Pharmacokinetics of methylphenidate in preschoolers with attention-deficit/hyperactivity disorder.

Abstract:

OBJECTIVE:The aim of this study was to compare the pharmacokinetics of immediate-release methylphenidate (MPH) in preschool and school-aged children with attention-deficit/hyperactivity disorder (ADHD). METHODS:Preschool children 4-5 years (n = 14) and school-aged children 6-8 years (n = 9) with diagnoses of ADHD were titrated to an effective dose of MPH based on parent, teacher, and clinician ratings in a protocol specified by the Preschoolers with ADHD Treatment Study (PATS) and then attended a laboratory school where the single morning dose of immediate release MPH was administered. Blood samples for measurement of MPH concentrations were obtained predose, and at 1, 2, 4, and 6 hours postdose. A nonlinear model was used to derive three pharmacokinetic (PK) values for analysis: Peak plasma concentration (C(max)), half-life (t(1/2)), and clearance (CL). RESULTS:The two groups did not differ in the mean mg dose of MPH (p = 0.33), or in the weight-adjusted mg/kg dose (p = 0.20). Dose-normalized C(max) was significantly higher (p = 0.003), and clearance was significantly slower (p = 0.0002) in preschool than in school-aged children. CONCLUSIONS:In this sample, age significantly affected absorption and metabolism of MPH, so that preschool children had greater exposure than school-aged children to the same weight-adjusted dose. These data suggest additional studies should be performed to characterize age-related differences in PK properties of MPH that may inform practitioners about dosing strategies based on the age and size of children being treated.

authors

Wigal SB,Gupta S,Greenhill L,Posner K,Lerner M,Steinhoff K,Wigal T,Kapelinski A,Martinez J,Modi NB,Stehli A,Swanson J

doi

10.1089/cap.2007.0043

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

153-64

issue

2

eissn

1044-5463

issn

1557-8992

journal_volume

17

pub_type

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