Is Response to OROS‐Methylphenidate Treatment Moderated by Treatment with Antidepressants or Psychiatric Comorbidity? A Secondary Analysis from a Large Randomized Double Blind Study of Adults with ADHD

摘要

SUMMARY Aims: The main aim of this post hoc analysis was to evaluate whether response to osmotic release oral system (OROS) methylphenidate (OROS‐MPH) was moderated by the concomitant use of antidepressants in attention‐deficit/hyperactivity disorder (ADHD) adults stabilized on these medicines for the treatment of depression or anxiety disorders, or a history of mood, anxiety, or substance use disorders. Methods: Two hundred and ninety‐six subjects were screened for participation; 227 were randomized (112 to OROS‐MPH and 115 to placebo), and 223 were analyzed ( N = 109 and N = 114 for OROS‐MPH and placebo, respectively). Subjects with anxiety disorders and depression treated with a stable medication regimen of non‐MAOI antidepressants or benzodiazepines for at least 3 months could be enrolled in the study. Subjects currently receiving pharmacotherapy for anxiety disorders or depression were required to have Hamilton‐Depression and Hamilton‐Anxiety rating scales below 15 (mild range). Results: Concomitant antidepressant use at baseline was not associated with ADHD response, OROS‐MPH dose, study completion rate, adverse effects, or exacerbation of anxiety/depression. We did find nominally significant evidence that a lifetime history of mood ( P = 0.09) or anxiety ( P = 0.04) disorders was a moderator of ADHD symptoms and that a lifetime history of substance use disorder ( P = 0.02) was a potential moderator of dose at endpoint. Discussion and Conclusions: We found few moderating effects in this large clinical trial of OROS‐MPH in adults with ADHD, which supports the robustness of the clinical response to OROS‐MPH in adult ADHD despite variable clinical pictures.