Rebound effects with long-acting amphetamine or methylphenidate stimulant medication preparations among adolescent male drivers with attention-deficit/hyperactivity disorder

J Child Adolesc Psychopharmacol. 2008 Feb;18(1):1-10. doi: 10.1089/cap.2006.0141.


This study investigated whether OROS methylphenidate (OROS MPH, Concerta) or extended-release mixed amphetamine salts (se-AMPH ER, Adderall XR) were associated with worsening of driving performance, or drug rebound, relative to placebo 16-17 hours post-ingestion. Nineteen male adolescent drivers aged 17-19 with attention-deficit/hyperactivity disorder (ADHD) were compared on a virtual reality driving simulator and an on-road drive after taking 72 mg of OROS MPH, 30 mg of se-AMPH ER, or placebo. Medication was taken at 08:00 in a randomized, double-blind, placebo-controlled, crossover study. Participants drove a simulator at 17:00, 20:00, 23:00, and 01:00, and drove their own cars over a 16-mile road course at 24:00. The main outcome measures were composite scores of driving performance. Neither OROS MPH nor se-AMPH ER was associated with significant worsening of simulator performance relative to placebo 17 hours post-ingestion in group comparisons. However, inattentive on-road driving errors were significantly more common on se-AMPH ER relative to placebo at midnight (p = 0.04), suggesting possible rebound. During both late simulator and on-road testing, driving performance variance was approximately 300% greater during the se-AMPH ER compared to the OROS MPH condition.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Amphetamine / administration & dosage
  • Amphetamine / adverse effects*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Automobile Driving*
  • Central Nervous System Stimulants / adverse effects*
  • Cross-Over Studies
  • Delayed-Action Preparations
  • Double-Blind Method
  • Humans
  • Male
  • Methylphenidate / adverse effects*
  • Time Factors


  • Central Nervous System Stimulants
  • Delayed-Action Preparations
  • Methylphenidate
  • Amphetamine