Early Morning Functioning in Stimulant-Treated Children and Adolescents with Attention-Deficit/Hyperactivity Disorder, and its Impact on Caregivers
Open accessAbstract
OBJECTIVE: The purpose of this study was to examine the temporal occurrence and severity of inadequate attention-deficit/hyperactivity disorder (ADHD) symptom control throughout the day, and, more specifically, the frequency and severity of associated functional impairments and their apparent emotional impact on parents and caregivers during the early morning routine before school, in children and adolescents with ADHD currently treated with stable doses of stimulant medications. METHODS: Information was obtained from 201 primary caregivers of children and adolescents with ADHD using a self-administered, on-line quantitative research survey. RESULTS: Inadequately controlled ADHD symptoms were rated as most severe during the evening homework time and the early morning routine. The majority of caregivers reported early morning ADHD symptoms and impairment of early morning functioning (EMF) as moderate to severe. Caregiver reactions to their child's early morning ADHD symptoms and unwanted behaviors included feeling overwhelmed, exhausted, and constantly stressed. CONCLUSIONS: Control of EMF impairments from inadequately controlled ADHD symptoms is a significant unmet need in children and adolescents with ADHD treated with stable morning doses of stimulant medications. Current orally administered stimulant treatment options have not addressed this challenge.
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Individuals treated with morning-dosed stimulants report emotional lability symptoms in the mornings, including frequent temper tantrums and sudden changes to their mood and feelings.
“Individuals treated with morning-dosed stimulants report EL symptoms in the mornings, including frequent temper tantrums and sudden changes to their mood and feelings (Sallee, 2015).”
From A Post-Hoc Analysis of Emotional Lability With Delayed-Release/Extended-Release Methylphenidate in Children Aged 6 to 12 Years of Age Participating in Two Phase 3 Clinical Trials (2024) · cites this paper as Sallee, 2015
The Conclusions report caregiver-observed, inadequately controlled early-morning ADHD symptoms in stimulant-treated children and adolescents. The Introduction also discusses a morning irritability and loss-of-temper measure from another study. Our copy does not establish frequent temper tantrums or sudden mood and feeling changes in Sallee’s survey, and the reports came from caregivers rather than the treated individuals. (LLM, conf=0.84)
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Cites
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“Current orally administered stimulant treatment options have not addressed this challenge.”
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Arnold, V. K., López, F. A., Childress, A. C., Po, M. D., Uchida, C. L., Cuthbertson, L., Sallee, F. R., & Incledon, B. (2024) · Journal of Attention Disorders · doi:10.1177/10870547241243155 · Cited by 1 · see citing works
“Individuals treated with morning-dosed stimulants report EL symptoms in the mornings, including frequent temper tantrums and sudden changes to their mood and feelings (Sallee, 2015).”
BackgroundInfluentialSelf-citation
- Authors
- Sallee, F. R.
- Affiliations
- University of Cincinnati (US)
- Corresponding author
- Sallee, Floyd R.
- Venue
- Journal of Child and Adolescent Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2015-09
- Volume
- 25
- Issue
- 7
- Pages
- 558-565
- ISSN
- 1044-5463 (ISSN-L)
- 1557-8992
- PMC
- PMC4576958
- OpenAlex
- W2098312887
- Cited by
- 39
- References
- 4
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 5 · 2016: 2 · 2015: 1
- FWCI
- 2.71
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Child and Adolescent Psychopharmacology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Shire
- Neos Therapeutics
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- attention deficit hyperactivity disorder, stimulant medication, symptom management, functional disability, caregiver stress, parent stress, children and adolescents, homework time
- MeSH terms
- Adolescent, Adult, Aged, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Stress, Psychological, Time Factors, Caregivers, Young Adult
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