Help your ADHD patients start the day well

The early peak of Ritalin® LA Covers the start of the school or work day and second peak prepares for the rest of the day.^4-7

This study was conducted in adults aged 21-34 years.

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Methylphenidate in the classroom – the formulation matters

Comparative efficacy of Ritalin® LA (20 mg and 40 mg) and Concerta® (18 mg and 36 mg) in children with ADHD in a five-way, randomised, placebo-controlled, single-blind, crossover study conducted in a classroom setting.²

Methods 

Children 6–12 years of age diagnosed with ADHD and stabilized on MPH (20–40 mg/day) participated in a five-way, randomised, placebo-controlled, single-blind, crossover study conducted in a laboratory classroom setting. Children alternately received single doses of extended-release MPH (Ritalin® LA) 20 and 40 mg, modified-release MPH (Concerta®)18 and 36 mg, and placebo over 6 consecutive weeks. Efficacy was assessed using SKAMP rating subscales and written math tests. Data were examined using between-treatment comparisons of area under the curve (AUC) for change from pre dose values during hours 0–4, 0–8, 8–12, and 0–12.

Results

• Fifty-three children completed the study
• For all efficacy measures, improvements from pre dose were significantly greater with Ritalin® LA40 mg than with Concerta® 36 mg in terms of AUC_0–4 (p ≤ 0.005), AUC_0–8 (p ≤ 0.006), and AUC_0–12 (p ≤ 0.035)
• For most measures, Ritalin LA® 20 mg was equivalent to both doses (18 mg and 36 mg) of Concerta® in AUC_0-4, AUC_0–8, andAUC_0–12
• No serious adverse events were reported

Conclusions 

• The efficacy of Ritalin LA20 mg is similar to that of Concerta® 18 and 36 mg during the first 8 hours post dose.
• Statistically greater benefits are observed with Ritalin® LA 40 mg than with Concerta® 36 mg and persist through hour 8 (p<0.001). 
• Active treatments show comparable efficacy from 8 to 12 hours post dose. 
• Both doses of each MPH formulation are well tolerated.

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References:

1. Maldonado R. Comparison of the pharmacokinetics and clinical efficacy of new extended-release formulations of methylphenidate. Expert Opin Drug Metab Toxicol 2013;9(8):1001-14. 

2. Silva R, Muniz R et al. Efficacy of two long-acting methylphenidate formulations in children with attention- deficit/hyperactivity disorder in a laboratory classroom setting. J Child Adolesc Psychopharmacol 2005;15(4):637-54. 

3. Ritalin Canadian Prescribing Information. Novartis Pharmaceuticals. 

4. Markowitz et al. Pharmacokinetics of Methylphenidate After Oral Administration of Two Modified-Release Formulations in Healthy Adults Clin Pharmacokinet 2003;42(4):393-401. 

5. Lopez F et al. Pediatric Drugs 2003;5(8):545-555 

6. Rafael Maldonado (2013) Comparison of the pharmacokinetics and clinical efficacy of new extended-release formulations of methylphenidate, Expert Opinion on Drug Metabolism & Toxicology, 9:8, 1001-1014, DOI: 10.1517/17425255.2013.7860412. 

7. Data on File 2020.