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Wednesday, December 14, 2005, 8:30 -9:30 pm
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Research Updates    
The effects of medication on driving safety.
As many of our readers are aware, driving is a significant risk for adolescents and adults with ADHD. Several studies have found an increase in car crashes and traffic citations for ADHD drivers. In addition these drivers report less safe driving behavior in their own appraisal of their driving. Medication for ADHD may lower these risks for persons with ADHD who drive. Treatment with stimulant medications has been shown to reduce cognitive impairments that may be associated with poor driving outcomes.

A November 2005 issue of The ADHD Report summarized a study by Russell Barkley and colleagues that explored the effects of two doses of methylphenidate on simulator driving performance in adults with ADHD.

These investigators studied 53 adults with ADHD who performed on a virtual-reality driving simulator and for whom self- and other ratings of safe driving behavior during the simulation were gathered, as well as measurements on their performance on a continuous performance task. These adults performed the tasks at baseline and then at doses of 10 and 20 mg of methylphenidate (MPH) and on placebo in a counterbalanced order. The high dose of MPH was associated with better inhibition on the CPT and lower steering variability and speed on the driving simulator. Lower dose was associated with more frequent use of turn signals.

The authors noted that medication treatment may be one way to reduce the risks associated with driving in persons with ADHD. Such driving risks should be considered by employers who hire those with ADHD who drive as part of their job and by parents as affected teenagers reach driving age.

Barkley, R., et al. (2005). Effects of two doses of methylphenidate on simulator driving performance in adults with attention deficit hyperactivity disorder. Journal of Safety Research, 36, 121-131.

Comparing Extended Release Adderall (Adderall XR and Atomoxetine (Strattera) in a school-aged children with ADHD
Stimulants are the most widely used medications to treat core symptoms of ADHD and they have been used form more than fifty years in this group of children. In the past couple of years, non-stimulant medication have become available, with Straterra having been approved for use in children and adults for treatment of ADHD. There has been a lack of data comparing the efficacy of these two pharmacologic treatments.

A recent study by Sharon Wigal and colleagues reported in the Journal of Attention Disorders compared the efficts of mixed amphetamine salts extended release (MAS XR; Adderall XR) and atomoxetine (Strattera) in children 6 to 12 years old with ADHD combined or hyperactivity-impulsive type in a randomized, double-blind, multicenter, parallel-group, forced-dose-escalation laboratory school study. The SKAMP (Swanson, Kotkin, Agler, M-Flynn, and Pelham) behavioral rating scale was the primary efficacy measure. Changes in mean SKAMP department scores from baseline were significantly greater for MAS XR ()n=102) than for atomoxetine (n=101) overall and at each week. Adverse events were similar for both treatment groups.

Wigal, S.B., et al. (2005). A laboratory school comparison of mixed amphetamine salts extended release (Adderall XR) and atomoxetine (Strattera) in school-aged children with attention defivit/hyperactivity diorder. Journal of Attention Disorder , 9 (1), 275-289.

November's Featured myADHD.com's Tools
Family communication can often become problematic in households where children and parents may suffer from ADHD. Family therapists often teach communication skills to help family members manage conflict at home. In their book, Negotiating Parent-Adolescent Conflict, authors Arthur Robin and Sharon Foster discuss numerous strategies of this type. You can benefit from November's myADHD.com tools below to help your family, or one that you are working with, learn communication skills.
• 7001 Overcoming Roadblocks to Family Communication
• 7002 Steps to Problem Solving in Family Meetings
• 7003 Problem-Solving Worksheet

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