PMID- 25015027
OWN - NLM
STAT- MEDLINE
DCOM- 20150511
LR  - 20211021
IS  - 1179-1918 (Electronic)
IS  - 1173-2563 (Print)
IS  - 1173-2563 (Linking)
VI  - 34
IP  - 9
DP  - 2014 Sep
TI  - Open-label dose optimization of methylphenidate modified release long acting 
      (MPH-LA): a post hoc analysis of real-life titration from a 40-week randomized 
      trial.
PG  - 639-49
AB  - BACKGROUND AND OBJECTIVES: In the management of attention-deficit hyperactivity 
      disorder (ADHD) in adults it is important to recognize that individual patients 
      respond to a wide range of methylphenidate doses. Studies with methylphenidate 
      modified release long acting (MPH-LA) in children have reported the need for 
      treatment optimization for improved outcomes. We report the results from a post 
      hoc analysis of a 5-week dose optimization phase from a large randomized, 
      placebo-controlled, multicenter 40-week study (9-week double-blind dose 
      confirmation phase, 5-week open-label dose optimization phase, and 26-week 
      double-blind maintenance of effect phase). METHODS: Patients entering the 
      open-label dose optimization phase initiated treatment with MPH-LA 20 mg/day; 
      up/down titrated to their optimal dose (at which there was balance between 
      control of symptoms and side effects) of 40, 60, or 80 mg/day in increments of 20 
      mg/week by week 12 or 13. Safety was assessed by monitoring the adverse events 
      (AEs) and serious AEs. Efficacy was assessed by the Diagnostic and Statistical 
      Manual of Mental Disorders, fourth edition, Attention-Deficit Hyperactivity 
      Disorder Rating Scale (DSM-IV ADHD RS) and Sheehan Disability Scale (SDS) total 
      scores. RESULTS: At the end of the dose confirmation phase, similar numbers of 
      patients were treated optimally with each of the 40, 60, and 80 mg/day doses 
      (152, 177, and 160, respectively) for MPH-LA. Mean improvement from baseline in 
      the dose confirmation phase in total scores of DSM-IV ADHD RS and SDS were 23.5 +/- 
      9.90 and 9.7 +/- 7.36, respectively. CONCLUSIONS: Dose optimization with MPH-LA 
      (40, 60, or 80 mg/day) improved treatment outcomes and was well-tolerated in 
      adult ADHD patients.
FAU - Huss, Michael
AU  - Huss M
FAU - Ginsberg, Ylva
AU  - Ginsberg Y
FAU - Arngrim, Torben
AU  - Arngrim T
FAU - Philipsen, Alexandra
AU  - Philipsen A
FAU - Carter, Katherine
AU  - Carter K
FAU - Chen, Chien-Wei
AU  - Chen CW
FAU - Gandhi, Preetam
AU  - Gandhi P
FAU - Kumar, Vinod
AU  - Kumar V
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Clin Drug Investig
JT  - Clinical drug investigation
JID - 9504817
RN  - 0 (Central Nervous System Stimulants)
RN  - 0 (Delayed-Action Preparations)
RN  - 207ZZ9QZ49 (Methylphenidate)
SB  - IM
MH  - Adult
MH  - Attention Deficit Disorder with Hyperactivity/*drug therapy/physiopathology
MH  - Central Nervous System Stimulants/*administration & dosage/adverse 
      effects/therapeutic use
MH  - Delayed-Action Preparations
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Female
MH  - Humans
MH  - Male
MH  - Methylphenidate/*administration & dosage/adverse effects/therapeutic use
MH  - Middle Aged
MH  - Psychiatric Status Rating Scales
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC4143596
EDAT- 2014/07/13 06:00
MHDA- 2015/05/12 06:00
PMCR- 2014/07/12
CRDT- 2014/07/13 06:00
PHST- 2014/07/13 06:00 [entrez]
PHST- 2014/07/13 06:00 [pubmed]
PHST- 2015/05/12 06:00 [medline]
PHST- 2014/07/12 00:00 [pmc-release]
AID - 213 [pii]
AID - 10.1007/s40261-014-0213-2 [doi]
PST - ppublish
SO  - Clin Drug Investig. 2014 Sep;34(9):639-49. doi: 10.1007/s40261-014-0213-2.