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Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects children, adolescents, and adults worldwide. The purpose of this review was to inform pharmacists of the numerous options to treat ADHD, with a focus on one of the more recently approved formulations, methylphenidate extended-release oral suspension (MEROS). Symptoms of ADHD can negatively impact an individual’s health and quality of life and impair function in multiple settings. Psychostimulants such as methylphenidate- and amphetamine-based agents are first-line pharmacologic treatments for ADHD. However, there are multiple formulations, including immediate release (administered two to three times/day), solid extended release (ER), or transdermal patch. MEROS is a once daily, long-acting liquid preparation that has demonstrated favorable safety and efficacy in patients with ADHD. MEROS may improve treatment adherence in patients who cannot tolerate or have difficulties administering pill or transdermal patch formulations

Abstract:

Purpose: To review the current literature on the various extended-release methylphenidate stimulant preparations regarding safety and efficacy in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Summary: The literature reviewed establishes the efficacy of the different long-acting methylphenidate stimulant formulations in treating children and adolescents with ADHD. Comparing and contrasting the different extended-release preparations allows for clinicians to help tailor ADHD treatments to individual patients. The extended release methylphenidate products provide the same efficacy as the immediate release formulations, but add the convenience of less frequent dosing. There are a few options for patients with difficulty swallowing tablets or capsules, including the Daytrana® transdermal patch and the liquid Quillivant XR®. Focalin XR®, Metadate CD®, and Ritalin LA® can all be opened and sprinkled on applesauce. Conclusions: Extended-release methylphenidate is effective in treating the symptoms of ADHD in children and adolescents. The different available dosage forms gives the clinician the opportunity to individualize treatment based on patient needs. *Data Sources: The literature included was retrieved from PubMed/MEDLINE using the terms methylphenidate, stimulant, extended-release, children, and attention/hyperactivity disorder. Reference citations from publications identified were also reviewed. Study Selection and Data Extraction: Double-blind clinical trials found using the search strategy above were included in this review. Open-label studies were included if no double-blind trials were published for that methylphenidate preparation.

David Sugrue | 2 IntroductionAttention-deficit hyperactivity disorder (ADHD) affects approximately 5% of school aged children worldwide. The disease typically presents in early child hood and can significantly impair academic achievement and development.1 Children with ADHD may present with symptoms including hyperactivity, impulsivity, and inattention which are all more pronounced than expected for a child’s developmental age.2 These symptoms can persistent all the way into adolescence and adulthood, impairing the child’s development in all stages. The etiology of ADHD is still not known, but evidence has shown that it consists of neurologic components and the child’s environmental factors.3ADHD can be treated with medications, behavioral therapy, or a combination of the two. Stimulants including methylphenidate and amphetamine are considered first line drug treatment.4There are many approved formulations of methylphenidate available on the market, therefore prescribers need to make clinical decisions as to which formulation is appropriate to initiate therapy or change therapy if needed. Prescribers, such as physicians and nurse practitioners, have the ability to tailor pharmacological therapy to meet the needs of each individual patient The objective of this paper is to review and compare the current methylphenidate preparations available for children to provide clinicians with the opportunity to individualize their patients’ therapy. By summarizing the information and data from current literature on the topic in this article, prescribers have access to the data needed to optimize ADHD therapy.