Processing speed can monitor stimulant-medication effects in adults with attention deficit disorder with hyperactivity

Nord J Psychiatry. 2017 May;71(4):296-303. doi: 10.1080/08039488.2017.1280534. Epub 2017 Feb 7.

Abstract

Background: Treatment responses to methylphenidate by adults with ADHD are generally monitored against DSM-IV/DSM-V symptomatology, rating scales or interviews during reviews.

Aims: To evaluate the use of single- and dual-dimension processing-speed and efficiency measures to monitor the effects of pharmacological treatment with methylphenidate after a short period off medication.

Methods: A Quick Test of Cognitive Speed (AQT) monitored the effects of immediate-release methylphenidate in 40 previously diagnosed and medicated adults with ADHD. Processing speed was evaluated with prior prescription medication, without medication after a 2-day period off ADHD medication, and with low-dose (10/20 mg) and high-dose (20/40 mg) methylphenidate hydrochloride (Medikinet IR).

Results: Thirty-three participants responded to the experimental treatments. One-way ANOVA with post-hoc analysis (Scheffe) indicated significant main effects for single dimension colour and form and dual-dimension colour-form naming. Post-hoc analysis indicated statistical differences between the no- and high-dose medication conditions for colour and form, measures of perceptual speed. For colour-form naming, a measure of cognitive speed, there was a significant difference between no- and low-dose medication and between no- and high-dose medications, but not between low- and high-dose medications.

Conclusions: Results indicated that the AQT tests effectively monitored incremental effects of the methylphenidate dose on processing speed after a 2-day period off medication. Thus, perceptual (colour and form) and cognitive speed (two-dimensional colour-form naming) and processing efficiency (lowered shift costs) increased measurably with high-dose medication. These preliminary findings warrant validation with added measures of associated behavioural and cognitive changes.

Keywords: Attention deficit disorder with hyperactivity; adults; central nervous system stimulant; cognition.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Attention / drug effects*
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Central Nervous System Stimulants / therapeutic use*
  • Color Perception / drug effects
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Methylphenidate / therapeutic use*
  • Middle Aged
  • Neuropsychological Tests
  • Pattern Recognition, Visual / drug effects
  • Reaction Time / drug effects*
  • Sweden
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Methylphenidate