Review Article
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Published Online: 3 June 2019

New Formulations of Stimulants: An Update for Clinicians

This article has been corrected.
VIEW CORRECTION
Publication: Journal of Child and Adolescent Psychopharmacology
Volume 29, Issue Number 5

Abstract

In the last 15 years, there has been a marked increase in the number of available stimulant formulations with the emphasis on long-acting formulations, and the introduction of several novel delivery systems such as orally dissolving tablets, chewable tablets, extended-release liquid formulations, transdermal patches, and novel “beaded” technology. All of these formulations involve changes to the pharmaceutical delivery systems of the two existing compounds most commonly employed to treat attention-deficit/hyperactivity disorder (ADHD), amphetamine (AMP) and methylphenidate (MPH). In addition to these new formulations, our knowledge about the individual differences in response has advanced and contributes to a more nuanced approach to treatment. The clinician can now make increasingly informed choices about these formulations and more effectively individualize treatment in a way that had not been possible before. In the absence of reliable biomarkers that can predict individualized response to ADHD treatment, clinical knowledge about differences in MPH and AMP pharmacodynamics, pharmacokinetics, and metabolism can be utilized to personalize treatment and optimize response. Different properties of these new formulations (delivery modality, onset of action, duration of response, safety, and tolerability) will most likely weigh heavily into the clinician's choice of formulation. To manage the broad range of options that are now available, clinicians should familiarize themselves in each of these categories for both stimulant compounds. This review is meant to serve as an update and a guide to newer stimulant formulations and includes a brief review of ADHD and stimulant properties.

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cover image Journal of Child and Adolescent Psychopharmacology
Journal of Child and Adolescent Psychopharmacology
Volume 29Issue Number 5June 2019
Pages: 324 - 339
PubMed: 31038360

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Published online: 3 June 2019
Published in print: June 2019
Published ahead of print: 30 April 2019

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Ronald Steingard [email protected]
Child Mind Institute, New York, New York.
Sarper Taskiran
Child Mind Institute, New York, New York.
Department of Psychiatry, Koc University School of Medicine, Istanbul, Turkey.
Daniel F. Connor
Division of Child and Adolescent Psychiatry, Department of Psychiatry University of Connecticut School of Medicine, Farmington, Connecticut.
John S. Markowitz
Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida.
Mark A. Stein
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.

Notes

Address correspondence to: Ronald Steingard, MD, Child Mind Institute, 101 East 56th Street, New York, NY 10022 [email protected]

Disclosures

R.S. has no disclosures. S.T. has no disclosures. D.F.C., MD, is consultant to Supernus Pharma, receives grant support from Takeda Pharma and royalties from WW Norton; J.S.M. has the following grant: NIH Grant 1R01HD093612—01A1: Carboxylesterase 1 Genetic Variation and MPH in ADHD (Markowitz PI). M.S. has received research support from Akili Interactive, Pfizer, Shire, Ironshore, and Supernus, and is an advisor to Akili Interactive, Cingulate Therapeutics, Medici, NEOS, NLS, Shire, Supernus, and Sunovian.

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