Methylphenidate challenge test in adults with attention deficit/hyperactivity disorder (ADHD): Clinical effects and their predictors
Corresponding Author
Daria Piacentino
Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
Correspondence
Daria Piacentino, Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Lorenz-Böhler-Straße 5, 39100 Bolzano-Bozen, Italy.
Email: [email protected]
Search for more papers by this authorPietro De Rossi
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
ASL RM5, SPDC Monterotondo, Rome, Italy
Search for more papers by this authorGeorgios D. Kotzalidis
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
Search for more papers by this authorIgnazio Maniscalco
Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
Search for more papers by this authorMaurizio Pompili
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
Search for more papers by this authorGiancarlo Giupponi
Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
Search for more papers by this authorChristoph Hiemke
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Mainz, Mainz, Germany
Search for more papers by this authorAndreas Conca
Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
Search for more papers by this authorCorresponding Author
Daria Piacentino
Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
Correspondence
Daria Piacentino, Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Lorenz-Böhler-Straße 5, 39100 Bolzano-Bozen, Italy.
Email: [email protected]
Search for more papers by this authorPietro De Rossi
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
ASL RM5, SPDC Monterotondo, Rome, Italy
Search for more papers by this authorGeorgios D. Kotzalidis
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
Search for more papers by this authorIgnazio Maniscalco
Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
Search for more papers by this authorMaurizio Pompili
NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
Search for more papers by this authorGiancarlo Giupponi
Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
Search for more papers by this authorChristoph Hiemke
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Mainz, Mainz, Germany
Search for more papers by this authorAndreas Conca
Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
Search for more papers by this authorAbstract
Objective
Adult and children attention deficit/hyperactivity disorder (ADHD) share similar symptoms and responses to drugs such as methylphenidate (MPH). Yet, in Europe, these drugs remain unlicensed for adults. We aimed to assess the effects of an acute MPH challenge on the four dimensions concentration, impulsivity, tension, and general well-being in ADHD adults, and identify predictors of improvement.
Methods
Therapeutic Drug Monitoring was performed to measure MPH plasma levels. A Visual Analogue Scale was administered to patients before and after the acute MPH challenge to measure self-reported changes in the four dimensions.
Results
After the acute MPH challenge, our 71 patients showed significant improvement in concentration and tension. The MPH challenge dose correlated with lower patients' age, greater side effects, increased concentration (p = .008) and decreased tension (p = .001). At multiple linear regression MPH plasma levels and absence of postdose side effects predicted concentration improvement, MPH plasma levels predicted tension improvement. MPH plasma levels were significantly higher in patients who reported an improvement in concentration, tension, and impulsivity compared to nonimprovers (p’s from .001 to .004).
Conclusions
These findings point to the efficacy of MPH challenge in improving concentration and tension in adult ADHD, thus emphasizing the need for a broader treatment access for these patients.
CONFLICT OF INTERESTS
All authors declare the absence of any sort of conflict of interests.
Supporting Information
| Filename | Description |
|---|---|
| hup2740-sup-0001-Tables.docxWord 2007 document , 24.5 KB | Table S1 Multiple linear regression of concentration improvement versus nonimprovement Table S2. Multiple linear regression of tension improvement versus nonimprovement |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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