Journal
EUROPEAN NEUROPSYCHOPHARMACOLOGY
Volume 21, Issue 7, Pages 508-515Publisher
ELSEVIER
DOI: 10.1016/j.euroneuro.2010.11.005
Keywords
ADHD; Adults; OROS-methylphenidate; Cognitive performance
Funding
- Ortho-McNeil Janssen Scientific Affairs, LLC
- Pediatric Psychopharmacology Council
- Elminda
- Janssen
- McNeil
- Shire
- Fundacion Areces
- Medice Pharmaceuticals
- Spanish Child Psychiatry Association
- Abbott
- Alza
- AstraZeneca
- Bristol Myers Squibb
- Celltech
- Cephalon
- Eli Lilly and Co.
- Esai
- Forest
- Glaxo
- Gliatech
- Merck
- NARSAD
- NIDA
- New River
- NICHD
- NIMH
- Novartis
- Noven
- Neurosearch
- Organon
- Otsuka
- Pfizer
- Pharmacia
- Prechter Foundation
- Stanley Foundation
- UCB Pharma, Inc.
- Wyeth
- Shire Pharmaceuticals
- Eli Lilly
- National Institutes of Health
- Ortho-McNeil
- Shire Development
- Shire Laboratories, Inc
- Glaxo-Smith Kline
- Janssen Pharmaceutical
- McNeil Pharmaceutical
- Novartis Pharmaceuticals
- National Institute of Mental Health
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The objective of this study was to evaluate the association between executive function deficits (EFDs) and response to methylphenidate treatment in ADHD in adults. We conducted a 6-week, parallel design, randomized, placebo controlled study in adults with DSM-IV ADHD. Our psychometric index of executive function used standardized neuropsychological testing. We assessed behaviors reflective of EFDs using the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A). Subjects with available measures of executive functioning (OROS-MPH N=40; Placebo N=47) were included for analysis. There was no difference in the percent of subjects completing the 6-week acute efficacy Phase I of the trial (100% (N=40) vs. 98% (N=46), p=0.4). The mean daily dose at Phase I endpoint was 84.6 +/- 31.6 mg (1.04 +/- 0.29 mg/kg) OROS-MPH and 100.5 +/- 21.9 mg (1.20 +/- 0.11 mg/kg) placebo (p=0.0007). Based on the neuropsychological testing at the baseline assessment, 40% of the ADHD subjects (N=35/87) were considered to have EFDs but 93% (N=81) of subjects had >= 2 BRIEF-A clinical scale T-scores >65. Regardless of the definition used, however, EFDs did not impact the clinical response to OROS-MPH. This randomized clinical trial showed that executive function deficits do not moderate the response to methylphenidate and measures of executive function deficits are not associated with response to OROS-MPH. (C) 2010 Elsevier B.V. and ECNP. All rights reserved.
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