Sex differences in the response of children with ADHD to once-daily formulations of methylphenidate

Edmund J.S. Sonuga-Barke, David Coghill, John S. Markowitz, James M. Swanson, Mieke Vandenberghe, Simon J. Hatch

    Research output: Contribution to journalArticle

    37 Citations (Scopus)

    Abstract

    Objectives Studies of sex differences in methylphenidate response by children with attention-deficit/hyperactivity disorder have lacked methodological rigor and statistical power. This paper reports an examination of sex differences based on further analysis of data from a comparison of two once-daily methylphenidate formulations (the COMACS study), which addresses these shortcomings. Method Children (184: 48 females; mean [SD]; age, 9.58 [1.83]; years) entered a double-blind, crossover trial of Concerta, MetadateCD/Equasym XL, or placebo. Attention-deficit/hyperactivity disorder symptoms were recorded at seven time points across the school day on the seventh day of treatment, using a laboratory classroom setting. Results More females had comorbid anxiety disorder. Males and females did not differ with regard to other characteristics. Observed sex differences in pharmacodynamic symptom profiles persisted after controlling for placebo and time 0 hours attention-deficit/hyperactivity disorder scores and the presence of an anxiety disorder. Females had a statistically superior response at 1.5 hours post-dosing and an inferior response at the 12-hour time point relative to their male counterparts, no matter which methylphenidate formulation was being assessed. Conclusions Dose titration of once-daily formulations of methylphenidate should ideally be based on systematic evidence of response at different periods across the day. The responses of female patients may require additional assessments later in the day to determine the optimal dose.
    Original languageEnglish
    Pages (from-to)701-710
    Number of pages10
    JournalJournal of the American Academy of Child & Adolescent Psychiatry
    Volume46
    Issue number6
    DOIs
    Publication statusPublished - Jun 2007

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    Methylphenidate
    Sex Characteristics
    Attention Deficit Disorder with Hyperactivity
    Anxiety Disorders
    Placebos
    Cross-Over Studies

    Keywords

    • Methylphenidate
    • Response
    • Sex differences

    Cite this

    Sonuga-Barke, Edmund J.S. ; Coghill, David ; Markowitz, John S. ; Swanson, James M. ; Vandenberghe, Mieke ; Hatch, Simon J. / Sex differences in the response of children with ADHD to once-daily formulations of methylphenidate. In: Journal of the American Academy of Child & Adolescent Psychiatry. 2007 ; Vol. 46, No. 6. pp. 701-710.
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    abstract = "Objectives Studies of sex differences in methylphenidate response by children with attention-deficit/hyperactivity disorder have lacked methodological rigor and statistical power. This paper reports an examination of sex differences based on further analysis of data from a comparison of two once-daily methylphenidate formulations (the COMACS study), which addresses these shortcomings. Method Children (184: 48 females; mean [SD]; age, 9.58 [1.83]; years) entered a double-blind, crossover trial of Concerta, MetadateCD/Equasym XL, or placebo. Attention-deficit/hyperactivity disorder symptoms were recorded at seven time points across the school day on the seventh day of treatment, using a laboratory classroom setting. Results More females had comorbid anxiety disorder. Males and females did not differ with regard to other characteristics. Observed sex differences in pharmacodynamic symptom profiles persisted after controlling for placebo and time 0 hours attention-deficit/hyperactivity disorder scores and the presence of an anxiety disorder. Females had a statistically superior response at 1.5 hours post-dosing and an inferior response at the 12-hour time point relative to their male counterparts, no matter which methylphenidate formulation was being assessed. Conclusions Dose titration of once-daily formulations of methylphenidate should ideally be based on systematic evidence of response at different periods across the day. The responses of female patients may require additional assessments later in the day to determine the optimal dose.",
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    Sex differences in the response of children with ADHD to once-daily formulations of methylphenidate. / Sonuga-Barke, Edmund J.S.; Coghill, David; Markowitz, John S.; Swanson, James M.; Vandenberghe, Mieke; Hatch, Simon J.

    In: Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 46, No. 6, 06.2007, p. 701-710.

    Research output: Contribution to journalArticle

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    T1 - Sex differences in the response of children with ADHD to once-daily formulations of methylphenidate

    AU - Sonuga-Barke, Edmund J.S.

    AU - Coghill, David

    AU - Markowitz, John S.

    AU - Swanson, James M.

    AU - Vandenberghe, Mieke

    AU - Hatch, Simon J.

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    N2 - Objectives Studies of sex differences in methylphenidate response by children with attention-deficit/hyperactivity disorder have lacked methodological rigor and statistical power. This paper reports an examination of sex differences based on further analysis of data from a comparison of two once-daily methylphenidate formulations (the COMACS study), which addresses these shortcomings. Method Children (184: 48 females; mean [SD]; age, 9.58 [1.83]; years) entered a double-blind, crossover trial of Concerta, MetadateCD/Equasym XL, or placebo. Attention-deficit/hyperactivity disorder symptoms were recorded at seven time points across the school day on the seventh day of treatment, using a laboratory classroom setting. Results More females had comorbid anxiety disorder. Males and females did not differ with regard to other characteristics. Observed sex differences in pharmacodynamic symptom profiles persisted after controlling for placebo and time 0 hours attention-deficit/hyperactivity disorder scores and the presence of an anxiety disorder. Females had a statistically superior response at 1.5 hours post-dosing and an inferior response at the 12-hour time point relative to their male counterparts, no matter which methylphenidate formulation was being assessed. Conclusions Dose titration of once-daily formulations of methylphenidate should ideally be based on systematic evidence of response at different periods across the day. The responses of female patients may require additional assessments later in the day to determine the optimal dose.

    AB - Objectives Studies of sex differences in methylphenidate response by children with attention-deficit/hyperactivity disorder have lacked methodological rigor and statistical power. This paper reports an examination of sex differences based on further analysis of data from a comparison of two once-daily methylphenidate formulations (the COMACS study), which addresses these shortcomings. Method Children (184: 48 females; mean [SD]; age, 9.58 [1.83]; years) entered a double-blind, crossover trial of Concerta, MetadateCD/Equasym XL, or placebo. Attention-deficit/hyperactivity disorder symptoms were recorded at seven time points across the school day on the seventh day of treatment, using a laboratory classroom setting. Results More females had comorbid anxiety disorder. Males and females did not differ with regard to other characteristics. Observed sex differences in pharmacodynamic symptom profiles persisted after controlling for placebo and time 0 hours attention-deficit/hyperactivity disorder scores and the presence of an anxiety disorder. Females had a statistically superior response at 1.5 hours post-dosing and an inferior response at the 12-hour time point relative to their male counterparts, no matter which methylphenidate formulation was being assessed. Conclusions Dose titration of once-daily formulations of methylphenidate should ideally be based on systematic evidence of response at different periods across the day. The responses of female patients may require additional assessments later in the day to determine the optimal dose.

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