Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-29T03:10:18.103Z Has data issue: false hasContentIssue false

Pharmacokinetics of Mixed Amphetamine Salts Extended Release in Adolescents With ADHD

Published online by Cambridge University Press:  07 November 2014

Abstract

Objective

A randomized, open-label, single-dose, three-treatment, three-period, crossover, phase I study was conducted to assess the pharmacokinetics of mixed amphetamine salts extended release (MAS XR) in adolescents with attention-deficit/hyperactivity disorder (ADHD).

Methods

Two cohorts of healthy adolescents 13–17 years of age with ADHD were enrolled in the study. Seventeen subjects, weighing ≤75 kg (≤ 65 lbs), were randomized to one of three dosing sequence groups (a single oral dose of MAS XR 10, 20, or 40 mg, follwed by crossover to the alternate treatments, with a 7-day washout between treatments). Six additional subjects, weighing >75 kg (>165 lbs), were randomized simihrly but received larger doses of MAS XR (20, 40, and 60 mg). Blood samples were collected before and at hours 1–12 after drug administration, as well as before and at hours 14, 24,48, and 60.

Findings

Linear pharmacokinetics of dextroamphetamine (D-amphetamine) and loamphetamine (L-amphetamine) were observed with MAS XR in both cohorts. The pharmacokinetics of D-amphetamine and L-amphetamine did not differ between male and female adolescents. A significant decrease in maximum exposure (Cmax) and increase in half-life were seen for both isomers with increasing age, but overall exposure (AUC was not affected. Cmax and AUC for both isomers decreased as body weight increased.

Conclusion

Exposure to MAS XR was linear and directly proportional to the dose administered in 13–17-year-old adolescents with ADHD. The time course of drug absorption and elimination did not appear to be affected by dose at 10–40 mg in subjects weighing ≤75 kg, and at 20–60 mg in subjects weighing >75 kg. Gender did not affect the pharmacokinetics of MAS XR; age and body weight influenced the profile of certain pharmacokinetic variables.

Type
Academic Supplement
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Rowland, AS, Umbach, DM, Stallone, L, Naftel, J, Bohlig, M, Sandler, DP. Prevalence of medication treatment for attention deficit-hyperactivity disorder among elementary school children in Johnston County, North Carolina. Am J Public Health. 2002;92:231234.Google Scholar
2.Barkley, RA, Fischer, M, Edelbrook, C, et al.The adolescent outcome of hyperactive children diagnosed by research criteria, I: an 8-year prospective follow-up study. J Am Acad Child Adolesc Psychiatry. 1990;29:546557.Google Scholar
3.Biederman, J, Faraone, S, Milberger, S, et al.Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study. J Am Acad Child Adolesc Psychiatry. 1996;35:343351.Google Scholar
4.Mannuzza, S, Klein, RG, Bessler, A, Matloy, P, LaPadula, M. Adult psychiatric status of hypetactive boys grown up. Am J Psychiatry. 1998;155:493498.CrossRefGoogle ScholarPubMed
5.Grcevich, S, Read, SC, Sea, D, Mays, DA, Tulloch, SJ. Safety and efficacy of MAS XR in adolescents with ADHD. Poster presented at: 51st Annual Meeting of the American Academy of Child and Adolescent Psychiatry; October 19-24, 2004; Washington, DC.Google Scholar
6.Diagnostic and Statistical Manual of Mental Disorders. 4th ed text rev. Washington, DC: American Psychiatric Association; 2000.Google Scholar
7.Kaufman, J, Birmaher, B, Brent, D, et al.Schedule fot Affective Disorders and Schizophrenia for School-aged Children-Present and Lifetime version (K-SADS-PL). J Am Acad Child Adolesc Psychiatry. 1997;36:980988.Google Scholar
8.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiattic Association; 1994.Google Scholar
9.Dzerk, AM, Lin, PP, Lee, JW, et al.A steteoselective LC/MS/MS method for the quantitation of R/S amphetamine in human EDTA plasma [abstract]. Pharm Res. 1997;14:S685.Google Scholar
10.Tulloch, SJ, Zhang, Y, McLean, A, Wolf, KN. SLI381 (Adderall XR), a two-component, extended-release formulation of mixed amphetamine salts: bioavailability of three test formularions and comparison of fasted, fed, and sprinkled adminisrtation. Pharmacotherapy. 2002;22:14051415.Google Scholar
11.McGough, JJ, Biederman, J, Greenhill, LL, et al.Phatmacokinetics of SLI381 (Adderall XR) an extended-release formulation of Adderall. J Am Acad Child Adolesc Psychiatry. 2003;42:684691.CrossRefGoogle ScholarPubMed
12.Tulloch, S, Frazer, N, Kisicki, JC, et al. Dose ptopottionality of 20, 40, and 60 mg of an extended-release formulation of mixed amphetamine salts in adults. Postet presented at: 43rd Annual National Clinical Dmg Evaluation Unit; May 26-28, 2003; Boca Raton, Fla.Google Scholar
13.Biederman, J, Lopez, FA, Boellner, SW, Chandler, MC. A randomized, double-blind, placebo-controlled, parallel-group study of SLI381 (Addetall XR) in children with attention-deficit/hyperactivity disorder. Pediatrics. 2002;110:258266.Google Scholar
14.McCracken, JT, Biederman, J, Greenhill, LL, et al.Analog classroom assessment of a once-daily mixed amphetamine formulation, SLI381 (Addetall XR), in childten with ADHD. J Am Acad Child Adolesc Psychiatry. 2003;42:673683.CrossRefGoogle ScholarPubMed
15.Weisler, RH, Chrisman, AK, Wilens, TE. Adderall XR dosed once-daily in adult patients with ADHD. Presented at: 156th Annual Meeting of the American Psychiatric Association; May 17-22, 2003; San Francisco, Calif.Google Scholar
16.Weisler, RH, Biederman, J, Chrisman, AK, et al. Long-tetm safety and efficacy of once-daily Adderall XR in adults with ADHD. Poster presented at: 156th Annual Meeting of the American Psychiatric Association; May 17-22, 2003; San Francisco, Calif.Google Scholar
17.Biederman, J, Spencer, TJ, Wilens, TE, et al. Long-term safety and efficacy of Adderall XR for adult ADHD. Presented at: 157th Annual Meeting of the American Psychiattic Association; May 1-6, 2004; New Yotk, NY.Google Scholar