The use of methylphenidate hydrochloride extended-release oral suspension for the treatment of ADHD

Abstract

More than 50 years ago, methylphenidate immediate-release (MPH-IR) was found to be effective in relieving symptoms of attention-deficit/hyperactivity disorder. Although the exact mechanism of the action is unknown, the efficacy of MPH is thought to be mediated by blocking the reuptake of norepinephrine and dopamine into the presynaptic neuron and increasing the release of these neurotransmitters into the extraneuronal space. Because of its short duration of effect, MPH-IR had to be dosed multiple times daily. In recent years, several methyphenidate extended-release (MPH-ER) formulations have been developed. Methylphenidate hydrochloride for extended-release oral suspension (MEROS or Quillivant^TM XR) is the first long-acting MPH-ER oral suspension developed to treat attention-deficit/hyperactivity disorder. It offers advantages when compared with other MPH-ER preparations for patients who cannot or prefer not to swallow or manipulate capsules or wear a transdermal patch, while maintaining comparable efficacy and duration of effect. The pharmacokinetic, efficacy and safety profiles of this controlled substance are reviewed.

Keywords::

• attention-deficit/hyperactivity disorder
• methylphenidate extended-release oral suspension
• NWP06
• Quillivant^TM XR

Financial & competing interests disclosure

A Childress has acted as a consultant and speaker and has received research support from Shire Pharmaceuticals, Inc., Novartis Pharmaceutical Corporation and Pfizer, has acted as a speaker and received research support from Bristol-Myers Squibb, has acted as a consultant and received research support from NextWave Pharmaceuticals, and has received research support from Somerset Pharmaceuticals, Inc. Noven, Abbott Laboratories, Lilly USA, LLC, Ortho-McNeill Janssen Scientific Affairs, Johnson & Johnson Pharmaceutical Research & Development, LLC, Sepracor Inc., Theravance, Forest, Neos, Otsuka, Sunovion and Rhodes. A Childress has also acted as a speaker for GlaxoSmithKline, has acted as a speaker, served on advisory board and received research support from Shionogi, and has acted as a consultant for Ironshore. F Sallee has been a clinical study grant recipient from Shire and Sunovion, has acted as a consultant for Otsuka, Neos, Ironshore Pharma, Purdue Pharma and Impax, and has equity, is a Shareholder of and Member Board of Directors for P2D Bioscience.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder diagnosed in children and adolescents.

• • A substantial number of children and adolescents have difficulty swallowing tablets and capsules.

• • Although effective stimulant treatment is available for ADHD, many formulations are difficult to administer to patients who have difficulty swallowing pills.

• • Methylphenidate hydrochloride for extended-release oral suspension fills an important medical need for patients with difficulty swallowing pills as the only long-acting liquid stimulant available for the treatment of ADHD.

Notes