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Rogge C, Barnhardt E. A Case Report of Orofacial Dyskinesia With Transdermal Methylphenidate. J Dev Behav Pediatr 2025:00004703-990000000-00239. [PMID: 40168652 DOI: 10.1097/dbp.0000000000001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 01/02/2025] [Indexed: 04/03/2025]
Abstract
BACKGROUND Methylphenidate transdermal systems are a generally safe and effective treatment option for individuals with attention deficit hyperactivity disorder (ADHD). CASE PRESENTATION A 9-year-old boy with a history of autism spectrum disorder, insomnia, ADHD combined type, and historical global developmental delays with high suspicion for intellectual disability presented to a developmental and behavioral pediatrics clinic for medication management related to his diagnosis of ADHD. Other pertinent medical history includes a history of pica, a branchial cleft cyst that has since been removed, intermittent constipation and early childhood trauma, resulting in permanent placement with his maternal grandparents. His birth history is notable for a presumed history of in utero exposure to marijuana. He has a family history of substance use disorder, depression, autism and ADHD. A chromosomal microarray and testing for Fragile X were completed in the past and unremarkable. Shortly after a first-time application of a starting dose methylphenidate transdermal system, he was noted to demonstrate involuntary lip puckering, tongue thrusting, and repetitive jaw opening and closing. Upon immediate discontinuation of the patch, the dyskinesia subsided with no persistent remaining symptoms. CONCLUSION To inform medication management for ADHD in children with comorbidities, it is valuable to define specific risk factors for adverse effects and intolerability of medication. Identifying if patient age, weight, comorbidities, previous antipsychotic or stimulant use, and concurrent medication use are demonstrable risk factors for dyskinesia can help practitioners develop a more individualized medication treatment plan for children with ADHD.
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Affiliation(s)
- Carson Rogge
- The Ohio State University College of Medicine, Columbus, OH
| | - Elizabeth Barnhardt
- Division of Developmental and Behavioral Pediatrics, Nationwide Children's Hospital, Columbus, OH
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2
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Kaur M, Patel M, Monis E. Exploring the limited use of transdermal medications in psychiatry: Challenges and potential solutions. World J Methodol 2024; 14:96145. [PMID: 39712570 PMCID: PMC11287543 DOI: 10.5662/wjm.v14.i4.96145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/29/2024] [Accepted: 07/10/2024] [Indexed: 07/26/2024] Open
Abstract
Transdermal medications are an useful yet underutilized tool in the field of psychiatry. Despite numerous advantages of using this route of medication delivery, transdermal medications remain less popular compared to other routes of medication administration such as oral and intramuscular routes in the management of various psychiatric conditions. In this editorial, we examine the advantages of transdermal medications with a brief overview of transdermal being used in psychiatry and other medical specialties. We discuss the factors that play a role in their limited usage in psychiatry. We highlight certain patient categories who can specifically benefit from them and discuss potential solutions that can broaden the perspective of treating clinicians making this an intriguing avenue in the field of psychiatry.
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Affiliation(s)
- Mandeep Kaur
- Department of Psychiatry and Behavioral Health, Cape Fear Valley Medical Center, Fayetteville, NC 28305, United States
| | - Meera Patel
- Department of Psychiatry and Behavioral Health, Cape Fear Valley Medical Center, Fayetteville, NC 28305, United States
| | - Elizabeth Monis
- Department of Psychiatry and Behavioral Health, Cape Fear Valley Medical Center, Fayetteville, NC 28305, United States
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Khan F, Mohiuddin S. Review of Clinical Considerations in the Management of Adolescents with ADHD During Ramadan. ADOLESCENT PSYCHIATRY 2024; 14:117-133. [DOI: 10.2174/0122106766298494240510052101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 01/04/2025]
Abstract
Background:
Fasting in Ramadan, a holy month in Islam, is considered a
religious obligation to Muslims after puberty. Fasting during Ramadan entails
abstinence from consuming food and liquids, as well as abstaining from other
activities, including smoking and sexual activity, from dawn until sunset. Literature
exists regarding the management of multiple medical conditions impacted by the
month of fasting; however, limited literature exists to guide the management of
Attention-Deficit/Hyperactivity Disorder (ADHD) during Ramadan.
Methods:
This systematic review employed a PUBMED search which was
conducted using keywords ((ADHD) AND (Muslims)) OR ((ADHD) AND
(FASTING)) OR ((ADHD) AND (RAMADAN)) OR ((RAMADAN) AND
(MANAGEMENT)) and search strategies to find existing literature on ADHD
management during Ramadan or while fasting.
Results:
Eight hundred and sixty-one results were obtained. Of these, full texts of
clinical trials, systematic reviews, reviews, randomized control trials, and metaanalyses
resulted in 303 results that were screened by title or abstract for relevance to
the topic. The duplicate articles were removed. Eighty-nine results were incorporated
into this paper, including full articles, book excerpts, and online articles.
Discussion:
Muslim adolescents may face challenges with academic and social
functioning as they navigate psychosocial changes in the context of Ramadan.
ADHD management options should be discussed with individuals who are planning
to fast. Pharmacologic management options include continuing on the current
regimen, dose adjustment to mitigate side effect exacerbation, a change in medication
class, or a change in medication formulation. For severe cases or cases with comorbid
conditions, continued fasting may not be recommended. In these cases, the patient
should attempt to seek counsel with their community’s religious scholar in
collaboration with their medication provider. Ultimately, there are limitations in the
available data, and there is a need for further investigation into the impacts of fasting
during Ramadan on individuals with ADHD and the effectiveness of interventions to
promote treatment adherence.
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Affiliation(s)
- Faraz Khan
- Department of Psychiatry, University of Michigan–Ann Arbor, USA
| | - Sarah Mohiuddin
- Department of Child and Adolescent Psychiatry, University of Michigan–Ann Arbor, USA
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Ryst E, Childress A. An updated safety review of the current drugs for managing ADHD in children. Expert Opin Drug Saf 2023; 22:1025-1040. [PMID: 37843488 DOI: 10.1080/14740338.2023.2271392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/12/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent condition that causes persistent problems with attention and/or hyperactivity-impulsivity and often results in significant impairment when left untreated. Medications for this disorder continue to evolve and provide new treatment options. Ongoing review of related medication safety and tolerability remains an important task for prescribers. AREAS COVERED This manuscript provides an updated safety review of medications used to treat ADHD in children and adolescents. PubMed and OneSearch online databases were utilized to search for literature relevant to the topic of ADHD medications and safety. Clinical trials of medications used to treat ADHD, systematic reviews and meta-analyses, and articles covering specific safety issues (adverse or unfavorable events) such as cardiovascular effects, seizures, impact on growth, depression, suicidal ideation, substance use disorders, psychosis, and tics are described. EXPERT OPINION Available pharmacologic treatments for ADHD have favorable efficacy, safety and tolerability and allow many patients to achieve significant improvement of their symptoms. Despite the availability of multiple stimulant and non-stimulant formulations, some individuals with ADHD may not tolerate available medications or attain satisfactory improvement. To satisfy unmet clinical needs, ADHD pharmaceutical research with stimulant and nonstimulant formulations targeting dopamine, norepinephrine, and novel receptors is ongoing.
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Affiliation(s)
- Erika Ryst
- College of Education and Human Development, University of Nevada, Reno, USA
| | - Ann Childress
- Center for Psychiatry and Behavioral Medicine, Inc, Las Vegas, NV, USA
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Cutler AJ, Suzuki K, Starling B, Balakrishnan K, Komaroff M, Meeves S, Castelli M, Childress A. d-Amphetamine Transdermal System in Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: Secondary Endpoint Results and Post Hoc Effect Size Analyses from a Pivotal Trial. J Child Adolesc Psychopharmacol 2023; 33:176-182. [PMID: 37339441 PMCID: PMC10282809 DOI: 10.1089/cap.2023.0005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Objectives: Amphetamines are a preferred treatment for attention-deficit/hyperactivity disorder (ADHD), with the dextroamphetamine transdermal system (d-ATS) providing an alternative to oral formulations. A pivotal trial of d-ATS in children and adolescents with ADHD met primary and key secondary endpoints. This analysis reports additional endpoints and safety findings from the pivotal trial and evaluates effect size and number needed to treat (NNT) for d-ATS. Methods: In this study, a 5-week, open-label dose-optimization period (DOP) preceded a 2-week, randomized, crossover double-blind treatment period (DBP). Eligible patients received d-ATS 5 mg during the DOP, with weekly evaluations for increase to 10, 15, and 20 mg (equivalent to labeled doses of 4.5, 9, 13.5, and 18 mg/9 hours, respectively) until reaching and maintaining the optimal dose, which was utilized for the DBP. Secondary endpoints included assessment of Attention-Deficit/Hyperactivity Disorder Rating Scale IV (ADHD-RS-IV), Conners' Parent Rating Scale Revised Short Form (CPRS-R:S), and Clinical Global Impression (CGI) scores. NNT was calculated for ADHD-RS-IV and CGI-Improvement (CGI-I). Safety assessments included treatment-emergent adverse events (TEAEs) and dermal safety. Results: In total, 110 patients entered the DOP, with 106 patients randomized (DBP). During the DBP, the least-squares mean (95% confidence interval) difference for d-ATS versus placebo in ADHD-RS-IV total score was -13.1 (-16.2 to -10.0; p < 0.001), with effect size of 1.1 and NNT of 3 for ADHD-RS-IV remission, ≥30% improvement, and ≥50% improvement. Significant differences between placebo and d-ATS were also observed for CPRS-R:S and CGI-I scales (p < 0.001), with NNT of 2 for CGI-I response. Most TEAEs were mild or moderate, with three leading to study discontinuation in the DOP and none in the DBP. No patients discontinued due to dermal reactions. Conclusions: d-ATS was effective in treating ADHD in children and adolescents, meeting all secondary endpoints, with a large effect size and NNT of 2-3 to achieve a clinically meaningful response. d-ATS was safe and well tolerated, with minimal dermal reactions. Clinical Trial Registration: NCT01711021.
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Affiliation(s)
- Andrew J. Cutler
- Department of Psychiatry, SUNY Upstate Medical University, Neuroscience Education Institute, Lakewood Ranch, Florida, USA
| | - Katsumi Suzuki
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Brittney Starling
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Kanan Balakrishnan
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Marina Komaroff
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Suzanne Meeves
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | | | - Ann Childress
- Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas, Nevada, USA
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Cutler AJ, Suzuki K, Starling B, Balakrishnan K, Komaroff M, Castelli M, Meeves S, Childress AC. Efficacy and Safety of Dextroamphetamine Transdermal System for the Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: Results from a Pivotal Phase 2 Study. J Child Adolesc Psychopharmacol 2022; 32:89-97. [PMID: 35020462 PMCID: PMC8972004 DOI: 10.1089/cap.2021.0107] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objectives: To assess efficacy and safety of the new Dextroamphetamine Transdermal System (d-ATS) to treat children and adolescents (aged 6-17 years) with attention-deficit/hyperactivity disorder (ADHD). Methods: In this phase 2, randomized, placebo-controlled study, 4 d-ATS patches of differing doses (5, 10, 15, and 20 mg) were evaluated. Patients began a 5-week, open-label, stepwise dose-optimization period in which they received a 5-mg d-ATS patch (applied to hip) for 9 hours. During weekly visits, patients were evaluated for possible adjustments to the next dose level based on efficacy and safety. Once at the optimal dose, that dose was maintained during a 2-week, crossover double-blind treatment period. Primary endpoint was to assess efficacy of d-ATS versus placebo as measured by Swanson, Kotkin, Agler, M-Flynn, and Pelham Scale (SKAMP) total score; key secondary endpoints included assessing onset and duration of efficacy by SKAMP total score, and additional secondary endpoints included Permanent Product Measure of Performance (PERMP) scores. Safety was assessed throughout. Results: d-ATS treatment resulted in significant improvements versus placebo in ADHD symptoms as measured by SKAMP total score, with overall least-squares mean difference (95% confidence interval) versus placebo of -5.87 (6.76, -4.97; p < 0.001) over the 12-hour assessment period. Onset of efficacy was observed at 2 hours postdose (p < 0.001), and duration of effect continued through 12 hours (patch removed at 9 hours), with significant differences between d-ATS and placebo at all time points from 2 hours onward (all p ≤ 0.003). Significant improvements versus placebo in PERMP-A and PERMP-C scores were also observed from 2 to 12 hours postdose with d-ATS treatment. d-ATS was safe and well-tolerated, with a systemic safety profile similar to that observed with oral amphetamines. Conclusions: This study demonstrates that d-ATS is an effective and well-tolerated treatment for children and adolescents with ADHD. These data indicate that d-ATS can deliver sustained levels of efficacy along with the advantages of transdermal drug delivery, making it a beneficial new treatment option. Clinical Trial Registration no.: NCT01711021.
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Affiliation(s)
- Andrew J. Cutler
- Department of Psychiatry, SUNY Upstate Medical University, Lakewood Ranch, Florida, USA.,Address correspondence to: Andrew J. Cutler, MD, SUNY Upstate Medical University, Department of Psychiatry, Lakewood Ranch, FL 34201, USA
| | - Katsumi Suzuki
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Brittney Starling
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Kanan Balakrishnan
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Marina Komaroff
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | | | - Suzanne Meeves
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Ann C. Childress
- Center for Psychiatry and Behavioral Medicine, Las Vegas, Nevada, USA
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7
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Siafaka P, Ipekci E, Caglar EŞ, Ustundag Okur N, Buyukkayhan D. Current Status of Pediatric Formulations for Chronic and Acute Children' Diseases: Applications and Future Perspectives. Medeni Med J 2021; 36:152-162. [PMID: 34239768 PMCID: PMC8226405 DOI: 10.5222/mmj.2021.78476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/29/2021] [Indexed: 12/04/2022] Open
Abstract
Infants and other children can be affected by various acute, chronic and many of them rare illnesses. Developing drugs for children is very challenging since they cannot intake tablets or hard oral solid dosage forms. Besides, most of the prescribed pediatric medications are unlicensed. The biggest issue that clinicians have to solve is that dosing in children is not based on weight or surface area of the body, as it happened in adults but is related to age variations in drug absorption, distribution, metabolism, and elimination. Thus, for pediatric patients, various therapeutic approaches have been proposed so as to develop suitable formulations such as liquid dosage forms, flexible capsules, milk-based products, etc. In addition, the administration of current pharmaceutical products to children might lead to some serious side effects which can also happen in adults but with a lower risk. Especially, infants are at high risk of getting poisoned by taking drugs used for adults. Moreover, children are very sensitive to the taste and smell of some pharmaceutical vehicles and can resist to intake them and this situation leads parents to search for tasteless and odorless medications. In this study, the current formulations for various diseases intended to be used in pediatric patients as well as various chronic and acute diseases of childhood are summarized. Authors believe that this review can help professionals who want to work with pediatric formulations to design more efficient and child-friendly drug delivery systems.
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Affiliation(s)
- Panoraia Siafaka
- Aristotle University of Thessaloniki, Department of Chemistry, Thessaloniki, Greece
| | - Esra Ipekci
- University of Health Sciences, Faculty of Pharmacy, Department of Pharmaceutical Technology, İstanbul, Turkey
| | - Emre Şefik Caglar
- University of Health Sciences, Faculty of Pharmacy, Department of Pharmaceutical Technology, İstanbul, Turkey
| | - Neslihan Ustundag Okur
- University of Health Sciences, Faculty of Pharmacy, Department of Pharmaceutical Technology, İstanbul, Turkey
| | - Derya Buyukkayhan
- University of Health Sciences, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, İstanbul, Turkey
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Correll CU, Starling BR, Huss M. Systematic review of transdermal treatment options in attention-deficit/hyperactivity disorder: implications for use in adult patients. CNS Spectr 2021:1-13. [PMID: 33843531 DOI: 10.1017/s1092852921000341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adults with attention-deficit/hyperactivity disorder (ADHD) often face delays in diagnosis and remain untreated, despite significant negative impacts. To evaluate the safety and efficacy of transdermal treatment options in children, adolescents, and adults, a systematic literature review was conducted, with a focus on the implications of transdermal therapies for ADHD in adults. METHODS A MEDLINE/Embase/BIOSIS/SCOPUS database search was conducted December 4, 2019, for English-language articles of interventional clinical trials using transdermal formulations for the treatment of ADHD without publication date limit. Assessed outcomes included efficacy, safety, adherence, abuse potential, cost efficacy, and health-related quality of life. RESULTS Of 23 eligible publications, 18 were in children or adolescents (n = 1699; range 23-305), and 5 in adults (n = 274; range 14-90); all included methylphenidate transdermal system (MTS). All seven pediatric publications reporting change in ADHD symptomology from baseline reported a significant improvement with MTS treatment. Similarly, in three adult publications, ADHD symptoms improved significantly with MTS treatment. Safety findings in pediatric and adult studies were comparable; the most frequently reported treatment-emergent adverse events (TEAEs), namely, headache, decreased appetite, and insomnia, were reported in 13/16 (81%) of publications reporting specific TEAEs. MTS-related dermal reactions were mostly mild and transient. Discontinuation due to dermal reactions was reported in 10 studies (range 0%-7.1% [1 of 14 patients]). MTS compliance was high when assessed (97%-99%). CONCLUSIONS Transdermal therapies provide a useful treatment formulation for ADHD. Studies of MTS and other transdermal formulations, such as amphetamine, in adult patients are needed in this underserved population.
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Affiliation(s)
- Christoph U Correll
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Brittney R Starling
- Research and Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, Johannes Gutenberg University of Medicine, Mainz, Germany
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A Case Series: Adjunctive Treatment of Major Depressive Disorder in the Geriatric Population with the Methylphenidate Patch. Case Rep Psychiatry 2019; 2019:2890913. [PMID: 31886000 PMCID: PMC6925763 DOI: 10.1155/2019/2890913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/03/2019] [Accepted: 11/14/2019] [Indexed: 11/18/2022] Open
Abstract
Major depressive disorder can affect anyone regardless of age. In geriatric populations depression is often overlooked and untreated, which subsequently may lead to serious consequences. Almost one third of elderly patients with depression fail to respond to initial treatment and require adjunctive treatment. Methylphenidate is one such option, which is seldom used in the geriatric population to treat depression despite reports of improvement in symptoms of mood within a brief period of time. Methylphenidate is also available in a patch formulation that can be used in patient's nonadherent to the medication, which is reported to be an issue in as many as 75% of the geriatric population. Here we present three geriatric patients who were diagnosed with recurrent severe major depressive disorder without psychotic features. The three patients responded well with methylphenidate as adjunctive treatment to conventional antidepressants.
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10
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Steingard R, Taskiran S, Connor DF, Markowitz JS, Stein MA. New Formulations of Stimulants: An Update for Clinicians. J Child Adolesc Psychopharmacol 2019; 29:324-339. [PMID: 31038360 PMCID: PMC7207053 DOI: 10.1089/cap.2019.0043] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In the last 15 years, there has been a marked increase in the number of available stimulant formulations with the emphasis on long-acting formulations, and the introduction of several novel delivery systems such as orally dissolving tablets, chewable tablets, extended-release liquid formulations, transdermal patches, and novel "beaded" technology. All of these formulations involve changes to the pharmaceutical delivery systems of the two existing compounds most commonly employed to treat attention-deficit/hyperactivity disorder (ADHD), amphetamine (AMP) and methylphenidate (MPH). In addition to these new formulations, our knowledge about the individual differences in response has advanced and contributes to a more nuanced approach to treatment. The clinician can now make increasingly informed choices about these formulations and more effectively individualize treatment in a way that had not been possible before. In the absence of reliable biomarkers that can predict individualized response to ADHD treatment, clinical knowledge about differences in MPH and AMP pharmacodynamics, pharmacokinetics, and metabolism can be utilized to personalize treatment and optimize response. Different properties of these new formulations (delivery modality, onset of action, duration of response, safety, and tolerability) will most likely weigh heavily into the clinician's choice of formulation. To manage the broad range of options that are now available, clinicians should familiarize themselves in each of these categories for both stimulant compounds. This review is meant to serve as an update and a guide to newer stimulant formulations and includes a brief review of ADHD and stimulant properties.
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Affiliation(s)
- Ronald Steingard
- Child Mind Institute, New York, New York.,Address correspondence to: Ronald Steingard, MD, Child Mind Institute, 101 East 56th Street, New York, NY 10022
| | - Sarper Taskiran
- Child Mind Institute, New York, New York.,Department of Psychiatry, Koc University School of Medicine, Istanbul, Turkey
| | - Daniel F. Connor
- Division of Child and Adolescent Psychiatry, Department of Psychiatry University of Connecticut School of Medicine, Farmington, Connecticut
| | - John S. Markowitz
- Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida
| | - Mark A. Stein
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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11
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Sandgren AM, Brummer RJ. ADHD-originating in the gut? The emergence of a new explanatory model. Med Hypotheses 2018; 120:135-145. [DOI: 10.1016/j.mehy.2018.08.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 08/25/2018] [Indexed: 12/12/2022]
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12
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Caballero J, Darsey EH, Walters F, Belden HW. Methylphenidate extended-release oral suspension for the treatment of attention-deficit/hyperactivity disorder: a practical guide for pharmacists. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2017; 6:163-171. [PMID: 29354563 PMCID: PMC5774317 DOI: 10.2147/iprp.s142576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects children, adolescents, and adults worldwide. The purpose of this review was to inform pharmacists of the numerous options to treat ADHD, with a focus on one of the more recently approved formulations, methylphenidate extended-release oral suspension (MEROS). Symptoms of ADHD can negatively impact an individual’s health and quality of life and impair function in multiple settings. Psychostimulants such as methylphenidate- and amphetamine-based agents are first-line pharmacologic treatments for ADHD. However, there are multiple formulations, including immediate release (administered two to three times/day), solid extended release (ER), or transdermal patch. MEROS is a once daily, long-acting liquid preparation that has demonstrated favorable safety and efficacy in patients with ADHD. MEROS may improve treatment adherence in patients who cannot tolerate or have difficulties administering pill or transdermal patch formulations.
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Affiliation(s)
- Joshua Caballero
- Department of Clinical and Administrative Sciences, College of Pharmacy, Larkin Health Sciences Institute, Miami, FL
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Affiliation(s)
- Gregory W Mattingly
- Washington University School of Medicine, Department of Psychiatry and Behavioral Neurosciences, St. Charles, MO, USA
- Midwest Research Group, St. Charles, MO, USA
| | - Joshua Wilson
- Washington University School of Medicine, Division of Child and Adolescent Psychiatry, Saint Louis, MO, USA
| | - Anthony L Rostain
- University of Pennsylvania Health System, Department of Psychiatry, Office of Education, Philadelphia, PA, USA
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14
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Busardò FP, Kyriakou C, Cipolloni L, Zaami S, Frati P. From Clinical Application to Cognitive Enhancement: The Example of Methylphenidate. Curr Neuropharmacol 2016; 14:17-27. [PMID: 26813119 PMCID: PMC4787280 DOI: 10.2174/1570159x13666150407225902] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/17/2015] [Accepted: 04/03/2015] [Indexed: 12/20/2022] Open
Abstract
Methylphenidate (MPD) is a central nervous system (CNS) stimulant, which belongs to the phenethylamine group and is mainly used in the treatment of attention deficit hyperactive disorder (ADHD). However, a growing number of young individuals misuse or abuse MPD to sustain attention, enhance intellectual capacity and increase memory. Recently, the use of MPD as a cognitive enhancement substance has received much attention and raised concerns in the literature and academic circles worldwide. The prescribing frequency of the drug has increased sharply as consequence of the more accurate diagnosis of the ADHD and the popularity of the drug itself due to its beneficial short-term effect. However, careful monitoring is required, because of possible abuse. In this review different aspects concerning the use of MPD have been approached. Data showing its abuse among college students are given, when the drug is prescribed short term beneficial effects and side effects are provided; moreover studies on animal-models suggesting long lasting negative effects on healthy brains are discussed. Finally, emphasis is given to the available formulations and pharmacology.
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Affiliation(s)
- Francesco Paolo Busardò
- Department of Anatomical, Histological, Medico-legal and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336 (00185) Rome, IT.
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15
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Stevens JR, Justin Coffey M, Fojtik M, Kurtz K, Stern TA. The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches. PSYCHOSOMATICS 2015. [DOI: 10.1016/j.psym.2015.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Zhai Y, Zhai G. Advances in lipid-based colloid systems as drug carrier for topic delivery. J Control Release 2014; 193:90-9. [DOI: 10.1016/j.jconrel.2014.05.054] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/21/2014] [Accepted: 05/27/2014] [Indexed: 10/25/2022]
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