FORENSIC TOXICOLOGY

Parent ratings favored lisdexamfetamine over placebo at three daytime assessments after morning dosing. Those home-setting observations add useful information, but they do not measure every intervening hour or prove an exact duration for each child.

A different setting from the laboratory classroom

Coghill and colleagues reported parent-rated outcomes from a seven-week randomized trial in children and adolescents aged 6–17. The full analysis set included 317 participants across lisdexamfetamine, placebo and a methylphenidate reference arm.

Parents completed an abbreviated Conners rating scale at 10 a.m., 2 p.m. and 6 p.m. following dosing at approximately 7 a.m. For this study, ratings concerned behavior immediately before assessment rather than the scale’s usual longer recall period.

Benefits were observed at each scheduled assessment

Both active treatments significantly improved the reported ratings relative to placebo at the scheduled times. The final observation was in the early evening, approximately eleven hours after the nominal morning dose.

This is evidence of benefit at sampled times. It is not continuous measurement, and variability in administration and individual response prevents assigning the same precise onset or offset to every participant. Parent impressions also differ from math-task performance observed in a controlled classroom.

Comparison and follow-up limitations

Methylphenidate was included as a reference, but the trial was not designed to support a definitive statistical comparison between the active medicines. Large numerical effect sizes cannot independently establish which is better.

Dropout, endpoint definitions, selected eligibility criteria and industry sponsorship constrain interpretation. These findings concern symptom-related behavior in a specific assessment framework; they do not demonstrate longer-term academic achievement, driving safety or a relationship between blood concentration and impairment.

Related research

See why early symptom ratings and math performance can differ.

Primary research

Efficacy of lisdexamfetamine dimesylate throughout the day in children and adolescents with attention-deficit/hyperactivity disorder: results from a randomized, controlled trial. doi:10.1007/s00787-013-0421-y.