In the past decades, methylphenidate has gained widespread popularity onto the pharmacological market, directed toward individuals with a diagnosis of Attention-deficit/hyperactivity disorder (ADHD...Show moreIn the past decades, methylphenidate has gained widespread popularity onto the pharmacological market, directed toward individuals with a diagnosis of Attention-deficit/hyperactivity disorder (ADHD), narcolepsy, traumatic brain injury, stroke, and even human immunodeficiency virus infections. This cognitive enhancer exerts its effects by binding to the dopamine transporter, resulting in heightened extracellular dopamine levels. However, the psychophysiological side-effects associated with this medication are not yet fully understood. The present study delves deeper into erratic psychophysiological side-effects, including psychosis, mood changes, experiences of seizures, tics and the development of skin rashes. Our primary objectives were twofold. Firstly, we aimed at exploring the frequency of adverse symptom perception in individuals receiving methylphenidate as treatment. Secondly, we sought to investigate the potential impact of treatment duration on symptom perception, and examine any potential correlation between the two. To achieve this, we implemented an online version of ‘The Methylphenidate monitoring side effects scale’ (MMSES), with a total of 135 participants, 22 belonging to the experimental group, with prescribed medication, and 113 to the control group, not receiving medication. The results of our study revealed that adverse symptom perception did not significantly differ between the experimental and the control group, (t = 0.31, p = .852). However, psychotic symptoms were significantly lower in the control group in comparison to the experimental group (t = 0.56, p = .041). Additionally, the correlational analysis demonstrated a non-significant relationship between treatment duration and symptom perception (r(20) = .21, p = .353). These preliminary findings need to be followed up by future research and require to be interpreted with caution due to a possibly confounding effect of age differences and other limitations. Future directions may comprise the inclusion of neuroimaging techniques to identify the pathophysiological changes associated with methylphenidate administration, and a larger sample size.Show less
This retrospective cohort study aimed to investigate the influence of stress on atypical symptom amelioration to first-choice psychostimulant medication in individuals with attention deficit...Show moreThis retrospective cohort study aimed to investigate the influence of stress on atypical symptom amelioration to first-choice psychostimulant medication in individuals with attention deficit hyperactivity disorder (ADHD). Understanding the impact of stress on the effectiveness of psychostimulant medications is crucial, given the high prevalence of stress-related psychiatric comorbidity in ADHD and the potential stress effects on psychostimulant effectivity. It was hypothesized that cardiovascular stress and stress-related psychiatric comorbidity are related to atypical symptom amelioration and that these two characteristics are interrelated. Additionally, the effect of medication and time will be explored. A unique subset from the SOPHISTICATE cohort was analysed, comprising of 460 patients diagnosed with ADHD who exhibited atypical treatment response following first-choice medication registration and were switched to a second-choice medication within 3 weeks. The adult version of the Quantified Behavioral Test (QbTest), a computerized tool that quantifies the core symptoms of ADHD was used to determine baseline symptom severity and treatment response, i.e. QbActivity (QbAct); QbImpulsivity (QbImp); and QbInattention (QbIna). Patients were divided into groups based on stresscharacteristics, and linear mixed models were employed to examine the impact of stresscharacteristics, first-choice medication and time on symptom amelioration (i.e. QbTest score after first- or second-choice medication – QbTest score at baseline; ∆). The results reveal that stress-characteristics were not related to atypical symptom amelioration after first-choice medication. However, patients with stress related psychiatric comorbidity show more inattentive symptom amelioration after second-choice medication registration β=.21, SE=.10, 95% CI [.02, .41], p=.031. Importantly, the effect of time was significant for all three symptom domainssuggesting a role of time to enable a typical response, i.e. ∆QbAct (F(1,462) = 387.818, p < .001), ∆QbImp (F(1, 462) = 235.224, p < .001) and on ∆QbIna (F(1, 463) = 319.655, p = .242). Additionally it was found that baseline symptom severity confounds the medication effect for ∆QbImp and for ∆QbAct. In conclusion, the results indicate that stress characteristics nor medication is related to an atypical response pattern to first-choice medication. The current study did reveal an important role of time to enable a ‘typical’ response. Limitations of the study included the lack of a reference group, the possibility of random effects, and quality of the cardiovascular data. In conclusion, while the impact of stress on treatment response could not be definitively determined based on the available data, future research should explore the complex interplay between stress, psychiatric comorbidity, and medication types to optimize treatment strategies and improve outcomes for patientsShow less
