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

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    51 Citations (Scopus)


    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 and Adolescent Psychiatry
    Issue number6
    Publication statusPublished - Jun 2007


    • Methylphenidate
    • Response
    • Sex differences


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