L'uso del metilfenidato in Italia: Bisogni ancora inevasi per i pazienti con ADHD

Methylphenidate is the drug of choice for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). It is available in Italy only as a single formulation that is not optimal in ensuring an efficient therapy. Although patients in treatment are limited in number, they often prefer to use prolonged-release formulations marketed in foreign countries because it is easier for them to follow the dosage schedules. In order to better understand the context, we identified formulations commercially available in Switzerland, Austria, and the United Kingdom through a search in the Mutual Recognition Information product index, as well as those available on the United States' market by consulting the Physicians' Desk Reference. A total of 25 oral formulations containing different doses of methylphenidate were found: 6 immediate-release formulations and 19 sustained-release formulations. The only available trans-dermal patch, as an extended release formulation, is marketed in the U.S.A. The drug is included in the ministerial table listing narcotic and psychotropic substances and is therefore subject to medical prescription through ministerial-copying receipt and to a specific procedure instituted for its import from a foreign country in accordance with the requirements of the February 11, 1997 Ministerial Decree. Waiting for the registration and marketing of different formulations also in Italy, a formal national or regional initiative promoting and supporting the importation of more appropriate formulations should be set up until more adequate formulations are registered and marketed in Italy as well.