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Outcomes of OROS® methylphenidate compared with atomoxetine in children with ADHD: A multicenter, randomized prospective study

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Abstract

This community-based study was designed to evaluate treatment outcomes with OROS® methylphenidate (MPH) and atomoxetine in children with attentiondeficit/hyperactivity disorder (ADHD), as assessed by physicians and parents in a setting that resembles clinical practice. In a multicenter, prospective, open-label study, children 6 to 12 years of age with ADHD were randomized (2:1, respectively) to 3 weeks of treatment with once-daily OROS MPH or atomoxetine. Investigatorrated measures of symptoms included the ADHD Rating Scale (ADHD-RS) and the Clinical Global Impression-Improvement of Illness scale (CGI-I). Assessments were made at baseline and during a telephone interview in week 1, a clinic visit in week 2, and a final clinic visit in week 3. In total, 1323 patients received OROS MPH (n=850) or atomoxetine (n=473). Significant reductions from baseline in investigator-evaluated ADHD-RS scores were observed among patients receiving OROS MPH and those receiving atomoxetine. At the end of the study, mean decreases from baseline ADHD-RS scores were 20.24 for OROS MPH and 16 for atomoxetine (P < .001). Between-treatment differences appeared to increase over time (2.77, 3.44, and 4.24 at weeks 1, 2, and 3, respectively; P < .001). Treatment response (ie, 25% reduction from baseline ADHD-RS scores) was significantly greater at each evaluation for patients taking OROS MPH than for those taking atomoxetine (P < .001). Similar percentages of patients taking OROS MPH (4.8%) and atomoxetine (5.5%) withdrew because of adverse events. Although community-based studies often lack the control of randomized, placebo-controlled trials, these results nevertheless suggest greater ADHD symptom improvement with OROS MPH compared with atomoxetine.

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References

  1. American Academy of Pediatrics. Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder.Pediatrics. 2000;105:1158–1170.

    Article  Google Scholar 

  2. Greenhill LL, Pliszka S, Dulcan MK, et al. Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults.J Am Acad Child Adolesc Psychiatry. 2002; 41(suppl):26S-49S.

    Article  PubMed  Google Scholar 

  3. Goldman LS, Genel M, Bezman RJ, Slanetz PJ. Diagnosis and treatment of attention-deficit/ hyperactivity disorder in children and adolescents: Council on Scientific Affairs, American Medical Association.JAMA. 1998;279:1100–1107.

    Article  PubMed  CAS  Google Scholar 

  4. Perrin JM, Stein MT, Amler RW, et al. Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder.Pediatrics. 2001;108:1033–1044.

    Article  Google Scholar 

  5. Wilens T, McBurnett K, Stein M, et al. ADHD treatment with once-daily OROS methylphenidate: final results from a long-term open-label study.J Am Acad Child Adolesc Psychiatry. 2005;44:1015–1023.

    Article  PubMed  Google Scholar 

  6. Pelham WE, Gnagy EM, Burrows-Maclean L, et al. Once-a-day Concerta methylphenidate versus three-times-daily methylphenidate in laboratory and natural settings [abstract].Pediatrics. 2001; 107:E105.

    Article  PubMed  CAS  Google Scholar 

  7. Wolraich ML, Greenhill LL, Pelham W, et al. Randomized, controlled trial of OROS methylphenidate once a day in children with attention-deficit/hyperactivity disorder.Pediatrics. 2001;108:883–892.

    Article  PubMed  CAS  Google Scholar 

  8. Michelson D, Allen AJ, Busner J, et al. Once-daily atomoxetine treatment for children and adolescents with attention deficit hyperactivity disorder: a randomized, placebo-controlled study.Am J Psychiatry. 2002;159:1896–1901.

    Article  PubMed  Google Scholar 

  9. Spencer T, Heiligenstein JH, Biederman J, et al. Results from 2 proof-of-concept, placebo-controlled studies of atomoxetine in children with attention-deficit/hyperactivity disorder.J Clin Psychiatry. 2002;63:1140–1147.

    PubMed  CAS  Google Scholar 

  10. Kratochvil CJ, Heiligenstein JH, Dittmann R, et al. Atomoxetine and methylphenidate treatment in children with ADHD: a prospective, randomized, open-label trial.J Am Acad Child Adolesc Psychiatry. 2002;41:776–784.

    Article  PubMed  Google Scholar 

  11. Ahmed SM, Beck B, Maurana CA, Newton G. Overcoming barriers to effective communitybased participatory research in US medical schools.Educ Health (Abingdon). 2004;17:141–151.

    Article  Google Scholar 

  12. Khanlou N, Peter E. Participatory action research: considerations for ethical review.Soc Sci Med. 2005;60:2333–2340.

    PubMed  CAS  Google Scholar 

  13. American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  14. Faries DE, Yalcin I, Harder D, Heiligenstein JH. Validation of the ADHD rating scale as a clinician administered and scored instrument.J Atten Disord. 2001;5:107–115.

    Article  Google Scholar 

  15. Guy W.ECDEU Assessment Manual for Psychopharmacology. Rockville, Md: National Institutes of Health; 1976.

    Google Scholar 

  16. Wigal S, McGough JJ, McCracken JT, et al. A laboratory school comparison of mixed amphetamine salts extended release (Adderall XR) and atomoxetine (Strattera) in school-aged children with attention deficit/hyperactivity disorder.J Atten Disord. 2005;9:275–289.

    Article  PubMed  Google Scholar 

  17. Steinhoff KW, Wigal T, Swanson J. Single daily-dose ADHD medication treatment effect size evaluation. Poster presented at: 50th Anniversary Meeting of the American Academy of Child and Adolescent Psychiatry; October 14–19, 2003; Miami Beach, Fla.

  18. Faraone SV. Understanding the effect size of ADHD medications: implications for clinical care.Medscape. 2003;8:1–7.

    Google Scholar 

  19. Crosby RD, Kolotkin RL, Williams GR. Defining clinically meaningful change in health-related quality of life.J Clin Epidemiol. 2003;56:395–407.

    Article  PubMed  Google Scholar 

  20. Swanson J, Gupta S, Lam A, et al. Development of a new once-a-day formulation of methylphenidate for the treatment of attention-deficit/hyperactivity disorder.Arch Gen Psychiatry. 2003;60:204–211.

    Article  PubMed  CAS  Google Scholar 

  21. MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder: Multimodal Treatment Study of Children With ADHD.Arch Gen Psychiatry. 1999;56:1073–1086.

    Article  Google Scholar 

  22. Michelson D, Adler L, Spencer T, et al. Atomoxetine in adults with ADHD: two randomized, placebo-controlled studies.Biol Psychiatry. 2003;53:112–120.

    Article  PubMed  CAS  Google Scholar 

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Kemner, J.E., Starr, H.L., Ciccone, P.E. et al. Outcomes of OROS® methylphenidate compared with atomoxetine in children with ADHD: A multicenter, randomized prospective study. Adv Therapy 22, 498–512 (2005). https://doi.org/10.1007/BF02849870

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