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Medical Areas: Psychiatry/Psychology
Drug Information
The following information is obtained from various newswires, published
medical journal articles, and medical conference presentations.
Company: Alza
Approval Status: Approved August 2000
Treatment Area: For the treatment of Attention Deficit Hyperactivity Disorder
Concerta is a central nervous system (CNS) stimulant approved
for the treatment of Attention Deficit Hyperactivity Disorder
(ADHD). Its active ingredient is methylphenidate, and it is
available as an extended-release tablet in four tablet strengths
(18mg, 27mg, 36mg or 54mg of methylphenidate HCL). Each tablet is
designed to have a 12-hour duration of effect.
ADHD has three characteristic symptoms: inattention,
hyperactivity, and impulsiveness. Some patients display more
symptoms of hyperactivity and impulsiveness, while others may
display more symptoms of inattentiveness. Methylphenidate has been
used to treat ADHD for more than 30 years, and helps increase
attention and decrease impulsiveness and hyperactivity in ADHD
patients.
Concerta was demonstrated to be effective in the treatment of
ADHD in three double-blind, active and placebo-controlled studies
in 416 children 6 to 12 years-old. The studies compared Concerta
given qd, methylphenidate given tid over 12 hours, and placebo
treatment in two single-center, three-week crossover studies and in
a multicenter, four-week parallel-group comparison. The primary
comparison of interest in all three trials was Concerta versus
placebo.
Symptoms of ADHD were evaluated by community school teachers
using the Inattention/Overactivity with Aggression (IOWA) Conners
scale. Statistically significant reduction in the
Inattention/Overactivity subscale versus placebo was shown
consistently across all three controlled studies for Concerta qd.
(from FDA Label)
Reported side effects of Concerta include (but are not limited
to) the following:
- Headache
- Stomach pain
- Sleeplessness
- Decreased appetite
Other side effects seen with methylphenidate include nausea,
vomiting, dizziness, nervousness, tics, allergic reaction,
increased blood pressure, and psychosis (abnormal thinking or
hallucinations).
Concerta is contraindicated in patients with marked anxiety or
agitation, glaucoma, or tics. It is also contraindicated during any
treatment with monoamine oxidase inhibitors.
Concerta uses osmotic pressure to deliver methylphenidate HCl at
a controlled rate. The system, which resembles a conventional
tablet in appearance, consists of an osmotically active trilayer
core surrounded by a semipermeable membrane with an
immediate-release drug overcoat.
The mode of methylphenidate HCl's therapeutic action in ADHD
is not known. Methylphenidate is thought to block the reuptake of
norepinephrine and dopamine into the presynaptic neuron and
increase the release of these monoamines into the extraneuronal
space. Methylphenidate is a racemic mixture comprised of the d- and
l-isomers. The d-isomer is more pharmacologically active than the
l-isomer. (from FDA Label)