Long-Lasting ADHD Patch May Be an Option
Patch Releases Ritalin-Like Drug as Long as Needed
Better Than Extended-Release Pills?
In a second study, Robert L. Findling, MD, director of child and adolescent psychiatry at University Hospital in Cleveland, led a team that compared the patch with placebo as well as with methylphenidate pills.
Compared with placebo, both the patch and methylphenidate pills improved 6- to 12-year-old kids' ADHD. Interestingly, ADHD scores improved more with the patch than with the pills, although the difference was not large enough to be considered scientific proof of superiority.
"In general, there was a trend toward a greater positive effect of treatment with [the patch] than [oral medication]," Findling and colleagues write in their presentation abstract.
Who Would Use the Patch?
Since the patch contains the same drug as other long-lasting ADHD drugs, why would a parent choose it? WebMD asked Leslie Rubin, MD, director of developmental pediatrics at Emory University School of Medicine.
Rubin remembers the sea change in ADHD treatment that methylphenidate brought about some 10 years ago.
"That was a revolution, because a child would get Ritalin and go to school, and by 11 a.m. it is not working any more," Rubin tells WebMD. "So we would have to prescribe another dose at school, and there would be long lines at the nurse's station. It was disruptive -- and the kids would get embarrassed."
Concerta, Rubin says, also solved some of the problems that haunted early extended-release versions of ADHD drugs. So why go to the patch?
"Well, some kids don't like to take pills or even liquids. And you can't break up extended-release pills and put them in applesauce -- you destroy the release mechanisms," Rubin says. "If approved by the FDA, the patch will offer an opportunity to give an ADHD medicine without the child having to swallow it."
Perhaps more importantly, the patch offers more control over how long a parent wants the stimulant medication to last.
"If you give a child a pill, it is in the body and you can't do anything about it," Rubin says. "But if you put the patch on, and the child needs, say, six hours today, you can leave it on for a corresponding amount of time."
Wigal agrees. She says the patch may release methylphenidate for as long as 16 hours. Her team is also studying what happens when the patch is removed at times shorter and longer than those used in the this study. So far, she says, it looks as though the patch must be removed for three hours before its effects wear off.