1. OROS-methylphenidate efficacy on specific executive functioning deficits in adults with ADHD: a randomized, placebo-controlled cross-over study.
- Author
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Bron TI, Bijlenga D, Boonstra AM, Breuk M, Pardoen WF, Beekman AT, and Kooij JJ
- Subjects
- Administration, Oral, Adult, Attention Deficit Disorder with Hyperactivity physiopathology, Central Nervous System Stimulants adverse effects, Central Nervous System Stimulants therapeutic use, Cross-Over Studies, Delayed-Action Preparations, Diagnostic and Statistical Manual of Mental Disorders, Double-Blind Method, Drug Monitoring, Female, Humans, Male, Methylphenidate adverse effects, Methylphenidate therapeutic use, Netherlands, Osmosis, Outpatient Clinics, Hospital, Patient Dropouts, Reaction Time drug effects, Recognition, Psychology drug effects, Severity of Illness Index, Young Adult, Attention Deficit Disorder with Hyperactivity drug therapy, Central Nervous System Stimulants administration & dosage, Executive Function drug effects, Methylphenidate administration & dosage
- Abstract
Attention-deficit/hyperactivity disorder (ADHD) is linked to impaired executive functioning (EF). This is the first study to objectively investigate the effects of a long-acting methylphenidate on neurocognitive test performance of adults with ADHD. Twenty-two adults with ADHD participated in a 6-weeks study examining the effect of osmotic-release oral system methylphenidate (OROS-mph) on continuous performance tests (CPTs; objective measures), and on the self-reported ADHD rating scale (subjective measure) using a randomized, double-blind, placebo-controlled cross-over design. OROS-mph significantly improved reaction time variability (RTV), commission errors (CE) and d-prime (DP) as compared to baseline (Cohen's d>.50), but did not affect hit reaction time (HRT) or omission errors (OE). Compared to placebo, OROS-mph only significantly influenced RTV on one of two CPTs (p<.050). Linear regression analyses showed predictive ability of more beneficial OROS-mph effects in ADHD patients with higher EF severity (RTV: β=.670, t=2.097, p=.042; omission errors (OE): β=-.098, t=-4.759, p<.001), and with more severe ADHD symptoms (RTV: F=6.363, p=.019; HRT: F=3.914, p=.061). Side effects rates were substantially but non-significantly greater for OROS-mph compared to placebo (77% vs. 46%, p=.063). OROS-mph effects indicated RTV as the most sensitive parameter for measuring both neuropsychological and behavioral deficits in adults with ADHD. These findings suggest RTV as an endophenotypic parameter for ADHD symptomatology, and propose CPTs as an objective method for monitoring methylphenidate titration., (Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.)
- Published
- 2014
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