Existing Delivery Methods for Medication
Choosing the best medication to treat children with ADHD takes cooperation between a child’s physician and parents. While medical treatment options include both stimulant and non-stimulant medications, until recently options for delivery of medication have been somewhat limited.
When recommending medication for children with ADHD, physicians must consider how the medication will be administered. For example:
Traditional ADHD medications are usually in pill form, requiring children to swallow a capsule or pill, which may cause stress for some children. When necessary, parents may split pills or crush them to sprinkle over a child’s food. But while it is okay to do this with some formulations, crushing some of the long acting formulations would cause the entire day’s worth of medication to be released at once.
Medications delivered in a patch offer additional flexibility, but there can be complications with children removing patches, or finding them physically irritating.
A physician must consider all of these issues when seeking the optimal medication for a child.
New Delivery Methods Coming on the Market
In the past 12 months, the FDA has approved several new delivery mechanisms, or formulations, of ADHD treatment. The oral liquid, chewable tablet, and oral disintegrating tablet may be helpful for parents, and can improve outcomes for children. These options have gone through trials in controlled “laboratory classroom” environments to prove their safety and efficacy. They provide new ways to maximize symptom control in children. Different formulations may be the key to finding the most effective medical treatment for your child.
- An extended-release oral liquid amphetamine (AMPH) became available in April 2016 for children ages 6 and up. This medication was evaluated in a laboratory classroom study with 108 participants aged 6-12 years who were diagnosed with ADHD. The medication was found to be effective compared to placebo beginning at one hour after dosing, and continued through 13 hours. Side effects were consistent with those expected from AMPH. An advantage of this medication is that patients may start at a low dose and have their dosage titrated to optimum effect with one prescription.
- An extended-release methylphenidate (MPH) chewable tablet is now available. It was studied in a laboratory classroom with 86 participants aged 6-12 years with ADHD. Efficacy for this formulation was found to began at 45 minutes after dosing and continued to 8 hours post dose. The chewable tablet takes away the stress of swallowing a pill during administration.
Oral Disintegrating tablet
- An extended-release AMPH oral disintegrating tablet (ODT) became available in May 2016. Instead of looking at medication efficacy using a laboratory classroom study, this drug was evaluated against Adderall XR in a bioequivalence study. In bioequivalence studies a new product is compared to a standard marketed product. If certain parameters such as drug concentration and total drug exposure are similar, the medications are considered to be bioequivalent. From the results of the study, it is assumed that the AMPH ODT will have effectiveness comparable to Adderall XR when given to patients.
These three delivery methods provide physicians with new options to improve treatment for their patients with ADHD. All three treatments can remove the stress of swallowing a pill or keeping a patch on an active child from administration. The oral liquid also allows flexible dosing within one prescription.
When choosing a treatment option for their patients, the ultimate goal for physicians is to find the most effective dose, as quickly as possible, while minimizing the side effects. Every child has different needs and responses to medications. It is vital that parents work with their child’s provider to customize the treatment approach and insure the higher probability of achieving symptom control with a longer duration.