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Since the discovery of ion-exchange resins, they have been used in many fields, including pharmacy. Ion-exchange resin-mediated preparations can realize a series of functions, such as taste masking and regulating release. However, it is very difficult to extract the drug completely from the drug–resin complex because of the specific combination of the drug and resin. In this study, methylphenidate hydrochloride extended-release chewable tablets compounded by methylphenidate hydrochloride and ion-exchange resin were selected for a drug extraction study. The efficiency of drug extraction by dissociating with the addition of counterions was found to be higher than other physical extraction methods. Then, the factors affecting the dissociation process were studied to completely extract the drug from the methylphenidate hydrochloride extended-release chewable tablets. Furthermore, the thermodynamic and kinetic study of the dissociation process showed that the dissociation process obeys the second-order kinetic process, and it is nonspontaneous, entropy-decreasing, and endothermic. Meanwhile, the reaction rate was confirmed by the Boyd model, and the film diffusion and matrix diffusion were both shown to be rate-limiting steps. In conclusion, this study aims to provide technological and theoretical support for establishing a quality assessment and control system of ion-exchange resin-mediated preparations, promoting the applications of ion-exchange resins in the field of drug preparation. [ABSTRACT FROM AUTHOR]

Purpose: Methylphenidate hydrochloride, which blocks the reuptake mechanisms of dopamine and norepinephrine, is used in attention deficit hyperactivity disorder (ADHD) treatment. Methylphenidate has many general side effects including ocular findings. In this study, we investigated the long-term effects of methylphenidate treatment on functional and structural ocular parameters.Methods: In this prospective study, children with ADHD were evaluated. All patients underwent a detailed ophthalmic examination before methylphenidate treatment. All patients were examined in the 3rd, 6th, 9th, 12th months of methylphenidate treatment. Visual acuities, color vision, pupil diameters, static, dynamic and cycloplegic retinoscopy, intraocular pressure (IOP), anterior chamber depth (ACD), axial length (AL) were evaluated and recorded.Results: A total of 22 children were included in this study. The best-corrected visual acuities (BCVA) of all patients for both eyes were 0.0 logMAR, and 90.9% of patients had blue-purple color weakness before the treatment. After 1 year of treatment, none of the patients had any change in BCVA and color vision. However, an increase in myopic values of static retinoscopy and a decrease in hyperopic values of cycloplegic retinoscopy were found. Additionally, accommodation capacities were found to be decreased and AL was found to be increased significantly for both eyes. Pupil diameter, IOP, and ACD values did not change significantly.Conclusion: Our results suggest that patients with ADHD may have blue color vision deficiencies because of the decreased retinal dopamine levels. Additionally, structural and ocular parameters, especially accommodation capacity, may be affected by methylphenidate treatment. [ABSTRACT FROM AUTHOR]

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Objective: Adult and children attention deficit/hyperactivity disorder (ADHD) share similar symptoms and responses to drugs such as methylphenidate (MPH). Yet, in Europe, these drugs remain unlicensed for adults. We aimed to assess the effects of an acute MPH challenge on the four dimensions concentration, impulsivity, tension, and general well‐being in ADHD adults, and identify predictors of improvement. Methods: Therapeutic Drug Monitoring was performed to measure MPH plasma levels. A Visual Analogue Scale was administered to patients before and after the acute MPH challenge to measure self‐reported changes in the four dimensions. Results: After the acute MPH challenge, our 71 patients showed significant improvement in concentration and tension. The MPH challenge dose correlated with lower patients' age, greater side effects, increased concentration (p =.008) and decreased tension (p =.001). At multiple linear regression MPH plasma levels and absence of postdose side effects predicted concentration improvement, MPH plasma levels predicted tension improvement. MPH plasma levels were significantly higher in patients who reported an improvement in concentration, tension, and impulsivity compared to nonimprovers (p's from.001 to.004). Conclusions: These findings point to the efficacy of MPH challenge in improving concentration and tension in adult ADHD, thus emphasizing the need for a broader treatment access for these patients. [ABSTRACT FROM AUTHOR]

Purpose: To assess clinical findings of eye examination in children having attention deficit hyperactivity disorder (ADHD) administered with methylphenidate hydrochloride. Methods: Fifty-seven consecutive patients diagnosed of ADHD and administered with oral methylphenidate hydrochloride treatment for at least one year were involved in this study (Group 1). Sixty healthy subjects (Group 2) having demographic features similar to group 1 were involved as a control group. All patients underwent detailed ophthalmological examination. Results: One hundred and seventeen consecutive subjects with a mean age of 11.2 ± 2.4 years (7–18 years) were enrolled. Fifty-seven consecutive patient (32 males, 25 females) under oral methylphenidate hydrochloride treatment (Group 1) and 60 healthy control subjects (30 males, 30 females) (Group 2)) were recruited for this prospective study. The mean methylphenidate hydrochloride dosage was 0.9 ± 0.1 mg/kg/day and the mean duration of methylphenidate hydrochloride usage was for 2.73 ± 0.73 years (1–7 years). High intraocular pressure was not observed in any of the patients in our study. We detected lens opacities in five eyes of five patients in group 1 (p = 0.019). The patient with the highest degree of cataract formation had been using MPH for 84 months and this patient’s cataract score was P4. Conclusion: Long-term use of methylphenidate may cause lens opacities. In particular, patients who have been using methylphenidate for more than two years should go for regular eye examination. [ABSTRACT FROM PUBLISHER]

To find an effective treatment protocol with fewer side-effects for attention deficit hyperactivity disorder (ADHD). Methods: 120 children meeting the inclusive and exclusive criteria were randomized into 3 groups: 40 cases in Group A treated with medication combined with behavior therapy, 40 cases in Group B treated with medication combined with acupuncture therapy and 40 cases in Group C treated with medication alone. The outcomes of clinical efficacy, change of Conners index of hyperactivity (CIH) and adverse drug reactions among the three groups were compared respectively. Results: Significant differences were found in clinical efficacy among 3 groups before and after treatment, and there were significant differences between Group A and C. The CIH scores of all three groups showed significant reduction before and after treatment, and significant differences were found in the CIH scores in each of the three groups after treatment, especially between group A and group C and group B and group C. Adverse drug reaction was observed in all three groups, with group B having less adverse reaction compared with groups A and C. Conclusions: The three interventions all have the effect of reducing symptoms of ADHD. Behavior therapy can obviously increase the clinical effect of Methylphenidate, while acupuncture can obviously reduce the adverse reactions of Methylphenidate. Each of the three treatment methods can be combined to increase the validity and safety of ADHD intervention. [ABSTRACT FROM AUTHOR]

Background: It is estimated that 22,800 children were living with an Acquired Brain Injury (ABI) (0.6% of children aged under 15 years) in Australia during 2003. Many children after a traumatic brain injury will experience difficulties with attention and concentration; a condition termed secondary Attention Deficit-Hyperactivity Disorder. There is conflicting evidence on whether treatment with stimulant therapy with medications such as methylphenidate or dexamphetamine will improve the attention and behavior of children with this condition. Methods/Design: Single patient trials (n-of-1s or SPTs) evaluate the effect of titrated doses of psychostimulants methylphenidate or dexamphetamine compared to placebo on attention and behavior, in children with TBI and secondary ADHD. The aggregation of multiple SPTs will produce a population estimate of the benefit. Forty-two children will be registered into the trial through rehabilitation services at three large children's hospitals in Australia. Patients will complete up to 3 cycles of treatment. Each cycle is 2 weeks long comprising seven days each of treatment and placebo, with the first two days of each cycle considered a washout period and the data not analysed. The order of treatment and placebo is randomly allocated for each cycle. The Conners' Parent Rating Scales long forms will be employed to measure change in attention-deficit/hyperactivity and related problems of the child, and the primary outcome measure is the Conners' Global Index Parent Version. Secondary outcomes include the teacher and child (if aged > 12 years) Conners' Rating Scales, the Behaviour Rating Inventory of Executive Function among other measures. This study will provide high-level evidence using a novel methodological approach to inform clinicians about the most appropriate treatment for individual children. Through aggregation of individual trials, a population estimate of treatment effect will be provided to guide clinical practice in the treatment of children with secondary ADHD after a traumatic brain injury. Discussion: This study employs an innovative methodological approach on the effectiveness of CNS stimulants for secondary ADHD from a brain injury. The findings will both guide clinicians on treatment recommendations, and inform the concept and acceptance of SPTs in paediatric research. [ABSTRACT FROM AUTHOR]

Background and Objective: Attention deficit hyperactivity disorder (ADHD) is the most common in psychology and Methylphenidate hydrochloride (MPH) is one of the most frequently prescribed pediatric medicine. This study was done to determine the effect of Methylphenidate hydrochloride on ovarian and pituitary gonadotropin hormone in peripubertal mice Materials and Methods: This experimental study was done on 40 preipubertal female mice (BALB/c) with three weeks age and approximate 12-15 gram. The mice were allocated randomly in one control and three experimental groups, designated as I, II and III. Animals in group I, II and III were received by gavage Methylphenidate hydrochloride with 2, 5 and 10 mg/kg body weight for six days, respectively. At the end of experiment body weight, serum estrogen, progesterone and pituitary gonadotropins were measured. Morphometric and histopathological evaluation of ovary were examined. Data were analyzed using SPSS-17, ANOVA and Tukey tests. Results: The body weight and ovary dimensions of animals in experimental groups were reduced significantly in comparison with control (P<0.05). Abnormal cells, structural alternations of granules cells and follicular growth abnormality were observed in experimental groups I and III in compare to control group. A significant reduction of estrogen, in group I, progesterone levels in group I and III were observed in comparison with the controls (P<0.05). Conclusion: This study showed that the Methylphenidate hydrochloride administration induces the reduction of body weight, ovary dimensions and hormones. [ABSTRACT FROM AUTHOR]

Background: It is estimated that 29% of deaths in Australia are caused by malignant disease each year and can be expected to increase with population ageing. In advanced cancer, the prevalence of fatigue is high at 70-90%, and can be related to the disease and/or the treatment. The negative impact of fatigue on function (physical, mental, social and spiritual) and quality of life is substantial for many palliative patients as well as their families/carers. Method/design: This paper describes the design of single patient trials (n-of-1 s or SPTs) of a psychostimulant, methylphenidate hydrochloride (MPH) (5 mg bd), compared to placebo as a treatment for fatigue, with a population estimate of the benefit by the aggregation of multiple SPTs. Forty patients who have advanced cancer will be enrolled through specialist palliative care services in Australia. Patients will complete up to 3 cycles of treatment. Each cycle is 6 days long and has 3 days treatment and 3 days placebo. The order of treatment and placebo is randomly allocated for each cycle. The primary outcome is a reduction in fatigue severity as measured by the Functional Assessment of Cancer Therapy-fatigue subscale (FACIT-F). Secondary outcomes include adverse events, quality of life, additional fatigue assessments, depression and Australian Karnovsky Performance Scale. Discussion: This study will provide high-level evidence using a novel methodological approach about the effectiveness of psychostimulants for cancer-related fatigue. If effective, the findings will guide clinical practice in reducing this prevalent condition to improve function and quality of life. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12609000794202. [ABSTRACT FROM AUTHOR]

This article is dedicated to the Memory of Professor Nadine Lambert, October 21 1926 – April 26 2006. There is a paradox that the amphetamine class of drugs used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) are also abused widely in society. This article reviews possible legal issues related to the topic and the historical discourse concerning addiction associated with the use of amphetamines and methylphenidate for the treatment of ADHD, Lambert's theories and the research counterclaims that are used to support the pharmaceutical manufacturer's report that ‘adequate treatment of ADHD may reduce the risk of substance abuse’. There are limitations in the Lambert studies and also limitations with other studies in the area. Further research and independent scientific and statistical analyses are required to determine any definitive conclusion. The author concludes that the claim and counterclaims cannot easily be resolved without a significant independent international inquiry. [ABSTRACT FROM AUTHOR]

Abstract A 28-year-old man with a history of myotonic dystrophy (MyD) is described. His progressively worsening excessive daytime sleepiness (EDS) was treated with methylphenidate hydrochloride. Polysomonography (PSG), the multiple sleep latency test (MSLT), middle latency-evoked response, and auditory event-related potentials were used to assess the cause of EDS. The PSG detected small numbers of central sleep apneic episodes. Mean sleep latency, which was determined by MSLT, increased from 5 min before treatment to 14 min after treatment. The Pa, P1, and N1 amplitudes at the Cz site increased after treatment, but P3 latency remained unchanged. These observations suggest that EDS and impairment of cognitive and information processing seen in a patient with MyD may be caused by a central nervous system disorder. [ABSTRACT FROM AUTHOR]