Published online November 1, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. 1100-1106 (doi:10.1542/peds.2007-0542)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (5)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Arnold, L. E.
Right arrow Articles by Ramadan, Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Arnold, L. E.
Right arrow Articles by Ramadan, Y.
Related Collections
Right arrow Neurology & Psychiatry
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

SPECIAL ARTICLE

Treating Attention-Deficit/Hyperactivity Disorder With a Stimulant Transdermal Patch: The Clinical Art

L. Eugene Arnold, MDa, Ronald L. Lindsay, MDb, Frank A. López, MDc, Sharon E. Jacob, MDd, Joseph Biederman, MDe, Robert L. Findling, MDf and Yaser Ramadan, MDa

a Department of Psychiatry, Ohio State University, Columbus, Ohio
b Arizona Child Study Center, St Joseph's Hospital and Medical Center, Phoenix, Arizona
c Children's Developmental Center, Maitland, Florida
d Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida
e Pediatric Psychopharmacology Department, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
f Departments of Psychiatry and Pediatrics, Case Western Reserve University, Cleveland, Ohio

Stimulant medications (amphetamine and methylphenidate) are the best-documented treatments for attention-deficit/hyperactivity disorder, but their short pharmacokinetic and behavioral half-lives have historically produced irksome time-course effects. New drug-delivery systems designed to eliminate the need for frequent dosing include the methylphenidate transdermal system, in which the matrix acts as both the drug reservoir and the skin adhesive. The methylphenidate transdermal system patch, in contrast to long-acting oral preparations, requires a paradigmatic shift in clinical thinking, as well as refinement of clinical management skills. For dosing with the methylphenidate transdermal system patch, clinicians must think in terms of a retrievable form of drug delivery (in milligrams per hour) rather than a fixed nonretrievable dose (in milligrams per dose or milligrams per day). Clinicians and patients can determine the optimal clinical dose by controlling 2 variables: (1) patch size (controlling milligrams per hour) and (2) duration of patch wear. The new paradigm is worth learning, because the patch offers several advantages over oral preparations for some patients, chiefly individualized control over effect duration (determined by when the patch is applied in the morning and removed in the afternoon/evening). Taking full advantage of this treatment option requires educating the patient and parents regarding practical elements of daily use. These elements include patch-site selection, application techniques, management of wear time to optimize the daily time course of clinical benefits, and skin hygiene. This article summarizes clinical principles that physicians may find useful in managing this new addition to the attention-deficit/hyperactivity disorder treatment armamentarium.

Key Words: attention-deficit/hyperactivity disorder • methylphenidate • transdermal system

Abbreviations: MTS—methylphenidate transdermal system • ADHD—attention-deficit/hyperactivity disorder

Accepted May 23, 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 The Annals of PharmacotherapyHome page
B. Chavez, M. A Sopko Jr., M. J Ehret, R. E Paulino, K. R Goldberg, K. Angstadt, and G. T Bogart
An Update on Central Nervous System Stimulant Formulations in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder
Ann. Pharmacother., June 1, 2009; 43(6): 1084 - 1095.
[Abstract] [Full Text] [PDF]