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Study Identifies Predictive Factors for Successful Treatment With Long-Acting Methylphenidate in Adult ADHD: Presented at ECNP

By Jenny Powers

ISTANBUL, Turkey -- September 19, 2009 -- Optimal treatment outcomes with long-acting osmotic controlled-release formulation of methylphenidate (MPH) in the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults are gender, age, and educational-status dependent, researchers stated here on September 15 at the 22nd European College of Neuropsychopharmacology (ECNP) Congress.

The post hoc analysis of the Long-Acting Methylphenidate in Adult ADHD (LAMDA) study showed that although all patients experienced symptom control, the strongest response to the long-acting MPH formulation was seen in patients who were male, employed, and had less formal education.

Angelica Ramos-Quiroga, Department of Psychiatry, Adult ADHD Program, Hospital Universitari Vall d'Hebron, Barcelona, Spain, and colleagues conducted the post hoc analysis.

In the LAMDA study, patients with ADHD aged 18 to 65 years were randomised to receive long-acting MPH 18 mg/day (n = 101), 36 mg/day (n = 102), 72 mg/day (n = 102), or placebo (n = 96). During the open-label (OL) phase of the study, the drug was flexibly dosed (18-90 mg/day).

The primary outcome was change in Conners' Adult ADHD Rating Scale (CAARS) score from baseline.

A significant treatment effect in total CAARS score (P < .05) was observed in both the double-blind (DB) and OL phases of the study for patients receiving MPH.

Positive associations with the reduction from baseline to the double-blind endpoint in CAARS were older age (P = .0358), male gender (P = .0056), and less education (P = .0079).

There was a greater reduction from baseline to OL endpoint in CAARS score for employed individuals, compared with unemployed (P = .0467).

Patients who were most likely to achieve normal range CAARS (within 95% range of non-ADHD population) at DB endpoint were male (P = .0001), had lower baseline CAARS (P = .0107), and received active treatment (P = .0303).

According to CAARS measurement, patients most likely to achieve normal range were those individuals who received treatment at the highest dose level, were employed, and had a lower baseline CAARS score; the greatest overall score reduction was seen in males, older individuals, and those with less education.

[Presentation title: Predictors of Treatment Outcome With Long-Acting Methylphenidate in Attention Deficit Hyperactivity Disorder in Adults. Abstract P.1.i.031]

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