Cited by 120Attention Deficit Hyperactivity DisorderTraffic and Road SafetyPharmaceutical studies and practices

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Impact of Methylphenidate Delivery Profiles on Driving Performance of Adolescents With Attention-Deficit/Hyperactivity Disorder: A Pilot Study

Cox, Daniel J., Merkel, R Lawrence, Penberthy, Jennifer Kim, Kovatchev, Boris, Hankin, Cheryl S.·2004·Journal of the American Academy of Child & Adolescent Psychiatry

DOI 10.1097/00004583-200403000-00007

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Abstract

Objective Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at high risk for driving accidents. One dose of methylphenidate (MPH) improves simulator driving performances of ADHD-diagnosed adolescents at 1.5 hours post-dose. However, little is known about the effects of different MPH delivery profiles on driving performance throughout the day.Method This randomized, crossover, single-blind study compared osmotic, controlled-release oral system (OROS) MPH (Concerta) given q.d. to immediate-release MPH (Ritalin) given in equal doses t.i.d. on driving performance among six male ADHD-diagnosed adolescent drivers aged 16 to 19 years. Under each treatment condition, participants were maintained on their medication dosage for 7 days, then drove a sophisticated driving simulator at 2 p.m., 5 p.m., 8 p.m., and 11 p.m. The primary outcome measure was each participant's computer-quantified Impaired Driving Score (IDS).Results IDS worsened in the evenings for participants receiving MPH t.i.d. but remained stable when they received once-daily OROS MPH. Participants performed significantly better when receiving OROS MPH q.d. compared with MPH t.i.d. (F = 9.3, df = 1, p =.004). When MPH was given t.i.d., IDS significantly worsened beginning at 8 p.m. compared to OROS MPH (p =.01).Conclusions Participants demonstrated significantly less variability and better driving performance when receiving OROS MPH q.d. compared to MPH t.i.d., particularly in the evenings.

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Authors: Cox, D. J., Merkel, R. L., Penberthy, J. K., Kovatchev, B., & Hankin, C. S.
Affiliations: University of Virginia Health System (US)
Corresponding author: Cox, Daniel J.
ORCID: Cox, Daniel J.
Merkel, R Lawrence
Penberthy, Jennifer Kim
Kovatchev, Boris
Venue: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
Published: 2004-03
Volume: 43
Issue: 3
Pages: 269-275
ISSN: 0890-8567 (ISSN-L)
DOI: 10.1097/00004583-200403000-00007
OpenAlex: W2010345730
Cited by: 120
References: 31
Citations by year: 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 5 · 2014: 3 · 2013: 6 · 2012: 6
FWCI: 10.09
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
Keywords: methylphenidate, attention deficit hyperactivity disorder, adolescents, driving performance, impaired driving, osmotic-release oral system, controlled-release formulation, immediate-release formulation, dosing frequency, driving simulator
MeSH terms: Adolescent, Adult, Central Nervous System Stimulants, Analysis of Variance, Attention Deficit Disorder with Hyperactivity, Automobile Driving, Delayed-Action Preparations, Humans, Male, Methylphenidate, Pilot Projects, Single-Blind Method, Cross-Over Studies

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Impact of Methylphenidate Delivery Profiles on Driving Performance of Adolescents With Attention-Deficit/Hyperactivity Disorder: A Pilot Study

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