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Methylphenidate for Treating ADHD: A Naturalistic Clinical Study of Methylphenidate Blood Concentrations in Children and Adults With Optimized Dosage.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
Linköping University, Department of Physics, Chemistry and Biology, Chemistry. Linköping University, Faculty of Science & Engineering. Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
Region Östergötland, Local Health Care Services in Central Östergötland, Department of Dependency in Linköping.
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2017 (English)In: European journal of drug metabolism and pharmacokinetics, ISSN 0378-7966, E-ISSN 2107-0180, Vol. 42, no 2, p. 295-307Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Methylphenidate (MPH), along with behavioral and psychosocial interventions, is the first-line medication to treat attention-deficit hyperactivity disorder (ADHD) in Sweden. The dose of MPH for good symptom control differs between patients. However, studies of MPH concentration measurement in ADHD treatment are limited.

OBJECTIVE: To describe blood and oral fluid (OF) concentrations of MPH after administration of medication in patients with well-adjusted MPH treatment for ADHD, and to identify the most suitable matrix for accurate MPH concentration during treatment.

METHODS: Patients were recruited from Child and Adolescent Psychiatry (CAP), General Psychiatry (GP), and the Department of Dependency (DD). Blood and OF samples were collected in the morning before MPH administration as well as 1 and 6 h after administration of the prescribed morning dose of MPH.

RESULTS: Fifty-nine patients aged between 9 and 69 years, 76 % males. The daily dose of MPH varied from 18 to 180 mg, but the median daily dose per body weight was similar, approximately 1.0 mg/kg body weight. The median MPH concentration in blood 1 and 6 h after the morning dose was 5.4 and 9.3 ng/mL, respectively. Highly variable OF-to-blood ratios for MPH were found at all time points for all three groups.

CONCLUSIONS: Weight is a reliable clinical parameter for optimal dose titration. Otherwise, MPH blood concentration might be used for individual dose optimization and for monitoring of the prescribed dose. Relying only on the outcome in OF cannot be recommended for evaluation of accurate MPH concentrations for treatment monitoring.

Place, publisher, year, edition, pages
2017. Vol. 42, no 2, p. 295-307
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Health Sciences
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URN: urn:nbn:se:liu:diva-134701DOI: 10.1007/s13318-016-0346-1ISI: 000405400500013PubMedID: 27220743OAI: oai:DiVA.org:liu-134701DiVA, id: diva2:1076713
Note

Funding agencies: Swedish Medical Research Council [2009-4740]; Medical Research Council of Southeast Sweden [FORSS-12147, FORSS-155281]

Available from: 2017-02-23 Created: 2017-02-23 Last updated: 2018-04-19

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Chermá, Maria D.Josefsson, MartinRydberg, IreneGustafsson, Per A.
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Division of Drug ResearchFaculty of Medicine and Health SciencesDepartment of Clinical PharmacologyChemistryFaculty of Science & EngineeringDepartment of Dependency in LinköpingCenter for Social and Affective NeuroscienceDepartment of Child and Adolescent Psychiatry in Linköping
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