Social adjustment and family function after drug switch from IR -methylphenidate to OROS-methylphenidate in patients with attention-deficit/hyperactivity disorder

Wen-Jiun Chou,1 Liang-Jen Wang,1 Chien-Ho Lin,2 Sun-Yuan Liang,3 Vincent Chin-Hung Chen,4 Yuh-Ming Hou,5 Rong-Rong Huang,6 Miao-Chun Chou,1 Chi-Yung Shang,7 Chi-Pui Ho,6 Meng-Chuan Lai8 1Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 2Department of Psychiatry, Chimei Medical Center, Tainan, 3Department of Psychiatry, Changhua Hospital, Changhua, 4Department of Psychiatry, Chang Gung Memorial Hospital and University, 5Chia-Yi Christian Hospital, Chiayi, 6Department of Child and Adolescent Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung, 7Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; 8Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK Purpose: This prospective, single-arm, open-label, 8-week, multicenter study investigated the effectiveness of switching from immediate-release methylphenidate (IR-MPH) to osmotic controlled-release methylphenidate (OROS-MPH) in patients with attention-deficit/hyperactivity disorder (ADHD).Patients and methods: Overall, 296 patients with ADHD (mean age: 9.5 years) already on IR-MPH treatment were enrolled. Upon enrollment, a flexible dose of OROS-MPH was administered, replacing IR-MPH. Patients were assessed at baseline and weeks 2, 4, and 8 using the Swanson, Nolan, and Pelham version IV scale (SNAP-IV) and the Clinical Global Impression for ADHD symptoms. The Social Adjustment Inventory for Children and Adolescents assessed social functions, and the Chinese Health Questionnaire (CHQ) and Family Adaptation, Partnership, Growth, Affection, and Resolve evaluated parental and family functions.Results: Switching from IR-MPH to OROS-MPH yielded significant improvements in all ADHD symptoms, as rated by parents, teachers (SNAP-IV), and study investigators (Clinical Global Impression). CHQ scores and all Social Adjustment Inventory for Children and Adolescents subscores except spare time scores improved significantly. Patients with poor IR-MPH adherence had greater improvements in teacher-rated SNAP-IV and mothers’ mental health (CHQ) after switching. Conclusion: Switching from IR-MPH to OROS-MPH improved patients’ behavioral ADHD symptoms and social adjustment, and mental health of patients’ mothers. This was most evident in patients who previously exhibited poor IR-MPH adherence. Keywords: ADHD, central nervous system stimulant, drug adherence, family, social adjustment