A drug for road accidents?
children - originally designed to avoid the stigma of having to
take medication during school hours - could also save lives on the
road, according to new research.
A single dose of Concerta (methylphenidate HCl), sold by Johnson & Johnson subsidiary Janssen Pharmaceutica in Europe, improved the driving of teenagers in a small clinical study when compared to a regimen of immediate-release methylphenidate three times a day.
The American Automobile Association notes that teenagers account for only 7 per cent of all drivers, yet they are involved in 14 per cent of all fatal auto accidents and 20 per cent of all accidents. And adolescents with ADHD are two to six times more likely to be given speeding violations, receive four to five times the number of violations, and are six to eight times more likely to have their licence suspended than comparable young drivers without ADHD.
The authors of the study, published in the March issue of the Journal of the American Academy of Child & Adolescent Psychiatry, believe that the delivery system used in Concerta may be behind the findings.
Concerta has been formulated using the OROS system developed by Alza, a trilayer tablet that minimises the peaks and troughs in blood levels experienced with stimulant medications taken several times a day.
In the case of Janssen's drug, trials have shown that the OROS formulation can maintain improved attention and behaviour for 12 hours after dosing, extending protection outside school or work hours.
The study used a computer simulator to assess the teenager's driving based on variables such as steering control, braking, and speed control.
Performance remained stable throughout the day when participants received Concerta, but it worsened throughout the day - with a sharp decline at 8:00 pm - when they received methylphenidate three times a day. Additionally, the teenagers tended to have more high-speed collisions, less steering control, and ignored more stop signals when they took the three-times-a-day treatment.
"The impact of these findings is important because many adolescents are likely to be driving during evening hours," said Daniel Cox of the University of Virginia, the lead author of the study.
According to the US Insurance Institute for Highway Safety, per mile driven, the nighttime fatal crash rate for 16-year-olds is nearly twice as high as during the day.
