Social adjustment and family function after drug switch from IR-methylphenidate to OROS-methylphenidate in patients with attention-deficit/hyperactivity disorder

Abstract

Purpose

This prospective, single-arm, open-label, 8-week, multicenter study investigated the effectiveness of switching from immediate-release methylphenidate (IR-MPH) to osmotic controlled-release methylphenidate (OROS-MPH) in patients with attention-deficit/hyperactivity disorder (ADHD).

Patients and methods

Overall, 296 patients with ADHD (mean age: 9.5 years) already on IR-MPH treatment were enrolled. Upon enrollment, a flexible dose of OROS-MPH was administered, replacing IR-MPH. Patients were assessed at baseline and weeks 2, 4, and 8 using the Swanson, Nolan, and Pelham version IV scale (SNAP-IV) and the Clinical Global Impression for ADHD symptoms. The Social Adjustment Inventory for Children and Adolescents assessed social functions, and the Chinese Health Questionnaire (CHQ) and Family Adaptation, Partnership, Growth, Affection, and Resolve evaluated parental and family functions.

Results

Switching from IR-MPH to OROS-MPH yielded significant improvements in all ADHD symptoms, as rated by parents, teachers (SNAP-IV), and study investigators (Clinical Global Impression). CHQ scores and all Social Adjustment Inventory for Children and Adolescents subscores except spare time scores improved significantly. Patients with poor IR-MPH adherence had greater improvements in teacher-rated SNAP-IV and mothers’ mental health (CHQ) after switching.

Conclusion

Switching from IR-MPH to OROS-MPH improved patients’ behavioral ADHD symptoms and social adjustment, and mental health of patients’ mothers. This was most evident in patients who previously exhibited poor IR-MPH adherence.

Keywords:

• ADHD
• central nervous system stimulant
• drug adherence
• family
• social adjustment

Supplementary material

Table S1 Number of available assessments at each visit

Acknowledgments

This study (CCT-TWN-MA6) was sponsored by Janssen Taiwan. We would like to thank all of the child psychiatrists and the study participants and their parents who participated in this study. The abstract of this paper was presented at the IACAPAP 20th world congress as a poster presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” in Neuropsychiatrie de l’Enfance et de l’Adolescence. 2012;60(5):S262 entitled “The family impact in children and adolescent with ADHD after the switch of treatment from immediate-release MPH to OROS-MPH”: http://www.em-consulte.com/en/article/736902.

Author contributions

All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.