Onset-of-action of psychostimulant medication for attention-deficit hyperactivity disorder (ADHD) can be delayed by up to two hours, leading to inadequately controlled morning symptoms.
In the Journal of Child and Adolescent Psychopharmacology (online, 21 July 2017), researchers tested a delayed-release formulation of extended-release methylphenidate (DR/ER-MPH) that can be taken in the evening but does not begin releasing the drug for 8–10 hours after administration
During the three-week trial, 81 children with ADHD randomly assigned to the DR/ER-MPH experienced a significant improvement in ADHD symptoms compared with 80 children randomly assigned to placebo. The researchers found a significant effect on at-home early morning symptoms and also showed that the effect lasted into the late afternoon and evening.
The study shows that early-morning functional impairment in ADHD can be controlled with DR/ER-MPH without compromising control later in the day, the team concluded.
 Pliszka S, Wilens T, Bostrom S et al. Efficacy and safety of HLD200, delayed-release and extended-release methylphenidate, in children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharm 2017;27:474–482. doi: 10.1089/cap.2017.0084