Lack of beneficial effect of planned treatment interruption in adults with ADHD treated with methylphenidate - clinical evidence.

IF 5.1 2区医学 Q1 PSYCHIATRY

Psychiatry Research Pub Date : 2026-08-20 DOI:10.1016/j.psychres.2026.117409

Daria Schetz, Adriana Schetz, Marcin Wirtwein, Jacek Sein Anand, Marek Wiergowski, Ivan Kocić

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引用次数: 0

Abstract

Objective: Planned weekend drug holidays during methylphenidate (MPH) treatment are used in clinical practice despite limited evidence in adults. This study compared continuous daily MPH use with planned weekend breaks in adult men with ADHD, focusing on real-world behavioral functioning, adherence, cognition, sleep, appetite, and adverse effects.

Methods: In this prospective observational comparative cohort study, adult men with ADHD receiving stable MPH treatment were not randomized by the investigators but were classified according to their pre-existing naturalistic treatment pattern established before study enrolment: continuous daily use (MPHC) or planned weekend breaks (MPH-PWB). Participants completed baseline and end-of-study questionnaires and cognitive tests and were followed for 28 days using structured daily diaries.

Results: Forty-three participants were included in the final analysis (MPHC, n = 23; MPH-PWB, n = 20). The weekend-break group showed higher mean daily procrastination (8.4 ± 1.4 vs. 7.5 ± 1.2; p = 0.028) and lower task completion (64.8% ± 12.6 vs. 74.1% ± 11.3; p = 0.017). Weekday-only analyses attenuated these differences. No clear between-group differences were observed in questionnaire outcomes, cognitive performance, sleep, appetite, adherence, or most non-cardiovascular adverse effects. Tachycardia occurred with similar frequency in both groups, whereas blood pressure elevation and palpitations were more frequent in the weekend-break group.

Conclusions: In adult men receiving stable MPH treatment, planned weekend breaks were not associated with a clear overall advantage and were linked to less favorable diary-based behavioral functioning and more frequent selected self-reported cardiovascular adverse effects. Routine weekend discontinuation should not be assumed to improve treatment quality.

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用哌甲酯治疗成人ADHD缺乏计划治疗中断的有益效果-临床证据。

目的：尽管在成人中证据有限，但在哌醋甲酯（MPH）治疗期间计划的周末用药假期在临床实践中使用。这项研究比较了成年ADHD患者每天持续使用MPH和计划周末休息的情况，重点关注现实世界的行为功能、依从性、认知、睡眠、食欲和不良反应。方法：在这项前瞻性观察性比较队列研究中，接受稳定MPH治疗的成年ADHD男性患者不是由研究人员随机分组的，而是根据他们在研究入组前已经存在的自然治疗模式进行分类：连续每日使用（MPHC）或计划周末休息（MPH- pwb）。参与者完成了基线和研究结束时的问卷调查和认知测试，并使用结构化的日常日记进行了28天的跟踪。结果：43名受试者纳入最终分析（MPHC, n = 23; MPH-PWB, n = 20）。周末休息组的平均每日拖延率较高（8.4±1.4比7.5±1.2,p = 0.028），任务完成率较低（64.8%±12.6比74.1%±11.3,p = 0.017）。仅工作日的分析减弱了这些差异。在问卷调查结果、认知表现、睡眠、食欲、依从性或大多数非心血管不良反应方面没有观察到明显的组间差异。两组发生心动过速的频率相似，而血压升高和心悸在周末休息组更频繁。结论：在接受稳定MPH治疗的成年男性中，计划好的周末休息与明显的总体优势无关，并且与不太有利的基于日记的行为功能和更频繁的选择自我报告的心血管不良反应有关。不应假定周末常规停药可以提高治疗质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychiatry Research 医学-精神病学

CiteScore

17.40

自引率

1.80%

发文量

527

审稿时长

57 days

期刊介绍： Psychiatry Research offers swift publication of comprehensive research reports and reviews within the field of psychiatry. The scope of the journal encompasses: Biochemical, physiological, neuroanatomic, genetic, neurocognitive, and psychosocial determinants of psychiatric disorders. Diagnostic assessments of psychiatric disorders. Evaluations that pursue hypotheses about the cause or causes of psychiatric diseases. Evaluations of pharmacologic and non-pharmacologic psychiatric treatments. Basic neuroscience studies related to animal or neurochemical models for psychiatric disorders. Methodological advances, such as instrumentation, clinical scales, and assays directly applicable to psychiatric research.