Extended-release dexmethylphenidate 30 mg/d versus 20 mg/d: duration of
attention, behavior, and performance benefits in children with
attention-deficit/hyperactivity disorder.
Author(s): Silva RR(1), Brams M, McCague K, Pestreich L, Muniz R.
Affiliation(s): Author information:
(1)Academic Behavioral Center, New York, NY, USA. RaulSilvaMD@gmail.com
Publication date & source: 2013, Clin Neuropharmacol. , 36(4):117-21
OBJECTIVE: This study aimed to compare the effects of dexmethylphenidate (D-MPH)
extended-release (ER) 30 mg and D-MPH-ER 20 mg on attention, behavior, and
performance in children with attention-deficit/hyperactivity disorder.
METHODS: In a randomized, double-blind, 3-period-by-3-treatment, crossover study,
children aged 6 to 12 years with attention-deficit/hyperactivity disorder
stabilized on methylphenidate (40-60 mg/d) or D-MPH (20-30 mg/d) received
D-MPH-ER 20 mg/d, 30 mg/d, and placebo for 7 days each (final dose of each
treatment period administered in a laboratory classroom). Swanson, Kotkin, Agler,
M-Flynn, and Pelham (SKAMP) Combined (Attention and Deportment) rating scale and
Permanent Product Measure of Performance (PERMP) math test assessments were
conducted at baseline and 3, 6, 9, 10, 11, and 12 hours postdose.
RESULTS: A total of 165 children (94 boys; mean age, 9.6 years) were randomized
(162 included in intent-to-treat analyses). Significant improvements were noted
for D-MPH-ER 30 mg over D-MPH-ER 20 mg at various late time points on the SKAMP
scales (Combined scores at 9, 10, 11, and 12 hours postdose; Attention scores at
10, 11, and 12 hours postdose; deportment scores at 9 and 12 hours postdose). The
PERMP math test-attempted and -correct scores (change from predose) were
significantly higher with D-MPH-ER 30 mg than with D-MPH-ER 20 mg at 10, 11, and
12 hours postdose. Both D-MPH-ER doses were superior to placebo at all time
points.
CONCLUSIONS: D-MPH-ER 30 mg was superior to D-MPH-ER 20 mg at later time points
in the day, suggesting that higher doses of D-MPH-ER may be more effective later
in the day.
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