The data, from two sources – a national review of emergency department visits and a pharmacokinetic/pharmacodynamic study – highlights a possible benefit related to reduced abuse potential that may be associated with the Oros formulation.
The Oros formulation initially releases the drug, followed by a more gradual release of the remaining dose in an ascending pattern, compared with an immediate-release, or short-acting, methylphenidate formulation.
The data from Drug Abuse Warning Network’s (DAWN) review of drug-related emergency department visits among ADHD treatments found that OROS methylphenidate had a lower frequency of emergency department reports of abuse compared to other methylphenidate formulations. Furthermore, DAWN found that of all ADHD treatments, non-methylphenidate stimulants (e.g., amphetamines, mixed amphetamine salts) had the most emergency department reports of abuse.
Overall findings showed that of the 1,102 reports of abuse gathered, long-acting OROS methylphenidate had the least number of reports (89), compared with other long- and short-acting methylphenidate formulations (301), and non-methylphenidate stimulants (651). Only the non-stimulant drug, atomoxetine, had a lower number of overall reports at 61.
The other data found that Oros produced lower abuse-related subjective effects compared to immediate-release methylphenidate at comparable total doses. In this double-blind, placebo-controlled, randomized, crossover study, 49 occasional stimulant-abusing adults were given 50 mg and 90 mg doses of immediate-release methylphenidate and 54 mg and 108 mg doses of Oros methylphenidate.
Although methylphenidate is proven to be an effective treatment for ADHD, some physicians may have concerns about the drug due to its abuse potential, said John Coleman, president of Prescription Drug Research Center. Most patients take prescription medications responsibly, however, recent reviews still show that illicit stimulant use among adolescents in the US remains a concern for physicians, parents and the general public.