Trial Summary
What is the purpose of this trial?This trial studies how methylphenidate affects brain activity and chemicals in adults with ADHD using brain scans. The goal is to develop better treatments for ADHD. Methylphenidate is the most common treatment for attention deficit hyperactivity disorder (ADHD) and has been shown to improve attention and behaviour.
Is the drug Methylphenidate a promising treatment for ADHD?Yes, Methylphenidate is a promising treatment for ADHD. It is effective in reducing ADHD symptoms in children and adolescents, especially during the school day. It is well-tolerated and can be used alone or with other therapies to help manage ADHD.267810
What safety data is available for Methylphenidate in treating ADHD?Several studies provide safety data for Methylphenidate in treating ADHD. A study on Metadate CD showed it is generally well-tolerated in clinical practice. Another study on OROS Methylphenidate (Concerta) confirmed its safety in adults. Methylphenidate CD was found to be well-tolerated in children and adolescents, with mild side effects. In France, Ritalin's adverse reactions were mostly non-serious and mild. Overall, Methylphenidate is considered safe with proper prescription and monitoring.13689
What data supports the idea that Methylphenidate for ADHD is an effective drug?The available research shows that Methylphenidate, in its controlled-delivery form, is effective in treating children and adolescents with ADHD. It provides better control of ADHD symptoms compared to a placebo and is as effective as the immediate-release version. In particular, Methylphenidate controlled-delivery capsules (like Equasym XL and Metadate CD) have been shown to be effective during the school day, making them a strong option for managing symptoms. Additionally, Dexmethylphenidate, a form of Methylphenidate, is effective at half the dose of regular Ritalin, offering another effective option for treatment.24567
Do I have to stop taking my current medications for the trial?The trial protocol does not specify whether you need to stop taking your current medications. However, if you have an adverse reaction to methylphenidate or other stimulant medications, you may be excluded from participating.
Eligibility Criteria
This trial is for right-handed adults with ADHD who can undergo MRI scans. It's not suitable for those with cognitive issues not due to ADHD, contraindications to MRI, pregnancy, breastfeeding, current smokers, history of bad reactions to stimulants like methylphenidate, uncontrolled medical conditions or past/current neurological disorders.Exclusion Criteria
I have a history of neurological disorders.
I have had a head injury with unconsciousness or lasting problems in the past year.
I have a health condition that is not well-managed.
My cognitive issues are not due to ADHD.
Treatment Details
The study tests the brain's response to Methylphenidate (a common ADHD medication) versus a placebo. Participants will receive both treatments at different times in a random order and undergo brain imaging (fMRI and MRS) along with neuropsychological testing after each dose.
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Methylphenidate firstExperimental Treatment2 Interventions
Single oral dose of methylphenidate (10mg or 15 mg) and then matching placebo after washout period of one week.
Group II: Placebo firstPlacebo Group2 Interventions
Matching placebo and then single oral dose of methylphenidate (10mg or 15 mg) after washout period of one week.
Methylphenidate is already approved in United States, Canada, European Union for the following indications:
🇺🇸 Approved in United States as Methylphenidate for:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Narcolepsy
🇨🇦 Approved in Canada as Methylphenidate for:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Narcolepsy
🇪🇺 Approved in European Union as Methylphenidate for:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Narcolepsy
Find a clinic near you
Research locations nearbySelect from list below to view details:
Johns Hopkins School of MedicineBaltimore, MD
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Who is running the clinical trial?
Johns Hopkins UniversityLead Sponsor
National Institutes of Health (NIH)Collaborator
References
[Utilization of methylphenidate(Ritalin) in France]. [2013]Methylphenidate (Ritalin) is the only psychostimulant approved in France and indicated in attention deficit hyperactivity disorder in children over 6 years. It is under restricted prescription and distribution conditions. As such, it requires a hospital initiated prescription from either a neurology, psychiatry or pediatric specialist and it is covered by the "narcotics" schedule. The French Pharmacovigilance database spontaneous adverse drug reactions reporting, since it was approved in 1995, were analyzed. 21 adverse drug reactions were reported. In 16 cases, methylphenidate was suspected. They were generally non-serious, mild side effects and in most cases promptly resolved. These results do not suggest methylphenidate misuse in France or an overuse in between 1300 and 4000 treated children, to date. Until more information is available concerning the long-term effects of methylphenidate, and in order to limit misuse, inappropriate or overuse, the current prescription and dispensing regulation should be maintained in France, and could well be developed in other countries.
Dexmethylphenidate--Novartis/Celgene. Focalin, D-MPH, D-methylphenidate hydrochloride, D-methylphenidate, dexmethylphenidate, dexmethylphenidate hydrochloride. [2018]Celgene has developed a chirally pure form of methylphenidate (Ritalin), called dexmethylphenidate [d-methylphenidate, d-methylphenidate hydrochloride, d-MPH; Focalin]. The drug has been launched in the USA and is undergoing registration in Canada for the treatment of children with attention-deficit hyperactivity disorder (ADHD). Dexmethylphenidate is the single isomer version of racemic methylphenidate (Ritalin), which contains the active d isomer of Ritalin. Dexmethylphenidate acts via the inhibition of reuptake of norepinephrine and dopamine. Research is ongoing to further clarify the mode of therapeutic action in ADHD. Dexmethylphenidate was developed with the aim of reducing drug load, adverse events and drug interactions. Dexmethylphenidate provides effective management of attention-deficit hyperactivity disorder at half the dose of Ritalin. In April 2000, worldwide rights (excluding Canada) to dexmethylphenidate were granted to Novartis. Celgene has also granted Novartis rights to all related intellectual properties and patents. Novartis will fund all remaining development and marketing expenses required for regulatory approval and commercialisation of dexmethylphenidate. Crystaal Corporation, the marketing division of Biovail Corporation International, has exclusive Canadian marketing rights for all formulations of dexmethylphenidate. Novartis launched dexmethylphenidate (Focalin) in the USA during Q1 2002. It is available as a D-shaped tablet (2.5, 5 and 10 mg doses). Novartis had planned to use the tradename Ritadex, however the FDA recommended an alternative name due to potential prescribing errors with Ritalin. The finalized tradename to be used is Focalin. In July 2001, a new drug submission was filed with Canada's Therapeutic Products Programme for dexmethylphenidate in the treatment of attention-deficit disorder and attention-deficit hyperactivity disorder. Novartis is also developing an extended-release version of chirally pure dexmethylphenidate. Dexmethylphenidate has been found to be effective and well tolerated in clinical trials, involving a total of 684 children with ADHD and in 15 healthy adult volunteers. Dexmethylphenidate is a schedule II drug.
A postmarketing clinical experience study of Metadate CD. [2019]The objective of the study was to investigate the effectiveness and safety of Metadate CD (methylphenidate HCl, USP) Extended Release Capsules in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD), in actual clinical practice.
Symptom control in children and adolescents with attention-deficit/hyperactivity disorder on switching from immediate-release MPH to OROS MPH Results of a 3-week open-label study. [2022]The aim of this study was to assess the impact of switching from immediate-release (IR) methylphenidate (MPH) to OROS MPH (CONCERTA, a once-daily long-acting MPH formulation, in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).
Comparison of the clinical efficacy of twice-daily Ritalin and once-daily Equasym XL with placebo in children with Attention Deficit/Hyperactivity Disorder. [2018]To compare the efficacy and safety of two methylphenidate (MPH) formulations--once-daily modified-release MPH (EqXL, Equasym XL) and twice-daily immediate-release methylphenidate (MPH-IR, Ritalin)--and placebo in children with Attention Deficit/Hyperactivity Disorder (ADHD).
Methylphenidate controlled-delivery capsules (EquasymXL, Metadate CD): a review of its use in the treatment of children and adolescents with attention-deficit hyperactivity disorder. [2018]Controlled-delivery methylphenidate (methylphenidate CD) [EquasymXL, Metadate CD], an oral stimulant, is approved in the US and EU to treat children aged>or=6 years who have been diagnosed with attention-deficit hyperactivity disorder (ADHD). Once-daily methylphenidate CD is generally well tolerated and effective in the treatment of children and adolescents with ADHD. Methylphenidate CD resulted in superior control of ADHD symptoms compared with osmotic release oral system (OROS) methylphenidate over a time period corresponding to that of an average school day in a laboratory classroom. In 3-week clinical trials conducted in a community setting, methylphenidate CD was superior to placebo and noninferior to methylphenidate immediate-release (IR) in the treatment of children and adolescents with ADHD. Thus, methylphenidate CD should be considered an important primary treatment on its own or in addition to behavioral and psychosocial interventions, for when a reduction in ADHD symptoms is required during the school day in preference to the evening.
Spotlight on methylphenidate controlled-delivery capsules (Equasym XL, Metadate CD) in the treatment of children and adolescents with attention-deficit hyperactivity disorder. [2019]Controlled-delivery methylphenidate (methylphenidate CD) [Equasym XL, Metadate CD], an oral stimulant, is approved in the US and EU to treat children aged > or = 6 years who have been diagnosed with attention-deficit hyperactivity disorder (ADHD). Once-daily methylphenidate CD is generally well tolerated and effective in the treatment of children and adolescents with ADHD. Methylphenidate CD resulted in superior control of ADHD symptoms compared with osmotic release oral system (OROS) methylphenidate over a time period corresponding to that of an average school day in a laboratory classroom. In 3-week clinical trials conducted in a community setting, methylphenidate CD was superior to placebo and non-inferior to methylphenidate immediate-release in the treatment of children and adolescents with ADHD. Thus, methylphenidate CD should be considered an important primary treatment on its own or in addition to behavioural and psychosocial interventions, for when a reduction in ADHD symptoms is required during the school day in preference to the evening.
Efficacy and safety of OROS methylphenidate in adults with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, double-blind, parallel group, dose-escalation study. [2022]To assess the efficacy and safety of OROS methylphenidate (Concerta; McNeil Pediatrics Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc, Titusville, NJ) in the management of attention-deficit/hyperactivity disorder (ADHD) in adults.
Adverse events in medication treatment-naïve children with attention-deficit/hyperactivity disorder: results from a small, controlled trial of lisdexamfetamine dimesylate. [2015]To evaluate the type, frequency, duration, and severity of treatment emergent adverse events (TEAEs) of the prodrug lisdexamfetamine dimesylate (LDX) in children with and without previous exposure to stimulant medication in the treatment of attention-deficit/hyperactivity disorder (ADHD).
The clinical impact of switching attention deficit hyperactivity disorder patients from OROS(®)-MPH to Novo-MPH ER-C(®): A paediatric practice review. [2021]In Canada, novo-methylphenidate extended-release capsules (Novo-MPH ER-C, Novopharm Limited, Canada) was approved as being bioequivalent to a current first-line treatment for attention deficit hyperactivity disorder (ADHD), CONCERTA (OROS-MPH, Janssen Inc, Canada). The present practice review was undertaken to determine whether bioequivalence of these products translates into therapeutic equivalence.