Her samler vi artikler om ADHD og Ritalin/metylfenidat.

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Ritalin/metylfenidat: Virkningsmekanisme
Ritalin: Sammenlignende studier
Sikkerhet og komorbiditeter


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Franke B, Michelini G, Asherson P et al. 
European Neuropsychopharmacology (2018), https://dol.org/10.1016/j.euroneuro.2018.08.001

Abstract: Attention-deficit/hyperactivity disorder (ADHD) is highly heritable and the most common neurodevelopmental disorder in childhood. In recent decades, it has been appreciated that in a substantial number of cases the disorder does not remit in puberty, but persists into adulthood. Both in childhood and adulthood, ADHD is characterised by substantial comorbidity including substance use. depression, anxiety, and accidents. However, course and symptoms of the disorder and the comorbidities may fluctuate and change over time, and even age of onset in child-hood has recently been questioned. Available evidence to date is poor and largely inconsistent with regard to the predictors of persistence versus remittance. Likewise, the development of comorbid disorders cannot be foreseen early on, hampering preventive measures. These facts call for a lifespan perspective on ADHD from childhood to old age. In this selective review we summarise current knowledge of the long-term course of ADHD, with an emphasis on clinical symptom and cognitive trajectories, treatment effects over the lifespan, and the development of comorbidities. Also, we summarise current knowledge and important unresolved issues on biological factors underlying different ADHD trajectories. We conclude that a severe lack of knowledge on lifespan aspects in ADHD still exists for nearly every aspect reviewed. We encourage large-scale research efforts to overcome those knowledge gaps through appropriately granular longitudinal studies.


PubMed Link: http://www.ncbl.nlm.nlh.gov/pubmed/30195575


Adult attention-deficit hyperactivity disorder: key conceptual issues.

Asherson P, Buitelaar J, Faraone SV et al. Lancet Psychiatry. 2016 Jun;3(6);568-78.
For many years, attention-deficit hyperactivity disorder (ADHD) was thought to be a childhood-onset disorder that has a limited effect on adult psychopathology. However, the symptoms and impairments that define ADHD often affect the adult population, with similar responses to drugs such as methylphenidate, dexamphetamine, and atomoxetine, and psychosocial interventions, to those seen in children and adolescents. As a result, awareness of ADHD in adults has rapidly increased and new clinical practice has emerged across the world. Despite this progress, treatment of adult ADHD in Europe and many other regions of the world is not yet common practice, and diagnostic services are often unavailable or restricted to a few specialist centres. This situation is remarkable given the strong evidence base for sate and effective treatments. Here we address some of the key conceptual issues surrounding the diagnosis of ADHD relevant to practicing health-care professionals working with adult populations. We conclude that ADHD should be recognised in the same way as other common adult mental health disorders, and that failure to recognise and treat ADHD is detrimental to the wellbeing of many patients seeking help tor common mental health problems. 

PubMed Link: http://www.ncbl.nlm.nlh.gov/pubmed/27183901


Emotional dysregulation in adults with attention-deficit/hyperactivity disorder-validity, predictability, severity, and comorbidity.

Corbisiero S, Mörstedt B, Bitto H et al.J Clin Psychol. 2016 May 6. [Epub ahead of print].
OBJECTIVES: Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity. However, this triad might not be able to explain the complete spectrum of ADHD symptoms, as emotional dysregulation (ED) frequently seems to accompany the disorder. The aim of this study was to further understand the role of ED in adult ADHD. 
METHOD: The sample comprised 393 adults with ADHD without or with comorbidity, and 121 adults without ADHD or any other mental disorder. Additionally, the sample focused on ED. The contribution of core symptoms and the effect of comorbidity on ED were tested and the predictive value of ED for the ADHD diagnosis itself analyzed. Finally, all subjects were categorized into groups-No ADHD, ADHD, and ADHD + ED-to analyze the differences in the severity of ADHD symptomatology in the three groups.
RESULTS: ED levels were found to be elevated in patients with ADHD. The core symptoms affected ED, and the ADHD diagnosis was predicted by ED. The addition of ED to a regression model with the core symptoms was shown to improve the predictability of the ADHD diagnosis. The presence of ED proved to be an indicator of the severity of adult ADHD independent of a present comorbidity. 

CONCLUSIONS: ED is a significant symptom in adult patients with ADHD and appears to be associated with ADHD itself. Whilst the presence of other mental disorders intensifies symptoms of ED, ED seems not to manifest solely as a consequence of comorbidity.

PubMed Link: http://www.ncb.nlm.nlh.gov/pubined/27153511


Factors associated with adherence to methylphenidate treatment in adult patients with attention-deficit/hyperactivity disorder and substance use disorders.

Adherence to treatment is one of the most consistent factors associated with a favorable addiction treatment outcome. Little is known about factors associated with treatment adherence in individuals affected with comorbid attention-deficit/hyperactivity disorder and substance use disorders (SUD). This study aimed to explore whether treatment-associated factors, such as the prescribing physician's (sub)specialty and methylphenidate (MPH) dose, or patient-related factors, such as sex, age, SJD subtype, and psychiatric comorbidity, were associated with adherence to MPH treatment Swedish national registers were used to identify adult individuals with prescriptions of MPH and medications specifically used in the treatment of SUD or a diagnosis of SUD and/or coexisting psychiatric diagnoses. Primary outcome measure was days in active MPH treatment in stratified dose groups (£36 mg, >37 mg to £54 mg, >55 mg to £72 mg, >73 mg to £90 mg, >91 mg to £108 mg, and >109 mg). Lower MPH doses (ie, £36 mg day 100) were associated with treatment discontinuation between days 101 and 830 (HR<36 mg, 1,67; HR37-54mg, 137; HR55-72mg, 1.36; HR73-90mg, 119; HR>108mg, 109). The results showed a linear trend (P < 0.0001) toward decreased risk of treatment discontinuation along with increase of MPH doses. In conclusion, this study shows that higher MPH doses were associated with long-term treatment adherence in individuals with attention-deficit/hyperactivity disorder and SUD.


Rommel AS, Lichtenstein P, Rydell M et al. Is Physical Activity Causally Associated With Symptoms of Attention-Deficit/Hyperactivity Disorder? J Am Acad Child Adolesc Psychiatry. 2015;54(7):565-570.

Raquel Vidal-Estrada, Bosch-Munso R, Nogueira M et al. Psychological treatment of attention deficit hyperactivity disorder in adults: a systematic review Actas Esp Psiquiatr. 2012;40(3):147-54.

Dalsgaard S, Oesterman SD, Leckman JF et al. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder a nationwide cohort. 
Lancet. 2015;385:2190-96. 

Dalsgaard S, Leckman JF, Mortensen PB et al. Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: a prospective cohort study.
Lancet Psychiatry. 2015;2:702-09. 

Ginsberg Y, Quintero J, Anand E et al. Underdiagnosis of ADHD in adult patients: A review of the Literature.
Prim Care Companion CMS Disord. 2014;16(3).

Huss M, Ginsberg Y, Tvedten T, Arngrim T et al. Methylphenidate Hydrochloride Modified-Release in Adults with Attention Deficit Hyperactivity Disorder: A Randomized Double-Blind Placebo-Controlled Trial.
Adv Ther. 2014;31(1):44-65.
Huss M, Ginsberg Y, Arngrim T et al. Open-Label Dose Optimization of Methylphenidate Modified Release Long Acting (MPH-LA): A Post Hoc Analysis of Real-Life Titration from a 40-Week Randomized Trial.
Clin Drug Investig. 2014;34(9):639-649. (NY) 

Ginsberg Y, Arngrim T, Philipsen A et al. Long-Term (1 Year) Safety and Efficacy of Methylphenidate Modified-Release Long-Acting Formulation (MPH-LA) in Adults with Attention-Deficit Hyperactivity Disorder: A 26-Week, Flexible-Dose, Open-Label Extension to a 40-Week, Double-Blind, Randomised, Placebo-Controlled Core Study.
CNS Drugs. 2014 Oct;28(10):951-62. (NY)

Ved behandling med metylfenidat hos barn og ungdom med ADHD er det utarbeidet sjekklister man kan bruke. Sjekkliste 1 før behandling. Sjekkliste 2: overvåkning av behandling samt en Tabell Se lenke for mer informasjon.



Kooij S, Bejerot S, Blackwell A et al. European consensus statement on diagnosis and treatment of Adult ADHD: The European NetWork Adult ADHD.
BMC Psychiatry. 2010;10:67.

Banaschewski T, Coghill D, Santosh P et al. Long-acting medications for the hyperkinetic disorders. A systematic review and European treatment guideline.
Eur Child Adolesc Psychiatry. 2006;15:476-95. 



Polanczyk G, Wilcutt EG, Salem GA et al. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis.
Int. J. Epidemiol. Advance Access published January 24, 2014.

Ginsberg Y,  Quintero J, Anand E et al. Underdiagnosis of ADHD in adult patients; A review of the Literature.
Prim Care Companion CNS Disord. 2014;16(3). 

Ginsberg Y, Beusterien KM, Amos K et al. The unmet needs of all adults with ADHD are not the same: a focus on Europe. Expert Reviews.
Informahealthcare.com. 2014;799-812. 

Dalsgaard S, Oesterman SD, Leckman JF et al. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder a nationwide cohort. 
Lancet. 2015;385:2190-96.  

Ginsberg Y, Långström N, Larsson et al. ADHD and criminality: could treatment benefit prisoners with ADHD who are at higher risk of reoffending?
Expert Rev. Neurother. 2013;13(4):345-348. 

Konstenius M, Larsson H, Lundholm L et al. An Epidemiological Study of ADHD, Substance Use, and Comorbid Problems in Incarcerated Women in Sweden.
J of Attention Disord. 2015 Jan;19(1):44-52.

Lichtenstein P, Halldner L, Zetterqvist J et al. Medication for Attention Deficit-Hyperactivity Disorder and Criminality. 
N Engl J Med. 2012;367:2006-14. 

Halmoey A, Fasmer OB, Gillber C et al. Occupational Outcome in Adult ADHD: Impact of Symptom Profile, Comorbid Psychiatric Problems, and Treatment of Attention Disord. 2009;13:175-87. 

Chang Z, Lichtenstein P, D Onofrio B et al. Serious transport accidents in adults with Attention Deficit/Hyperactivity Disorder and the effect of medication. A population-based study. JAMA Psychiatry. 2014;71(3):319-25. 

Biederman J, Petty CR, Oconnor  KB et al. Predictors of persistence in girls with attention deficit hyperactivity disorder: results from an 11-year controlled follow-up study. Acta Psychiatr Scand. 2012;125:147-156.

Coghill D. The Impact of Medications on Quality of Life in Attention-Deficit Hyperactivity Disorder. A Systematic Review.
CNS Drugs. 2010;24(10):843-866.
Coles T, Coon C, DeMuro C et al. Psychometric evaluation of the Sheehan Disability Scale in adult patients with attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat. 2014;10:887-895. 


Ritalin®: Virkningsmekanisme

Tripp G, Wickens JR. Review. Neurobiology of ADHD. Neuropharmacology. 2009;57:579-589. 

Patrick KS,Gonzales MA,Straughn AB et al. New methylphenidate formulations for the treatment of attention-deficit/hyperactivity disorder. Expert Opin Drug Deliv. 2005;2:121-43.


Ritalin®: Sammenlignende studier

Huss M, Ginsberg Y, Tvedten T et al. Methylphenidate Hydrochloride Modified-Release in Adults with Attention Deficit Hyperactivity Disorder: A Randomized Double-Blind Placebo-Controlled Trial. Adv Ther. 2014;31(1):44-65.

Huss M, Ginsberg Y, Amgrim T et al. Open-Label Dose Optimization of Methylphenidate Modified Release Long Acting (MPH-LA): A Post Hoc Analysis ot Real-Life Titration from a 40-Week Randcmized Trial. Clin Drug Investig. 2014;34(9):639-649. 
Ginsberg Y, Arngrim T, Philipsen A et al. Long-Term (1 Year) Safety and Efficacy of Methylphenidate Modified-Release Long-Acting Formulation (MPH-LA) in Adults with Attention-Deficit Hyperactivity Disorder: A 26-Week, Flexible-Dose, Open-Label Extension to a 40-Week, Double-Blind, Randomised, Placebo-Controlled Core Study. CNS Drugs. 2014 Oct;28(10):951-62. 

Markowitz J, Straughn AB, Patrick KS et al. Pharmacokinetics of Methylphenidate After Oral Administration of Two Modified-Release Formulations in Healthy Adults. Clin Pharmacokinet. 2003;42(4):393-401.

Haessler F, Tracik F, Dietrich H et al. A pharmacokinetic study of two modified-release methylphenidate formulations under different food conditions in healthy volunteers. International Journal of Clinical Pharmacology and Therapeutics. 2008;46(9):466-476. http://www.ncbl.nlrn.nlh.gov/pubmed/18793577

Lopez FA , Silva R, Pestreich L et al. Comparative Efficacy of Two Once Daily Methylphenidate Formulations (Ritalin LA and Concerta) and Placebo in Children with Attention Deficit Hyperactivity Disorder Across the School Day. Pediatr Drugs. 2003;5{8):545-555. http://www.ncbl.nlm.nlh.gov/pubmed/12895137

Silva R, Munich R, Pestreich LK et al. Efficacy of Two Long-Acting Methylphenidate Formulations in Children with Attention-Deficit/Hyperactivity Disorder in a Laboratory Classroom Setting. J. Am. Acad. Child Adolesc. Psychiatry. 2005;15(4):637-654. http://www.ncbl.nlm.nlh.gov/pubmed/16190795

Schulz E, Fleichhaker C, Hennighausen K et al. A Double-Blind, Randomized, Placebo/Active Controlled Crossover Evaluation of the Efficacy and Safety of Ritalin LA in Children with Attention-Deficit/Hyperactivity Disorder in a Laboratory Classroom Setting Journal of Child and Adolescent Psychopharmacology. 2010;20(5):377-385.

Sikkerhet og komorbiditeter

Humphreys K, Eng T, Lee SS. Stimulant Medication and Substance Use Outcomes A Meta-analysis. JAMA Psychiatry. 2013;70(7):740-749. http://www.ncbl.nlm.nlh.gov/pubmed/23754458

Konstenius M, Jayaram-Lindstrom N, Guterstam J et al.. Methylphenidate for ADHD and Drug Relapse in Criminal Offenders with Substance Dependence: A 24-week Randomized Placebo-controlled Trial. Addiction. 2014;109(3):440-449.

Poulton A, Melzer E, Tait PR et al. Growth and pubertal development of adolescent boys on stimulant medication for attention deficit hyperactivity disorder. Med J Aust. 2013 Jan 21;198(1):29-32.  

Kollins SH. A qualitative review of issues arising in the use of psychostimulant medications in patients with ADHD and comorbid substance use disorders. Current Medical Research and Opinion. 2008;24(5):1345-1357. http://www.ncbl.nlm.nlh.gov/pubmed/18384709

Spencer TJ. Issues in the Management of Patients with Complex Attention-Deficit Hyperactivity Disorder Symptoms. 
CNS Drugs. 2009;23(1):9-20.

Ginsberg Y, Hirvikoski T, Lindefors N. Attention Deficit Hyperactivity Disorder (ADHD) among longer-term prison inmates is a prevalent. persistent and disabling disorder. BMC Psychiatry. 2010;(10):112. 

Cooper WO, Habel LA, Sox CM et al. ADHD Drugs and Serious Cardiovascular Events in Children and Young Adults. 
N Engl J Med. 2011 Nov 17;365(20):1896-904. http://www.ncbl.nlm.nih.gov/pubmed/22043968    

Faraone S, Biederman J, Morley CP et al. Effect of Stimulants on Height and Weight A Review of the Literature. J. Ann, Acad. Child Adolesc. Psychiatry. 2008:47(9):994-1009. 
http://www.ncbl.nlm.nlh.gov/ pub med/18580502

Yoon SY, Jain U, Shapiro CM. Sleep in attention-deficit/hyperactivity disorder in children and adults: Past, present, and future. 
Sleep Med Rev. 2012;16(4):371-88. 


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