CoChat
Sign Up
Cited by 123Attention Deficit Hyperactivity DisorderPharmacogenetics and Drug MetabolismPharmaceutical studies and practices

Pharmacokinetic and Pharmacodynamic Drug Interactions in the Treatment of Attention-Deficit Hyperactivity Disorder

Markowitz, John S., Patrick, Kennerly S.·2001·Clinical Pharmacokinetics
DOI 10.2165/00003088-200140100-00004
Open this paper in CoChat — free account

Abstract

The psychostimulants methylphenidate, amphetamine and pemoline are among the most common medications used today in child and adolescent psychiatry for the treatment of patients with attention-deficit hyperactivity disorder. Frequently, these medications are used in combination with other medications on a short or long term basis. The present review examines psychostimulant pharmacology, summarises reported drug-drug interactions and explores underlying pharmacokinetic and pharmacodynamic considerations for interactions. A computerised search was undertaken using Medline (1966 to 2000) and Current Contents to provide the literature base for reports of drug-drug interactions involving psychostimulants. These leads were further cross-referenced for completeness of the survey. Methylphenidate appears to be more often implicated in pharmacokinetic interactions suggestive of possible metabolic inhibition, although the mechanisms still remain unclear. Amphetamine was more often involved in apparent pharmacodynamic interactions and could potentially be influenced by medications affecting cytochrome P450 (CYP) 2D6. No published reports of drug interactions involving pemoline were found. The alpha2-adrenergic agonists clonidine and guanfacine have been implicated in several interactions. Perhaps best documented is their antagonism by tricyclic antidepressants and phenothiazines. In additional, concurrent beta-blocker use, or abrupt discontinuation, can lead to hypertensive response. Although there are few published well-controlled interaction studies with psychostimulants and alpha2-adrenergic agonists, it appears that these agents may be safely coadministered. The interactions of monoamine oxidase inhibitors with psychostimulants represent one of the few strict contraindications.

Integrity signals

Registry

Crossref · 10.2165/00003088-200140100-00004

Cites

158 of 158 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A recent review concluded that methylphenidate is more implicated in pharmacokinetic interactions suggestive of possible metabolic inhibition, while amphetamine is more involved in pharmacodynamic interactions and could potentially be influenced by medications affecting cytochrome P450 (CYP2D6).

    “A recent review on drug interactions in the treatment of ADHD concluded that methylphenidate appears to be more implicated in pharmacokinetic interactions suggestive of possible metabolic inhibition, while amphetamine was more involved in pharmacodynamic interactions and could potentially be influenced by medications affecting cytochrome P450 (CYP2D6) [304].”

    From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [304]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Markowitz, J. S., & Patrick, K. S.
Affiliations
Medical University of South Carolina (US)
Corresponding author
Patrick, Kennerly S.
ORCID
Venue
Clinical Pharmacokinetics
Publisher
Springer Science and Business Media LLC
Published
2001
Volume
40
Issue
10
Pages
753-772
ISSN
0312-5963 (ISSN-L)
DOI
10.2165/00003088-200140100-00004
OpenAlex
W2051606673
Cited by
123
References
158
Citations by year
2026: 2 · 2025: 1 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 7 · 2016: 10 · 2015: 2 · 2014: 6 · 2013: 7 · 2012: 3
FWCI
0.88
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Pharmacokinetics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
Keywords
drug-drug interactions, attention deficit hyperactivity disorder, psychostimulants, methylphenidate, amphetamine, pemoline, CYP2D6, alpha-2 adrenergic agonists, clonidine, guanfacine, tricyclic antidepressants, phenothiazines, beta-blockers, monoamine oxidase inhibitors, pharmacokinetic interactions, pharmacodynamic interactions
MeSH terms
Adrenergic alpha-Agonists, Adult, Central Nervous System Stimulants, Anticonvulsants, Antidepressive Agents, Antihypertensive Agents, Attention Deficit Disorder with Hyperactivity, Child, Drug Interactions, Humans

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review