title: No Superiority of Treatment With Osmotic Controlled-Release Oral Delivery System-Methylphenidate Over Short/Medium-Acting Methylphenidate Preparations in the Rate and Timing of Injuries in Children With Attention-Deficit/Hyperactivity Disorder.
abstract: OBJECTIVE
  Methylphenidate (MPH) treatment in patients with attention-deficit/hyperactivity disorder (ADHD) is reported to reduce the risk for injuries. In the present study, the rate and timing of injuries were compared among the various MPH preparations (4 and 6-8 vs 12 hour-acting) in children with ADHD.
  
  
  METHODS
  This real-world retrospective study covered the years 2011 to 2013. Participants included 2042 youngsters (aged 4-18 years, 13.01 ± 3.2 years; 71.8% males and 28.2% females) diagnosed with ADHD according to the International Statistical Classification of Diseases, 10th Revision criteria and treated with various MPH preparations. They were divided into 2 groups by their treatment preparation as follows: MPH-immediate release (MPH-IR)-4 hour-acting pooled with MPH-slow release/long-acting (MPH-SR/LA)- 6 to 8 hour-acting versus osmotic controlled-release oral delivery system-MPH (OROS-MPH; Concerta)-12 hour-acting that consisted of pooling of OROS-MPH only and OROS-MPH combined with the other MPH preparations. The monthly rates of injury, specifically, late injury (occurrence between 4:00 p.m. to midnight) and for multiple injuries, the time interval between injuries, were assessed.
  
  
  RESULTS
  No significant differences in monthly rate of nonfatal injuries were found between OROS-MPH with or without 4/6 to 8 hour-acting MPH-formulations versus only 4/6 to 8 hour-acting MPH-preparations (P = 0.53). Neither were differences found in the between-injury time interval (P = 0.83) or in late-injury-rates (P = 0.37) between those groups.
  
  
  CONCLUSIONS
  This real-world-naturalistic study in the community demonstrates that, in ADHD pediatric populations, OROS-MPH preparation is not superior to short/medium-acting (4/6-8 hours) MPH preparations regarding the rate and timing of injuries.
authors.affiliation: *Child and Adolescent Division, Geha Mental Health Center, Petah Tikva; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; ‡Maccabi Healthcare Services, Jerusalem and Plain Region, Jerusalem; §Department of Community Mental Health, Haifa University, Haifa; ‖Research Unit, Geha Mental Health Center; and ¶Felsenstein Medical Research Center, Tel Aviv University, Petah Tikva, Israel.
authors.forename: Pavel
authors.initials: P
authors.lastname: Golubchik
authors.forename: Arad
authors.initials: A
authors.lastname: Kodesh
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage* / Q000009:adverse effects; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate