Cited by 97Attention Deficit Hyperactivity DisorderTraffic and Road SafetyPharmaceutical studies and practices

Controlled-Release Methylphenidate Improves Attention During On-Road Driving by Adolescents with Attention-Deficit/Hyperactivity Disorder

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Cox, D. J., Humphrey, J. W., Merkel, R. L., Penberthy, J. K., Kovatchev, B.·2004·The Journal of the American Board of Family Medicine

Abstract

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is associated with a 3- to 4-fold increase in both driving-related accidents and associated injuries. Methylphenidate (MPH) is the most commonly prescribed psychostimulant medication for ADHD. It has been demonstrated to improve performance on a driving simulator. This study investigated whether a once-daily, long-acting, osmotic, controlled-release MPH formulation improves the driving performance of ADHD adolescents while driving their own car on an actual road segment. METHODS: Twelve ADHD-diagnosed male adolescent drivers (mean age, 17.8 years) prescribed a standard dose of 1.0 mg/kg (if they were not already taking methylphenidate) of controlled-release MPH participated in this repeated-measures crossover study. On 2 separate occasions (off/on medication randomized), participants drove a standard 16-mile road course incorporating rural, highway, and urban streets. A rater, blind to medication conditions, sat in the back seat and rated impulsive (eg, "cutting off" another driver) and inattentive (eg, drove past designated turn) driving errors. RESULTS: Impulsive driving errors were observed to occur rarely under both medication and no medication conditions. Inattentive driving errors were more common and were significantly reduced while the subject was on medication (4.6 versus 7.8; P <.01). The improvement in driving performance (change in number of errors recorded) from first to second testing was positively correlated with medication dosage (r = 0.60; P <.01). CONCLUSIONS: Once-daily controlled-release MPH improves real-life driving performance of adolescent males diagnosed with ADHD. In particular, it significantly reduces driving errors arising from inattention.

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Research works printed but not linked: 3

  1. Murphy K, Barkley RA. Attention deficit hyperac- tivity disorder adults: comorbidities and adaptive im- pairments. Comp Psychiatry 1996;37:393-401.
  2. DuPaul G, Power T, Anastopoulos A, Reid R. ADHD rating scale-IV. New York: Guilford Press; 1998.
  3. Biederman J. Practical considerations in stimulant drug selection for the attention-deficit/hyperactivity patient-efficacy, potency and titration. Today's Therapeutic Trends 2002;20:311-28.

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Authors
Cox, D. J., Humphrey, J. W., Merkel, R. L., Penberthy, J. K., & Kovatchev, B.
Affiliations
  • University of Virginia (US)
  • University of Virginia Health System (US)
Venue
The Journal of the American Board of Family Medicine
Published
2004-07-01
Volume
17
Issue
4
Pages
235-239
ISSN
  • 1557-2625 (ISSN-L)
  • 1558-7118
OpenAlex
W2133838173
Cited by
97
References
21
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 3 · 2013: 1 · 2012: 8
FWCI
6.01
Type
journal article
Language
en
Open access
Locations
  • The Journal of the American Board of Family Medicine (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
attention deficit hyperactivity disorder, methylphenidate, adolescents, driving performance, inattention, road safety, psychostimulants, drug dosing
MeSH terms
Adolescent, Central Nervous System Stimulants, Attention, Attention Deficit Disorder with Hyperactivity, Automobile Driving, Drug Administration Schedule, Humans, Impulsive Behavior, Male, Methylphenidate, Treatment Outcome

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