Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
J Atten Disord. 2011 May;15(4):286-94. doi: 10.1177/1087054710367880. Epub 2010 May 21.
The main aim of this study was to examine the efficacy, tolerability, and compliance of an extended-release formulation of methylphenidate (OROS-MPH) in adults with ADHD receiving immediate-release methylphenidate (IR-MPH).
Participants were outpatient adults with ADHD who were stable on IR-MPH-administered TID. Participants were randomized (4:1) to equipotent doses of OROS-MPH or to continue IR-MPH and were assessed weekly for 6 weeks with the Adult ADHD Investigator System Symptom Report Scale (AISRS).
Randomization of 53 IR-MPH responders to IR- or OROS-MPH had no effect on AISRS score at endpoint (11.2 ± 6.9 vs. 10.7 ± 5.1, p = .8). Participants stabilized on IR-MPH and switched to OROS-MPH remained satisfied over 71% of the time. However, the IR-MPH group missed more doses (7.3 ± 6.8 vs. 3.3 ± 4.2, p = .02) than the OROS-MPH group.
Findings showed that adults with ADHD can be successfully switched from an effective regimen of IR-MPH TID to once-daily OROS-MPH. Results also demonstrated better compliance with OROS-MPH than with IR-MPH treatment.
本研究的主要目的是检验长效哌甲酯（OROS-MPH）在接受即时释放型哌甲酯（IR-MPH）治疗的 ADHD 成年患者中的疗效、耐受性和顺应性。
参与者为门诊 ADHD 成年患者，他们在接受 IR-MPH TID 治疗时病情稳定。参与者随机（4:1）接受等效剂量的 OROS-MPH 或继续接受 IR-MPH 治疗，并在 6 周内每周接受成人 ADHD 研究者系统症状报告量表（AISRS）评估。
53 名对 IR-MPH 有反应的患者随机分组接受 IR-MPH 或 OROS-MPH 治疗，对终点时 AISRS 评分无影响（11.2 ± 6.9 与 10.7 ± 5.1，p =.8）。在稳定接受 IR-MPH 治疗并换用 OROS-MPH 的患者中，有超过 71%的时间保持满意。然而，IR-MPH 组漏服的剂量（7.3 ± 6.8 与 3.3 ± 4.2，p =.02）多于 OROS-MPH 组。
研究结果表明，ADHD 成年患者可以成功地从有效的 IR-MPH TID 方案转换为每日一次的 OROS-MPH。结果还表明，与 IR-MPH 治疗相比，患者对 OROS-MPH 的依从性更好。
