Poster
139
(#139) Attention-Deficit/Hyperactivity Disorder Symptoms and Side-Effect Profile of Serdexmethylphenidate/Dexmethylphenidate (SDX-dMPH, Azstarys) Versus Other Stimulants in the Real-World Setting
Psych Congress 2025
Abstract: Aim: To compare extended-release (ER) methylphenidate (MPH) and amphetamine (AMP) medications in terms of patient-reported side effects, including insomnia, appetite suppression, end-of-dose crash, and symptom return after dose wears off.
Methods: From May 2022 to January 2024, 1,395 patients were surveyed and categorized by treatment: SDX/d-MPH (n = 96), d-MPH ER (n = 64), MPH ER (n = 158), AMP ER (n = 380), and lisdexamfetamine (n = 697). All patients received monotherapy with an ER stimulant within the first 90 days of treatment. The ADHD Symptom and Side Effect Tracking (ASSET) scale assessed symptom severity and adverse events at each clinic visit. Logistic regression determined whether ER treatment could be predicted by reported side-effect rates, and McFadden R² assessed model fit and likelihood of treatment group assignment.
Results: The sample was 57% female, 39% male, and 4% non-cisgender, with a mean age of 32.5 years (range 7-78). Racial distribution was 87% White, 3.1% Asian, 2.6% Black or African American, and 1.3% Indigenous or Pacific Islander. Numerically, SDX/d-MPH was associated with fewer reported side effects across outcomes. Statistically significant lower rates of insomnia (P = .005; McFadden R2 [263] = .075) and end-of-dose crash (P = .009; McFadden R2 [263] = .075) were reported with SDX/d-MPH versus other ER stimulants.
Conclusion: SDX/d-MPH was associated with significantly lower rates of insomnia and end-of-dose crash and fewer overall side effects compared to other ER stimulants, suggesting it may offer a favorable tolerability profile for patients with ADHD.
Short Description: Research describing real-world, patient-reported experiences of side effects to medications approved for the treatment of patients with ADHD is limited. In this study, differences between methylphenidate (MPH) and amphetamine (AMP) extended-release (ER) medications were investigated in mean frequencies of patient-reported side effects including insomnia, appetite suppression, end-of-dose crash, and return of symptoms after dose wearing off.
Name of Sponsoring Organization(s): Corium LLC
Methods: From May 2022 to January 2024, 1,395 patients were surveyed and categorized by treatment: SDX/d-MPH (n = 96), d-MPH ER (n = 64), MPH ER (n = 158), AMP ER (n = 380), and lisdexamfetamine (n = 697). All patients received monotherapy with an ER stimulant within the first 90 days of treatment. The ADHD Symptom and Side Effect Tracking (ASSET) scale assessed symptom severity and adverse events at each clinic visit. Logistic regression determined whether ER treatment could be predicted by reported side-effect rates, and McFadden R² assessed model fit and likelihood of treatment group assignment.
Results: The sample was 57% female, 39% male, and 4% non-cisgender, with a mean age of 32.5 years (range 7-78). Racial distribution was 87% White, 3.1% Asian, 2.6% Black or African American, and 1.3% Indigenous or Pacific Islander. Numerically, SDX/d-MPH was associated with fewer reported side effects across outcomes. Statistically significant lower rates of insomnia (P = .005; McFadden R2 [263] = .075) and end-of-dose crash (P = .009; McFadden R2 [263] = .075) were reported with SDX/d-MPH versus other ER stimulants.
Conclusion: SDX/d-MPH was associated with significantly lower rates of insomnia and end-of-dose crash and fewer overall side effects compared to other ER stimulants, suggesting it may offer a favorable tolerability profile for patients with ADHD.
Short Description: Research describing real-world, patient-reported experiences of side effects to medications approved for the treatment of patients with ADHD is limited. In this study, differences between methylphenidate (MPH) and amphetamine (AMP) extended-release (ER) medications were investigated in mean frequencies of patient-reported side effects including insomnia, appetite suppression, end-of-dose crash, and return of symptoms after dose wearing off.
Name of Sponsoring Organization(s): Corium LLC
