Lisdexamfetamine Did Not Meaningfully Change Midazolam Exposure in a Healthy-Volunteer Study

A negative metabolic interaction result does not establish that combined behavioral effects are absent.

What the paper found

Thirty healthy volunteers participated in a crossover interaction study using several enzyme probes. Midazolam assessed CYP3A activity. Its exposure measures were similar with and without lisdexamfetamine under the tested conditions.

What the evidence cannot establish

The study concerned pharmacokinetics in selected volunteers. It did not test every dose, chronic clinical condition or real-world driving task, and enzyme activity is only one possible source of an interaction.

Implications for forensic review

Specify that the finding concerns midazolam disposition rather than an ability of a stimulant to cancel sedation. In an individual case, review dose, route, other enzyme modifiers and observed function. Similar concentrations do not establish equivalent performance in all circumstances.

Source and related reading

Source: PMC4488187, supplied full-text paper. Findings are paraphrased; case-review implications are an interpretation.

Related: Unchanged Midazolam Exposure Does Not Establish Absence of Every Lemborexant Interaction.