27mg Concerta tablets listed on PBS

A new 27mg form of the long-acting stimulant medication Concerta (methylphenidate hydrochloride) has recently been placed on the PBS, available with authority. It is hoped that this will allow for greater flexibility in treatment and better outcomes with fewer side effects.

ADHD affects between 3-5% of primary school aged children, and can be a major influence on their overall quality of life. The DSM-IV criteria for ADHD include displaying six or more symptoms of inattention and six or more symptoms of hyperactivity over a period of six months, which is maladaptive and inconsistent with developmental level. These symptoms must lead to some form of impairment in two or more settings, and there must be clear evidence of significant impairment in social, academic or occupational functioning.³

Stimulant medications have been shown to reduce the symptoms of ADHD, and are thus used as a first line medical agent. Some stimulant medications, have a short half-life which can require them to be taken at inconvenient intervals such as during school;¹ however, methylphenidate hydrochloride (Concerta) has the much longer duration of effect, lasting up to 12 hours. This both makes dosing easier for the children and their parents, but could also increase compliance due to the less confusing regimen.²

This medication was previously only available in 18mg, 36mg and 54mg tablets and the large differences in the amounts reduced the flexibility available to doctors in the prescribing of this agent. Now though, a new 27mg tablet has been introduced requiring a PBS authority prescription, but allowing dosages to be tailored to the patients needs in a more accurate way than before.²

It is hoped that this flexibility will allow for better symptom control with reduced side effects, thus leading to better compliance amongst patients and more positive outcomes for both the patient, their carer and their doctor.  

References:

1. Novartis Pharmaceuticals Australia Pty Ltd. ‘Ritalin 10, Ritalin LA (Methylphenidate hydrochloride)’ [online], MIMS Online, Available at: http://www.mims.com.au (last accessed: 2/08/2007)
2. Janssen-Cilag. ‘Concerta (Methylphenidate hydrochloride)’ [online], MIMS Online, Available at: http://www.mims.com.au (last accessed: 2/08/2007)
3. Sadock, BJ and Sadock, VA, Pocket Handbook of Clinical Psychiatry. 2005, Lippincott Williams and Wilkins: New York.