Thursday, December 22, 2005

Patch or Pill for ADHD?

Those suffering from ADHD may soon have a choice of taking pills of using a patch. The patch will deliver methylphenidate, the same ingredient that’s found in Ritalin, Concerta, and Methylin, throughout the day. Pending FDA approval, it will be the first ADHD medicine that doesn’t have to be taken orally. The company plans to call it Daytrana.
This transdermal delivery system is designed to provide a continuous release of medicine throughout the day. It will pass through the skin and go directly into the blood stream, and it will be water-resistant. Studies reported at the American and Canadian Academies of Child and Adolescent Psychiatry find it’s effectiveness as well as the once a day drug. Of 80 ADHD kids, aged 6-12, studied, those receiving the real patch, not a placebo, did much better. Their behavior and attention, tested throughout the day, had improved. They also achieved better results on age-adjusted math tests. Side effects were similar to other stimulant drugs, nausea, vomiting, decreased appetite, and those with sensitive skin experienced irritation.
Another study on the patch compared it with a placebo and methylphenidate pills. Both the patch and pills improved ADHD symptoms in 6-12 year olds. Scores improved slightly more with the patch compared to the pills, but the difference wasn’t significant enough to claim scientific proof of superiority.
The patch would be ideal for children who can’t swallow pills. This is especially important for those taing the extended release pills because they cant’ be broken up or the release mechanisms will be destroyed. Another important factor is that the patch offers parents control over how long they want the medication to last. Once a child swallows a pill, you can’t do anything about it. The patch may release methylphenidate for up to 16 hours. And it must be removed for three hours before its effects wear off. But parents can decide to remove it earlier or leave it on beyond the school day. Knowing there was continuing efficacy beyond that 12 hour time point may give them more options.

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