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Papers of the Week

2020 Apr

World J Biol Psychiatry



A Prospective Open-Label Trial of Long-Acting Liquid Methylphenidate for the Treatment of Attention Deficit/Hyperactivity Disorder in Intellectually Capable Adults with Autism Spectrum Disorder.


Joshi G, DiSalvo M, Wozniak J, Ceranoglu AT, Yule A, Surman C, Fried R, Galdo M, Hoskova B, Belser A, Biederman J
World J Biol Psychiatry. 2020 Apr; 21(4):274-290.
PMID: 31607204.


This treatment trial is aimed at assessing the short-term tolerability and efficacy of liquid-formulation extended-release methylphenidate (MPH-ER) for the treatment of ADHD in adults with high-functioning autism spectrum disorder (HF-ASD). Six-week open-label trial (ClinicalTrials.gov: NCT02096952) was conducted in 15 HF-ASD adults (mean age: 24.9 ± 4.6; male: 12 [80%]) suffering from moderate-severe ADHD. MPH-ER was administered based on a flexible titration schedule. Efficacy was assessed on clinician- and self-rated measures. Tolerability was assessed by documenting treatment-emergent adverse events (AEs) and other safety measures. Short-term MPH-ER treatment was associated with significant improvement in ADHD severity (Adult ADHD Investigator Symptom Report Scale [AISRS] mean change [MC]: -22.8 ± 8.8, p < 0.001; Adult ADHD Self-Report Scale [ASRS] MC: -8.2 ± 15.3, p < 0.001). Twelve (80%) participants were deemed responders, based on ≥30% reduction in AISRS score and an ADHD Clinical Global Impression-Improvement score ≤2. MPH-ER was well-tolerated (treatment-limiting AEs: 1/15; severe AEs: 1/15) at mean dose of 48.7 ± 15 mg/day. AEs were transient and experienced by 13/15 (87%) participants at mild to moderate severity. Frequently reported AEs were as typically expected (headache [53%], insomnia [33%], anxiety [33%], decreased appetite [27%]). Our findings suggest that MPH-ER is effective and well-tolerated in the treatment of ADHD in HF-ASD adults.