Varying the Wear Time of the Methylphenidate Transdermal System in Children With Attention-Deficit/Hyperactivity Disorder
Abstract
Objective Children with attention-deficit/hyperactivity disorder often have varying needs for coverage of their symptoms throughout the day. The objectives of this study were to determine the efficacy, duration of action, and safety of methylphenidate transdermal system worn for variable times by children (ages 6-12) diagnosed with ADHD. Method Methylphenidate dose was optimized over 5 weeks using 10-, 15-, 20-, or 30-mg patches worn for 9 hours. The efficacy of 4- and 6-hour wear times was then assessed in an Analog Classroom setting during a randomized, placebo-controlled, double-blind, three-way crossover phase. The main efficacy measures were the Swanson, Kotkin, Agler, M-Flynn, and Pelham Rating Scale deportment scale and the Permanent Product Measure of Performance math test. Results All of the efficacy measures indicated that 4- and 6-hour wear times improved ADHD symptoms and that medication effects on the Swanson, Kotkin, Agler, M-Flynn, and Pelham Rating Scale deportment scale and Permanent Product Measure of Performance math test decreased between 2 and 4 hours after patch removal. The majority of adverse events were transient and mild to moderate in severity. Conclusions These findings suggest that the duration of medication effect is related to the wear time of the patch and may be tailored to accommodate the schedules of patients.
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The findings of the current study align closely with the results seen in children in a laboratory school setting.
“The findings of the current study align closely with the results seen in children in a laboratory school setting [16].”
Efficacy of long-acting stimulants in the laboratory school setting has been demonstrated for children with ADHD across the day and at 12 and 13 hours postdose.
“While similar studies in adults are limited, efficacy of long-acting stimulants in the laboratory school setting has been demonstrated for children with ADHD across the day and at 12 [15,22,25,33,34] and 13 hours postdose [16].”
In both the current study and the prior pediatric laboratory school study, LDX demonstrated significant separation from placebo through the last postdose time points assessed on an objective measure of task productivity and accuracy throughout the day.
“In both studies, LDX demonstrated significant separation from placebo through the last postdose time points assessed on an objective measure of task productivity and accuracy throughout the day.”
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Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD)
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“The use of the LSP, and specifically the PERMP assessment, has been applied widely to evaluate the effects of long-acting stimulants for children with ADHD [15,22-26].”
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- Authors
- WILENS, T. E., BOELLNER, S. W., LÓPEZ, F. A., TURNBOW, J. M., WIGAL, S. B., CHILDRESS, A. C., ABIKOFF, H. B., & MANOS, M. J.
- Affiliations
- Cleveland Clinic (US)
- Corresponding author
- WILENS, TIMOTHY E.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2008-06
- Volume
- 47
- Issue
- 6
- Pages
- 700-708
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2094244099
- Cited by
- 58
- References
- 5
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 4 · 2019: 1 · 2018: 1 · 2016: 3 · 2015: 3 · 2014: 6 · 2013: 2 · 2012: 5
- FWCI
- 6.05
- Type
- journal article
- Language
- en
- Open access
- closed
- 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
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- methylphenidate, transdermal patch, attention deficit hyperactivity disorder, children, duration of action, adverse events, dose optimization
- MeSH terms
- Administration, Cutaneous, Adolescent, Central Nervous System Stimulants, Attention, Attention Deficit Disorder with Hyperactivity, Child, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Female, Humans, Male, Methylphenidate, Personality Assessment, Treatment Outcome, Cross-Over Studies
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