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Poster Abstr Acts May 28 – 31, 2013 Wednesday, May 29, 2013 Poster Session I Regency 1 Ballroom

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Poster Abstr Acts May 28 – 31, 2013 Wednesday, May 29, 2013 Poster Session I Regency 1 Ballroom NCDEU An Annual Meeting of the ASCP Recognizing Unmet Needs in Psychopharmacology: From Biomarkers to Breakthrough Therapies POSTER ABSTR acTS MAY 28 – 31, 2013 Wednesday, May 29, 2013 Poster Session I Regency 1 Ballroom 1 THE EFFECTS OF BEHAVIORAL PARENT TRAINING AND ACUTE STIMULANT MEDICATION TREATMENT FOR PARENTS WITH ADHD Dara Babinski, M.A.1, James G. Waxmonsky, MD2, William E. Pelham, Jr., PhD, ABPP2 1University of Florida, 2Florida International University Half of families initiating behavioral parent training (BPT) do not improve. Parental ADHD symptoms may reduce the efficacy of BPT (Chronis et al., 2004), but there are no a priori studies of parents meeting full DSM-IV ADHD criteria. Stimulant medication has been shown to improve parenting (Chronis- Tuscano et al., 2008; Waxmonsky et al., in preparation), but it is not known whether there is additional benefit to receiving medication after completing BPT. This study evaluated the efficacy of BPT for parents with ADHD, and also explored the acute effects of medication on parent child interactions. Participants were 12 parents and their children (ages 6-12) who met DSM ADHD criteria. Parents were first stabilized on stimulant medication during weekly visits with study psychiatrists using the ADHD-RS to titrate to optimal dose. Then, parents discontinued medication and were randomly assigned to a 3, 4, or 5 week baseline, during which they provided semiweekly ratings of their impairment (i.e., Sheehan Disability Scale; SDS; Sheehan et al., 1996), parenting (i.e., Alabama Parenting Questionnaire-9; APQ-9; Elgar et al., 2007) and their child’s behavior (i.e., Home Situations Questionnaire; HSQ; Barkley, 1997; Parent Daily Report; PDR; Patterson et al., 1982). After baseline, parents and their children completed two laboratory tasks (Wells et al., 2006), within two weeks, once on their optimally dosed medication and once on a placebo to assess the effects of medication on parent-child behavior. Parents then completed eight BPT sessions, during which they were not medicated. Semiweekly ratings were collected during BPT, and two more parent-child tasks (medication vs. placebo) were conducted upon BPT completion to assess the effects of BPT and the acute effects of medication after receiving BPT. Data was collected for 12 parents, although two dropped out after the third BPT session. Semiweekly ratings showed that 83.33% of parents reported improved child behavior (i.e., HSQ, PDR), and 50% reported improved parent impairment (i.e., SDS). Only 41.67% of parents reported using less inconsistent discipline, 16.67% reported greater use of positive parenting, and poor monitoring ratings were unchanged. Observed parent and child behavior was analyzed by 2 (pre-BPT vs. post-BPT) x 2 (medication vs. placebo) ANOVAs. Effects (p<.05) of BPT emerged across all parent behaviors (i.e., setting stage, behavior modification, annoy, positive reinforcement, warmth) and some child behaviors (i.e., complain, comply). No medication or interaction effects were found. BPT, but not medication, was associated with improvements in parent and child behavior. The effects of BPT demonstrated in our study contrast previous studies of parental ADHD and BPT, although previous studies were post hoc between-subject designs, and did not allow for exploration of individual responses to BPT, as in our within-subject study. While we found no medication effects, parents in this study received medication only during the parent-child assessments, and it may be the case that medication effects emerge over a longer period of time, when administered during BPT. These results, although preliminary, suggest that at least some parents with ADHD benefit from BPT. Learning Objectives: Describe recent research on treatments for parents with ADHD Describe the results of a multiple baseline study of examining the efficacy of behavioral parent training for parents with ADHD To explore the effects of acute medication treatment for parents before and after receiving behavioral parent training Source of Funding: Not applicable Literature References: Chronis-Tuscano et al., (2008). Efficacy of osmotic-release oral system (OROS) methylphenidate for mothers with attention-deficit/hyperactivity disorder (ADHD): preliminary report of effects on ADHD symptoms and parenting. Journal of Clinical Psychiatry, 69, 1938-1947. Chronis et al. (2004). Enhancements to the behavioral parent training paradigm for families of children with ADHD: review and future directions. Clinical child and family psychology review., 7, 1-27. 2 DISPOSITION OF D,L-METHYLPHENIDATE IN ORGANIC CATION TRANSPORTER 3 (OCT3) KNOCKOUT MICE Hao-Jie Zhu1, Brinda Bryan, BSc2, John S. Markowitz, Pharm.D.3 1University of Flroida, 2University of Florida - Department of Pharmacotherapy and Translational Research, 3University of Florida Background: The organic cation transporter 3 (OCT3, SLC22A3), a protein belonging to the solute carrier 22 (SLC22) gene family, is extensively expressed in the brain, heart, and some other major organs in both humans and rodents. OCT3 facilitates the transmembrane transport of numerous xenobiotics and endogenous compounds positively charged at physiological pH. A pharmacokinetic (PK) study conducted in Oct3 knockout (KO) mice has demonstrated that the uptake of the prototypic OCT3 substrate 1-phenyl- 4-methyl-pyridinium (MPP+) into the heart was markedly lower in the KO mice relative to the wild type (WT) animals (1). Moreover, decreased Oct3 expression in the choroid plexus epithelial cells resulted in significant increase of the concentrations of methamphetamine in several brain regions in mice (2). This study was conducted to determine the effect/role of OCT3 on the disposition of the psychostimulant d,l- methylphenidate (dl-MPH) in the brain and heart utilizing an Oct3 KO mouse model. Methods: The study included 2 groups (WT and Oct3 KO mice). Each group contained 7 males with body weight ranging from 30.0 to 40.0 g. dl-MPH was administered via i.p. injection at a dose of 6.0 mg/kg with the injection volume limited to 10 µl/g mouse. The blood, brain, and heart samples were collected 30 min post-administration. The concentrations of d- and l-isomers of MPH and its primary hydrolytic metabolite ritalinic acid were determined in these samples utilizing an enantiospecific LC- MS/MS assay established in our laboratory (3). Results: The concentrations of d-MPH, l-MPH, and ritalinic acid in the plasma, brain, and heart were not significantly different between WT and Oct3 KO mice. However, as has been recognized in human subjects, d-MPH concentrations in all tissues tested in both WT and Oct3 KO mice were significantly higher than l-MPH, as a result of stereoselective metabolism of dl-MPH by carboxylesterase 1 (CES1). Conclusions: Our study suggests that dl-MPH is unlikely to be the substrate of OCT3, and OCT3 does not affect disposition of dl-MPH in the brain and heart or otherwise contribute to interindividual PK variability. Learning Objectives: The participant will become familiar with the physiological role(s) of the Organic Cation Transporter 3 (OCT3) within the CNS The participant will become familiar with the role of OCT3 in the transport of methylphenidate Source of Funding: This study was supported by NIH grant 1R01DA022475-01A1 (J.S.M.) Literature References: 1. Zwart R, et al. Impaired activity of the extraneuronal monoamine transporter system known as uptake-2 in Orct3/Slc22a3-deficient mice. Mol Cell Biol. 2001;21(13):4188-96. 2. Nakayama H, et al. The role of organic cation transporter-3 in methamphetamine disposition and its behavioral response in rats. Brain Res. 2007;1184:260-9. 3. Zhu HJ, et al. Enantiospecific determination of DL-methylphenidate and DL-ethylphenidate in plasma by liquid chromatography-tandem mass spectrometry: application to human ethanol interactions. J Chromatogr B Analyt Technol Biomed Life Sci. 2011;879(11-12):783-8. 3 DOES PHARMACOLOGICAL TREATMENT OF ADHD IN ADULTS ENHANCE PARENTING PERFORMANCE? James G. Waxmonsky, MD1, Daniel Waschbusch, Ph.D.2, Dara Babinski, M.A.3, Hugh Humphery, MD1, Kathleen I. Crum, Bachelor of Arts4, Janine J. Slavec, M.A.5, Junea N. Augustus1, William E. Pelham, Jr., PhD, ABPP1, Melissa Bernsetein, M.A.5 1Florida International University, 2Center for Children and Families, Dept of Psychology, Florida International University, 3University of Florida, 4Florida International University Center for Children and Families, 5University of Maine Introduction: Emerging evidence has found that parental ADHD symptoms impair parenting performance (Chronis-Tuscano & Stein, 2012). Most prior research on this topic has relied on self-report; however, there are appreciable limitations of relying on self-ratings of parenting. This study explores the impact of treatment of parental ADHD with lisdexamfetamine dimesylate (LDX) on parenting performance in a laboratory setting. Methods: All adult participants met full DSM IV criteria for ADHD and had a child between the ages of 5-15 with ADHD. There were 44 applicants who were consented of which 38 met all eligibility criteria and elected to participate. Adult participants were optimized on LDX over 3 weeks. In Phase I, parent- child dyads completed two laboratory interactions, once with the adult on blinded optimal dose and once on placebo. The child was unmedicated for both assessments. During each assessment, parents completed age appropriate homework and non-academic tasks (joint play for younger participants and a family problem solving discussion for older subjects) with their child. In Phase II, parents were randomly assigned to continue blinded, optimized treatment or placebo for an additional month followed by a final parent-child interaction task. Parent and child behavior codes were summed to form composite codes based on the Dyadic Parent-Child Interaction Scoring System (Eyberg et al. 2010). Results: Twenty four participants (64%) completed the entire trial. Ten subjects dropped due to adverse events, and four were lost to follow up with most discontinuations occurring during the medication optimization phase. The mean LDX dose was 50mg at the end of the optimization phase.
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