Is Response to OROS‐Methylphenidate Treatment Moderated by Treatment with Antidepressants or Psychiatric Comorbidity? A Secondary Analysis from a Large Randomized Double Blind Study of Adults with ADHD
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SUMMARY: Aims: The main aim of this post hoc analysis was to evaluate whether response to osmotic release oral system (OROS) methylphenidate (OROS‐MPH) was moderated by the concomitant use of antidepressants in attention‐deficit/hyperactivity disorder (ADHD) adults stabilized on these medicines for the treatment of depression or anxiety disorders, or a history of mood, anxiety, or substance use disorders. Methods: Two hundred and ninety‐six subjects were screened for participation; 227 were randomized (112 to OROS‐MPH and 115 to placebo), and 223 were analyzed ( N = 109 and N = 114 for OROS‐MPH and placebo, respectively). Subjects with anxiety disorders and depression treated with a stable medication regimen of non‐MAOI antidepressants or benzodiazepines for at least 3 months could be enrolled in the study. Subjects currently receiving pharmacotherapy for anxiety disorders or depression were required to have Hamilton‐Depression and Hamilton‐Anxiety rating scales below 15 (mild range). Results: Concomitant antidepressant use at baseline was not associated with ADHD response, OROS‐MPH dose, study completion rate, adverse effects, or exacerbation of anxiety/depression. We did find nominally significant evidence that a lifetime history of mood ( P = 0.09) or anxiety ( P = 0.04) disorders was a moderator of ADHD symptoms and that a lifetime history of substance use disorder ( P = 0.02) was a potential moderator of dose at endpoint. Discussion and Conclusions: We found few moderating effects in this large clinical trial of OROS‐MPH in adults with ADHD, which supports the robustness of the clinical response to OROS‐MPH in adult ADHD despite variable clinical pictures.
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Many studies have reported improvements in comorbid psychiatric symptoms when ADHD is effectively treated.
“Many studies have reported improvements in comorbid psychiatric symptoms when ADHD is effectively treated.”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [113]
The Discussion (page not specified) says that stimulants do not treat depression or anxiety disorders, rather than reporting improvement in those comorbid conditions when ADHD is treated. The Results (page not specified) found a significant ADHD response to OROS-methylphenidate but no difference from placebo in depression or anxiety symptoms. (LLM, conf=0.86)
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Experimental — accuracy not yet measuredCo-administration of SSRIs or SNRIs with stimulants improves functional outcomes in ADHD with comorbid anxiety or depressive symptoms.
“Other studies have demonstrated the efficacy of co-administration of SSRIs or serotonin-norepinephrine reuptake inhibitors (SNRIs) with stimulants on functional outcomes in ADHD with comorbid anxiety or depressive symptoms [113,114].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [113]
The Discussion (p. 130) concludes that concomitant antidepressant use did not interfere with the safety or ADHD efficacy of OROS-methylphenidate. That does not establish improved functional outcomes from co-administration: the Results analyze antidepressants as a group, and the Introduction states that people with active depression or anxiety were excluded. (LLM, conf=0.86)
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- Authors
- Biederman, J., Mick, E., Spencer, T., Surman, C., & Faraone, S. V.
- Affiliations
- Harvard University (US)
- SUNY Upstate Medical University (US)
- Corresponding author
- Biederman, Joseph
- Venue
- CNS Neuroscience & Therapeutics
- Publisher
- Wiley
- Published
- 2011-08-05
- Volume
- 18
- Issue
- 2
- Pages
- 126-132
- ISSN
- 1755-5930 (ISSN-L)
- 1755-5949
- PMC
- PMC6493536
- OpenAlex
- W1569188301
- Cited by
- 20
- References
- 31
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2018: 1 · 2017: 1 · 2015: 1 · 2014: 5 · 2013: 1 · 2012: 1
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- CNS Neuroscience & Therapeutics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Janssen Scientific Affairs
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- adult ADHD, OROS methylphenidate, psychiatric comorbidity, mood disorders, anxiety disorders, substance use disorders, treatment moderators, ADHD medication, benzodiazepines
- MeSH terms
- Administration, Oral, Adult, Antidepressive Agents, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Delayed-Action Preparations, Double-Blind Method, Drug Interactions, Female, Humans, Male, Methylphenidate, Middle Aged, Osmosis, Comorbidity, Treatment Outcome, Young Adult
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