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EV1107

Processing speed measures and d-methylphenidate plasma concentrations in adults with ADHD and substance use disorder

PROCESSING SPEED MEASURES AND PLASMA CONCENTRATIONS OF D-METHYLPHENIDATE IN ADULTS WITH ADHD AND SUBSTANCE USE DISORDER

Improvements in AQT measures of cognitive speed following a methylphenidate dose were not associated with changes in d-MPH plasma concentrations.

The primary aim of the study was to examine whether performance on the neuropsychological AQT (A Quick Test of Cognitive Speed) test was associated with plasma concentrations of the active enantiomer d-MPH in adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) and substance use disorder who were receiving methylphenidate (MPH) treatment. Plasma concentration data obtained from 21 participants before dosing and 5 hours after dosing, at the time of the AQT assessments, were analyzed. In the AQT, patients rapidly name the color of the figures on the first plate (AQT-C), their shape on the second plate (AQT-F), and both their color and shape on the third plate (AQT-CF); each plate contains 40 figures, and the upper limits of the normal range were set at 25 s, 30 s, and 55 s, respectively. All participants showed improvement from pre-dose to post-dose on the AQT Color test, and significant gains were observed across all three tests. However, no correlations were found between differences in pre- and post-dose MPH plasma concentrations and changes in AQT-C, AQT-F, and AQT-CF scores. Among the nine participants who improved on all three tests, post-dose d-MPH plasma concentrations varied widely, ranging from 13 to 277 ng/mL; in some patients, AQT completion times remained high despite high d-MPH levels. The authors note that a possible explanation for this lack of association between plasma levels and improvement in AQT performance may be a learning effect at the second assessment.

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