Response to methylphenidate by adult and pediatric patients with attention-deficit/hyperactivity disorder: the Spanish multicenter DIHANA study

JR Valdizán-Usón,¹ A Cánovas-Martínez,² MT De Lucas-Taracena,³ F Díaz-Atienza,⁴ LS Eddy-Ives,⁵ A Fernández-Jaén,⁶ M Fernández-Pérez,⁷ M García-Giral,⁸ P García-Magán,⁹ M Garraus-Oneca,¹⁰ MA Idiazábal-Alecha,¹¹ M López-Benito,¹² G Lorenzo-Sanz,¹³ J Martínez-Antón,¹⁴ MA Martínez-Granero,¹⁵ F Montañés-Rada,¹⁶ F Mulas-Delgado,¹⁷ G Ochando-Perales,¹⁸ E Ortega-García,¹⁹ A Pelaz-Antolín,²⁰ JA Ramos-Quiroga,²¹ FC Ruiz-Sanz,²² J Vaquerizo-Madrid,²³ A Yusta-Izquierdo<sup>24

1</sup>Unidad Trastornos Neurofuncionales, Clínica Montpellier, Zaragoza, ²Hospital Dr Peset, Valencia, ³Hospital 12 de Octubre, Madrid, ⁴Hospital Virgen de las Nieves, Granada, ⁵Centre Mèdic Sant Ramon, Santa Coloma de Gramenet, Barcelona, ⁶Hospital Universitario Quirón, Madrid, ⁷Centro de Salud La Felguera, Langreo, Asturias, ⁸Hospital Clínic, Barcelona, ⁹Unidad Salud Mental, Talavera de la Reina, ¹⁰Clínica Universitaria de Navarra, Pamplona, ¹¹Hospital Ntra. Sra. del Pilar, Barcelona, ¹²Centro Salud Contrueces, Gijón, ¹³Hospital Ramón y Cajal, Madrid, ¹⁴Complejo Hospitalario Carlos Haya, Málaga, ¹⁵Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, ¹⁶Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, ¹⁷Hospital Universitario La Fe, Valencia, ¹⁸Hospital Universitario La Fe, Valencia, ¹⁹Complejo Asistencial Universitario de León, ²⁰Centro Salud Mental, Alcalá de Henares, ²¹Hospital Universitari Vall d'Hebron. CIBERSAM. Department of Psychiatry and Legal Medicine. Universitat Autònoma de Barcelona, ²²Hospital General Rio Carrión, Palencia, ²³Hospital Materno-Infantil, Badajoz, ²⁴Hospital Universitario, Guadalajara, Spain

Background: The purpose of this multicenter Spanish study was to evaluate the response to immediate-release methylphenidate by children and adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), as well as to obtain information on current therapy patterns and safety characteristics.
Methods: This multicenter, observational, retrospective, noninterventional study included 730 patients aged 4–65 years with a diagnosis of ADHD. Information was obtained based on a review of medical records for the years 2002–2006 in sequential order.
Results: The ADHD predominantly inattentive subtype affected 29.7% of patients, ADHD predominantly hyperactive-impulsive was found in 5.2%, and the combined subtype in 65.1%. Overall, a significant lower Clinical Global Impression (CGI) score and mean number of DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision) symptoms by subtype were found after one year of treatment with immediate-release methylphenidate; CGI decreased from 4.51 to 1.69, symptoms of inattention from 7.90 to 4.34, symptoms of hyperactivity from 6.73 to 3.39, and combined subtype symptoms from 14.62 to 7.7. Satisfaction with immediate-release methylphenidate after one year was evaluated as “very satisfied” or “satisfied” by 86.90% of the sample; 25.75% of all patients reported at least one adverse effect. At the end of the study, 41.47% of all the patients treated with immediate-release methylphenidate were still receiving it, with a mean time of 3.80 years on therapy.
Conclusion: Good efficacy and safety results were found for immediate-release methylphenidate in patients with ADHD.

Keywords: attention deficit hyperactivity disorder, ADHD, pharmacologic treatment, methylphenidate, satisfaction