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The clinical profile of children with ADHD that require OROS-methylphenidate combined with shorter-acting formulations

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ADHD Attention Deficit and Hyperactivity Disorders

Abstract

Long-acting methylphenidate (MPH) formulations, including OROS-MPH, were found to be effective in alleviating ADHD symptoms throughout the day. However, sustained stimulant activity may lead to prolonged suppression of appetite and insomnia. In this study, we characterized the clinical profile of children and adolescents for whom a once-daily lower dose of OROS-MPH combined with a shorter-acting agent was more tolerable than single higher OROS-MPH dose. In our cohort of 128 children treated with OROS-MPH, 47 (36.7 %) better tolerated a lower dose of OROS-MPH combined with short-acting MPH formulations (Group I). Nevertheless, for the majority (81 patients—63.3 %), a standard single moderate dose of OROS-MPH was sufficient (Group II). The mean daily doses of MPH were: 0.83 ± 0.21 mg/kg for Group I and 1.06 ± 0.29 mg/kg for Group II. There were no significant differences in the prevalence of learning disorders, tic disorders, epilepsy and conduct disorders between these two groups. However, anxiety and marginally depression were more prevalent in Group I (46.8 and 9.7 %) than in Group II (27.2 and 1.2 %). Patients in Group I were also more tending to receive psychotherapy than patients in Group II.

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Conflict of interest

The authors received no financial support for the research and declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Ethical standard

The study was approved by the Clalit Health Services Institutional Review Board (Helsinki Committee).

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Authors and Affiliations

  1. Department of Pediatrics, Child Development Center, Carmel Medical Center, Clalit Health Services, Haifa, Israel

    Nathanel Zelnik

  2. Child Development Center, Clalit Health Services, Haifa, Israel

    Ruth Terkel-Dawer

  3. The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel

    Nathanel Zelnik

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  1. Nathanel Zelnik
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  2. Ruth Terkel-Dawer
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Correspondence to Nathanel Zelnik.

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Zelnik, N., Terkel-Dawer, R. The clinical profile of children with ADHD that require OROS-methylphenidate combined with shorter-acting formulations. ADHD Atten Def Hyp Disord 7, 313–318 (2015). https://doi.org/10.1007/s12402-015-0168-z

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  • DOI: https://doi.org/10.1007/s12402-015-0168-z

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