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01-12-2006 | ORIGINAL CONTRIBUTIONS

Long-acting medications for the hyperkinetic disorders

A systematic review and European treatment guideline

Authors: Priv. Doz. Dr. Tobias Banaschewski, David Coghill, Paramala Santosh, Alessandro Zuddas, Philip Asherson, Jan Buitelaar, Marina Danckaerts, Manfred Döpfner, Stephen V. Faraone, Aribert Rothenberger, Joseph Sergeant, Hans-Christoph Steinhausen, Edmund J.S. Sonuga-Barke, Eric Taylor

Published in: European Child & Adolescent Psychiatry | Issue 8/2006

Abstract

A systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorder is reported, giving effect sizes and numbers-to-treat for extended-release stimulant preparations and atomoxetine (ATX). A panel of experts from several European countries used the review to make recommendations about the use of these drugs in practice, and conclusions are reported: (1) Long-acting preparations should be available and used; (2) They should not replace short-acting drugs (which will be the initial treatment for many children for reasons of cost and flexibility of dosing). Individual clinical choice is needed. (3) Both ATX and extended-release preparations of stimulants should be available. The choice will depend upon the circumstances, and detailed recommendations are made.

Available only for authorised users

The spelling of dexamfetamine reflects the changes made in ‘Recommended International Non-proprietary Names’ (rINN) and ‘New British Approved Names’ (BAN) and follow European Directive 92/27/EEC. “Amphetamine” has not yet followed the convention. We are therefore following this inconsistent rule of spelling to help people using electronic retrieval. Trade rather than generic names of drugs have been used to distinguish the different preparations conveniently.

Useful websites with fuller information about these interactions can be found at http://medicine.iupui.edu/flockhart/table.htm or at http://www.medscape.com/druginfo/druginterchecker?src=ads

However, the IR MPH overcoat of the capsule could still be misused.

Since these are determined by price, and price will vary from time to time and place to place, the prescriber is advised to check these generalisations against current circumstances. When considering the total medication costs there is more than just the cost of one pill to consider. Many patients taking one medication require longer coverage, top-up doses and medication for comorbidities or side effects. One should not choose a long-acting medication purely based on price.

It has to be mentioned that clinician ratings were based on different sources of information. The Medikinet retard and Equasym XL studies used direct observations (lab-school ratings). In the Strattera trials, clinical investigators were specifically instructed not to use any other information as the basis for the rating except parent interviews (most Strattera studies), respectively teacher reports (one Strattera study; 75. Weiss M, Tannock R, Kratochvil C, Dunn D, Velez-Borras J, Thomason C, Tamura R, Kelsey D, Stevens L, Allen AJ (2005) A randomised, placebo-controlled study of once-daily ATX in the school setting in children with ADHD. J Am Acad Child Adolesc Psychiatry 44:647–655).

The appearance of placebo and Concerta XL was different, i.e. it was not a blinded study.

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Title: Long-acting medications for the hyperkinetic disorders
A systematic review and European treatment guideline
Authors: Priv. Doz. Dr. Tobias Banaschewski
David Coghill
Paramala Santosh
Alessandro Zuddas
Philip Asherson
Jan Buitelaar
Marina Danckaerts
Manfred Döpfner
Stephen V. Faraone
Aribert Rothenberger
Joseph Sergeant
Hans-Christoph Steinhausen
Edmund J.S. Sonuga-Barke
Eric Taylor
Publication date: 01-12-2006
Publisher: Steinkopff-Verlag
Published in: European Child & Adolescent Psychiatry / Issue 8/2006
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI: https://doi.org/10.1007/s00787-006-0549-0

At a glance: The STEP trials

Springer Medicine

Long-acting medications for the hyperkinetic disorders

A systematic review and European treatment guideline

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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