To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: APA MEETING: Once-Daily Adderall More Effective Than Ritalin For ADHD URL: http://www.pslgroup.com/dg/FF1D6.htm Doctor's Guide May 19, 1999
WASHINGTON, DC -- May 19, 1999 -- A new study presented today at the annual meeting of the American Psychiatric Association shows that Shire Richwood Inc.'s Adderall(R) (mixed salts of a single-entity amphetamine product), a treatment for attention deficit/hyperactivity disorder (ADHD), was significantly better at reducing inattention and other ADHD symptoms than the standard ADHD treatment. These findings were observed with 70 percent of patients taking Adderall on once-daily dosing and 15 percent of patients taking Ritalin(R) (methylphenidate) on once-daily dosing. This type of dosing is important, as it allows children to avoid taking their medication in school. A second study that analysed patient records also showed that children taking Adderall were more likely than those taking Ritalin to avoid needing an in-school dose of medication -- and were less likely to switch or discontinue their medication. "Other drugs used to treat ADHD can require dosing three times a day, including a midday dose that typically must be given at school," said Steven Pliszka, M.D., lead investigator of one of the studies and chief of child and adolescent psychiatry at the University of Texas Health Science Center at San Antonio. "In our study, Adderall not only was more effective, but also lasted longer, so a single dose given in the morning often covered the entire school day." In-school dosing can be a serious issue. Children can suffer from the stigma of having to take their medication at school, in front of their peers. In some instances, teen-agers are put in charge of taking their own medication and may forget -- or be too embarrassed -- to take their midday dose. Bringing a medication to school also increases the chances that it will be misplaced or fall into the wrong hands. In-school dosing also can be a burden on school nurses, who have a variety of responsibilities in addition to dispensing medication to students. The reduced need for in-school dosing could give nurses more time to concentrate on other duties, such as tending to sick students and conducting health education programs in the classroom, according to Judith Vessey, Ph.D., of the National Association of School Nurses. Some schools even lack the resources to have a nurse on staff, adding further to the problem of in-school dosing. "Avoiding having to take medication in school is an important benefit, as it can ease the burden on school staff who are responsible for administering medication and it allows kids to go through their school day without interruption or embarrassment," said Dr. Vessey, professor of nursing at the Johns Hopkins University School of Nursing. In Dr. Pliszka's study, 58 children diagnosed with ADHD were given Adderall, Ritalin, or placebo for three weeks in a double-blind parallel-group design. All groups started week one on a once-daily dosing regimen. If the children's afternoon or evening behaviour did not improve after week one, a midday or 4 p.m. dose was added for week two. Teachers rated morning and afternoon behaviours, while parents rated evening behaviours. Results showed that Adderall was significantly superior to Ritalin in reducing inattention and opposition at the doses studied. In addition, the study showed that 70 percent of patients taking Adderall and 15 percent of patients taking Ritalin were still on once-daily dosing at the end of the study, based on a pre-defined dose titration scheme. "These new studies clearly support the use of Adderall as a first-line therapy for ADHD, because it can eliminate the issue of in-school dosing and thus help improve compliance -- a major concern with ADHD medications," said Stephen Grcevich, M.D., lead investigator of one of the studies and Senior Clinical Instructor at Case Western Reserve University in Cleveland. Dr. Grcevich's study evaluated data from the medical charts of 164 children with ADHD, and compared the dosing strategies (such as the need for in-school dosing) and safety of Adderall. Fifty-four of the children had been prescribed Adderall during their initial visit, while 75 children had been prescribed Ritalin. The study showed that 48 percent of children who took Adderall did not require in-school dosing, whereas 88 percent of children who took Ritalin did require an in-school dose. In addition, only nine percent of children who took Adderall discontinued or switched their initial therapy within the first six months of treatment, compared with 39 percent of children who started therapy with Ritalin. In the studies, both medications were well tolerated, and side effects were similar to placebo. The most common side effects associated with stimulant use are insomnia, loss of appetite, stomach pain, headache, irritability and weight loss. ADHD affects three percent to five percent of all school-age children and is considered the most frequently diagnosed psychiatric disorder in children and adolescents. The most common behaviours exhibited by those who have ADHD are inattention, hyperactivity and impulsivity. Psychostimulants -- medications that stimulate areas of the brain that control attention, impulses and self-regulation of behaviour -- are among the most successful treatments for people with ADHD. In fact, at least 70 percent of children with ADHD respond positively to psychostimulants. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. 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