin reactions to the MTS patch.This is the first study demonstrating that long-acting methylphenidate improves activities of daily living among young adults with ADHD. Specifically, methylphenidate improved safety in routine driving while reducing ADHD symptoms with minimal adverse effects.
authors.affiliation: Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, Charlottesville, VA, USA. djc4f@virginia.edu
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cox
authors.forename: Margaret
authors.initials: M
authors.lastname: Davis
authors.forename: Amori Yee
authors.initials: AY
authors.lastname: Mikami
authors.forename: Harsimran
authors.initials: H
authors.lastname: Singh
authors.forename: Richard L
authors.initials: RL
authors.lastname: Merkel
authors.forename: Roger
authors.initials: R
authors.lastname: Burket
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001334:Automobile Driving / Q000706:statistics & numerical data*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012309:Risk-Taking; D016896:Treatment Outcome; D014741:Video Recording; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate