scholarly journals Viloxazine in the Treatment of Attention Deficit Hyperactivity Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Amber N. Edinoff ◽  
Haseeb A. Akuly ◽  
John H. Wagner ◽  
Megan A. Boudreaux ◽  
Leah A. Kaplan ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Neurodevelopmental Disorder ◽  
Treatment Options ◽  
Early Response ◽  
Clinical Effects ◽  
Phase 3 ◽  
Double Blind ◽  
Hyperactivity Disorder ◽  
Serotonergic Activity

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children. Over the past twenty years, research on the disease and its characteristics and treatment options has grown exponentially. The first-line pharmacologic treatment of ADHD is stimulants, which have a response rate of ~70%. With the support of four phase 3 studies involving more than 1,000 pediatric patients 6–17 years old, the FDA has approved the non-stimulant, serotonin-norepinephrine modulating agent (SNMA) viloxazine in an extended-release capsule (viloxazine ER) for treatment of ADHD in children aged 6–17. Viloxazine modulates serotonergic activity as a selective 5-HT22B receptor antagonist and 5-HT2C receptor agonist and moderately inhibits norepinephrine transporter (NET), thus blocking the reuptake of norepinephrine. A phase 2 study by Johnson et al. found that once-daily dosing of viloxazine ER in 200, 300, or 400 mg dosages in children with ADHD for eight weeks resulted in a statistically significant reduction of ADHD-RS-IV total score. A post hoc analysis of data from four phase 3, randomized, placebo-controlled, double-blind, three-arm, clinical trials by Faraone et al. found that early response to viloxazine treatment, defined as a change in ADHD-RS-5 total score at week 2, best predicted the treatment response at week 6 [75% positive predictive power (PPP), 75% sensitivity]. Proper treatment of the symptoms and comorbidities associated with ADHD is crucial in improving a patient's quality of life, cognitive function, and overall therapeutic outcomes. Viloxazine's mechanism of action, clinical effects, and limited side effect profile point toward the drug's relevance in the treatment of ADHD.

scholarly journals Individualization of attention-deficit/hyperactivity disorder treatment: pharmacotherapy considerations by age and co-occurring conditions

CNS Spectrums ◽  
2020 ◽  
pp. 1-20 ◽  
Author(s):  
Greg W. Mattingly ◽  
Joshua Wilson ◽  
Leticia Ugarte ◽  
Paul Glaser
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Neurodevelopmental Disorder ◽  
Treatment Options ◽  
Hyperactivity Disorder ◽  
Psychosocial Therapy ◽  
Adhd Treatment ◽  
Disorder Treatment ◽  
Adhd Medications

Abstract Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that manifests in childhood and can persist into adolescence and adulthood. Impairments associated with ADHD can impact quality of life, social interactions, and increase the risk of morbidity and mortality; however, for many patients, effective treatment can lessen these effects. Pharmacotherapy with stimulants or nonstimulants is recommended in conjunction with psychosocial therapy for most patients. Determining the optimal pharmacotherapy can be complex, and the clinician needs to consider many factors such as the patient’s age, comorbidities, and lifestyle. Furthermore, the needs of the patient with ADHD will change over time, with specific challenges to consider at each stage of life. A variety of Food and Drug Administration (FDA)-approved stimulant and nonstimulant formulations are available with different modes of delivery and durations of effect. This armamentarium of ADHD medications can be used to individualize ADHD treatment for each patient’s needs. This article combines current information from the literature and the first-hand experience of the authors to provide guidance on ADHD treatment options for patients of different ages and for some of the more common comorbidities.

scholarly journals A Cross-Sectional Study of 0.6 Million Children with Attention-Deficit/Hyperactivity Disorder in the United States

2020 ◽  
Vol 10 (01) ◽  
pp. e97-e103
Author(s):  
Irene Rethemiotaki
Keyword(s):  
United States ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Family Income ◽  
Neurodevelopmental Disorder ◽  
Multiple Logistic Regression Analysis ◽  
The United States ◽  
Cross Sectional ◽  
Children With Adhd ◽  
Hyperactivity Disorder

AbstractAttention-deficit hyperactivity disorder (ADHD) is an increasingly recognized chronic neurodevelopmental disorder. This work aims at studying the prevalence and clinical characteristics of children with ADHD in the United States in the period between 2009 and 2018. Data from the National Health Interview Survey were analyzed by univariate and multivariate statistics to assess the role of socioeconomic factors in the development of ADHD. It has been studied 615,608 children, 51.2% male and 48.7% female. The prevalence of ADHD was 9.13%, with males predominating over females. The number of children with ADHD increased from 2009 to 2018 by 14.8%. As specified by multiple logistic regression analysis, males (odds ratio [OR] 2.38) who have neither mother nor father (OR 1.76) are twice as likely to have ADHD compared with their peers. In addition, family income (OR 1.40) and parent's education (OR 1.12) were significantly associated with ADHD. It has been highlighted the significance of deprivation of both family and financial comfort as primary indicators for ADHD in children. Moreover, children with ADHD were more likely to be males in the age group of 12 to 17.

scholarly journals Systematic review of transdermal treatment options in attention-deficit/hyperactivity disorder: implications for use in adult patients

CNS Spectrums ◽  
2021 ◽  
pp. 1-13
Author(s):  
Christoph U. Correll ◽  
Brittney R. Starling ◽  
Michael Huss
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
English Language ◽  
Treatment Options ◽  
Adult Patients ◽  
Publication Date ◽  
Potential Cost ◽  
Hyperactivity Disorder ◽  
Related Quality ◽  
Treatment Safety

Abstract Background Adults with attention-deficit/hyperactivity disorder (ADHD) often face delays in diagnosis and remain untreated, despite significant negative impacts. To evaluate the safety and efficacy of transdermal treatment options in children, adolescents, and adults, a systematic literature review was conducted, with a focus on the implications of transdermal therapies for ADHD in adults. Methods A MEDLINE/Embase/BIOSIS/SCOPUS database search was conducted December 4, 2019, for English-language articles of interventional clinical trials using transdermal formulations for the treatment of ADHD without publication date limit. Assessed outcomes included efficacy, safety, adherence, abuse potential, cost efficacy, and health-related quality of life. Results Of 23 eligible publications, 18 were in children or adolescents (n = 1699; range 23-305), and 5 in adults (n = 274; range 14-90); all included methylphenidate transdermal system (MTS). All seven pediatric publications reporting change in ADHD symptomology from baseline reported a significant improvement with MTS treatment. Similarly, in three adult publications, ADHD symptoms improved significantly with MTS treatment. Safety findings in pediatric and adult studies were comparable; the most frequently reported treatment-emergent adverse events (TEAEs), namely, headache, decreased appetite, and insomnia, were reported in 13/16 (81%) of publications reporting specific TEAEs. MTS-related dermal reactions were mostly mild and transient. Discontinuation due to dermal reactions was reported in 10 studies (range 0%-7.1% [1 of 14 patients]). MTS compliance was high when assessed (97%-99%). Conclusions Transdermal therapies provide a useful treatment formulation for ADHD. Studies of MTS and other transdermal formulations, such as amphetamine, in adult patients are needed in this underserved population.

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