Treatment Of Attention Deficit Hyperactivity Disorder Research Articles

A Retrospective Chart Review Evaluating the Changes in Depressive Symptoms in Adult Patients With Attention-Deficit/Hyperactivity Disorder (ADHD) With the Treatment of the Underlying ADHD.

Adult attention-deficit/hyperactivity disorder (ADHD) represents a significant public health burden. ADHD is often comorbid with many other psychiatric disorders, with a high co-occurrence with depression. However, there is a paucity in our understanding of the potential impact of treating patients' ADHD on their depressive symptoms. The primary objective of this study was to assess the effect of treating adult ADHD on comorbid depressive symptoms without directly administering treatment for depression in an integrated behavioral health clinic in the primary care setting. We performed a retrospective chart review between April 2021 and May 2022 on adult patients treated in the Primary Care Adult Integrated Behavioral Health Clinic at an urban family medicine residency clinic. For patients with ADHD, we administered the Adult ADHD Self-Report Scale (ASRS-v1.1) to serve as a marker of ADHD symptom burden and the nine-item Patient Health Questionnaire(PHQ-9) to serve as a marker of depressive symptom burden. We administered the questionnaires prior to initiating ADHD treatment and again at the three-month follow-up visit. The ADHD treatment included pharmacotherapy and brief psychological interventions targeted at ADHD. We compared the ASRS scores and PHQ-9 scores at baseline and after three months to determine whether ADHD treatment had any impact on PHQ-9 scores. At baseline, the average ASRS score was 11.3 and the average PHQ-9 score was 8.25. Comparing scores after three months of intervention to the initial scores, our preliminary results demonstrated a trend of improvement in both ASRS and PHQ-9 scores. A total of 75% (n=24/32) of the patients had an improvement in ASRS scores, and 56.7% (n=17/30) of the patients had an improvement in PHQ-9 scores at three months. At three months, there was a decline in PHQ-9 scores with a decrease in ASRS scores following treatment. Our preliminary results suggest that integrated behavioral health treatment of ADHD using a combination of pharmacological and non-pharmacological interventions may play a role in improving comorbid depressive symptoms.

Diagnosis and Treatment of ADHD in the Pediatric Population.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood with approximately 6 million children (age 3 to 17 years) ever diagnosed based on data from 2016-2019. ADHD is characterized by a constant pattern of inattention and/or hyperactivity-impulsivity symptoms that interferes with development or functioning. Specific criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition Text Revision assist with the diagnosis with multiple guidelines available providing non-pharmacologic and pharmacologic recommendations for the treatment of ADHD in the pediatric population. While all guidelines similarly recommend behavioral and/or stimulant therapy as first-line therapy based on age, not all stimulant products are equal. Their differing pharmacokinetic profiles and formulations are essential to understand in order to optimize efficacy and safety for patients. Additionally, new stimulant products and non-stimulant medications continue to be approved for use of ADHD in the pediatric population and it is important to know their differences in formulation, efficacy, and safety to other products currently available. Lastly, due to drug shortages, it is important to understand product similarities and differences to select alternative therapy for patients.

Clinico-Demographic Profile of Children and Adolescents with Attention Deficit Hyperactivity Disorder Presenting to a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. ADHD leads to significant impairment in overall functioning of the child. There is limited information concerning the clinical scenario of ADHD within Nepal. The study aims to determine the clinico-demographic profile and pattern of medication use in the treatment of ADHD. This study retrospectively examines the records of children diagnosed with ADHD at the Child and Adolescent Psychiatry (CAP) Unit, Kanti Children's Hospital (KCH), Nepal. Approval for the study was granted by KCH's Institutional Review Board. The analysis focused on data extracted from hospital records of ADHD patients spanning from 1 January 2021 to 30 June 2023 encompassing two and a half years. A total of 585 children were diagnosed with ADHD, with a mean age 7±3.04 years. The majority 501 (85.64%) were male, and 377 (64.44%) were from the school going age group (6 to 11 years). The prevalent psychiatric comorbidities included Autism Spectrum Disorder (ASD) at 102 (17.43%), Intellectual Disability (ID) at 93(15.89%), and Oppositional Defiant Disorder (ODD) at 36 (6.15%). The commonly used medication was Clonidine 165 (28.20%) followed by Atomoxetine 154 (26.32%) and Risperidone 65 (11.11%). The study indicates that ADHD is highly prevalent in Nepal. Comorbidities like ASD and ID are frequently seen which further necessitates the need for structured assessments and multidisciplinary approaches to address ADHD. In our context with limited treatment options, the management of ADHD is extremely challenging.

Pharmacists' Knowledge, Attitudes And Beliefs About Attention Deficit And Hyperactivity Disorder And Medical Treatment

Attention deficit hyperactivity disorder (ADHD) is a common and devastating disorder that poses a significant burden on families and society.ADHD treatment is multifaceted and requires long-term care and support. As pharmacists are directly involved in the distribution of medication, they are well positioned to collaborate with patients, support their treatment, highlight the importance of adherence to medication, and explain the medicine. This survey study aimed to identify pharmacists' knowledge gaps, attitudes and beliefs about ADHD and its medical treatment, and their experience in ADHD management. In our study, a questionnaire was prepared for pharmacists in Sivas Center, covering descriptive questions such as the pharmacist's age and professional year, what pharmacists do when they encounter children and adolescents with attention problems and/or mobility, and their thoughts on the diagnosis and treatment of ADHD, and applied face-to-face. The study involved 113 pharmacists. Respondents were asked to assess their level of knowledge regarding ADHD. It was observed that 29.2% of the participants had limited knowledge about ADHD and 14.2% had good knowledge. Nearly half (48.7%) of the respondents acknowledged their lack of knowledge on psychostimulants. It was revealed that 41.6% of the pharmacists consider ADHD treatment medication to be potentially addictive. When comparing survey responses on ADHD among participants based on their professional experience, it was discovered that there is a statistically significant relationship (p

Serdexmethylphenidate/dexmethylphenidate capsules for children and adolescents with attention-deficit/hyperactivity disorder (ADHD): a plain language summary

What is this summary about? This is a plain language summary of 2 articles published in the Journal of Child and Adolescent Psychopharmacology. It describes a medication called serdexmethylphenidate/dexmethylphenidate, or SDX/d-MPH for short. SDX/d-MPH is marketed under the name Azstarys®. It is in capsule form taken by mouth once a day in the morning and meant for treating patients aged 6 years and older with attention-deficit/hyperactivity disorder, commonly referred to as ADHD. This summary focuses on studies that were done in children and adolescents aged 6 to 12 years with ADHD. The study results showed how SDX/d-MPH reduced the symptoms of ADHD, how fast the medication began to work and for how long it worked in the study patients, as well as the medication's safety during 1 year of treatment. What are the key takeaways? Two main studies were done in patients with ADHD. The first study was conducted in a laboratory classroom, which is a simulated school classroom setting with children and adolescents aged 6 to 12 years with ADHD. The patients received either SDX/d-MPH or a placebo. The results of this study showed that the effect of SDX/d-MPH on reducing ADHD symptoms started approximately 30 minutes after taking the SDX/d-MPH capsule and lasted for approximately 13 hours. The placebo did not have this effect. The most common side effects for those taking SDX/d-MPH were headache, abdominal (belly) pain, insomnia and upper respiratory tract infection. The second study was also done in patients aged 6 to 12 years with ADHD. The purpose was to examine how safe and tolerable SDX/d-MPH was during 1 year of treatment. In this study, no placebo was given. The findings from the second study showed that SDX/d-MPH was safe and tolerable during the 1-year treatment period, with the most common side effects being decreased appetite, upper respiratory tract Scott H. Kollins1,2, Andrea Marraffino3, Andrew J. Cutler4,5, Charles Oh6, Matthew N. Brams7, Rene Braeckman8 & Ann C. Childress9 1 Duke University School of Medicine, Durham, NC, USA; 2 Akili Interactive, Inc., Boston, MA, USA; 3 Accel Research Sites Network, Maitland, FL, USA; 4 SUNY Upstate Medical University, Syracuse, NY, USA; 5 Neuroscience Education Institute, Lakewood Ranch, FL, USA; 6 Corium LLC, Boston, MA, USA; 7 Bayou City Research, Houston, TX, USA; 8 Zevra Therapeutics Inc, Celebration, FL, USA; 9Center for Psychiatry and Behavioral Medicine, Las Vegas, NV, USA Placebo: an inactive substance that has no medication but looks exactly the same as the actual medication and is taken in exactly the same way as the study drug. Side effect: an undesirable effect of a medication. Insomnia: difficulty sleeping. Tolerable: means that a patient can endure a medication even with the some of the side effects. infection, sore throat and nose, decreased weight and irritability. This study also showed that SDX/d-MPH was effective throughout the 1-year treatment period. What were the main conclusions? In the first study, children with ADHD treated with SDX/d-MPH showed noticeable improvements in ADHD symptoms as early as 30 minutes after the medication was given, and those improvements lasted up to 13 hours. SDX/d-MPH was also found to be as safe as other ADHD treatments containing methylphenidate (MPH). Results of the second study showed that children with ADHD could be treated safely with SDX/d-MPH. Clinical Trial Registration: NCT03460652 ( ClinicalTrials.gov )

Future of ADHD Care: Evaluating the Efficacy of ChatGPT in Therapy Enhancement.

This study explores the integration of large language models (LLMs), like ChatGPT, to improve attention deficit hyperactivity disorder (ADHD) treatments. Utilizing the Delphi method for its systematic forecasting capabilities, we gathered a panel of child ADHD therapy experts. These experts interacted with our custom ChatGPT through a specialized interface, thus engaging in simulated therapy scenarios with behavioral prompts and commands. Using empirical tests and expert feedback, we aimed to rigorously evaluate ChatGPT's effectiveness in therapy settings to integrate AI into healthcare responsibly. We sought to ensure that AI contributes positively and ethically to therapy and patient care, thus filling a gap in ADHD treatment methods. Findings show ChatGPT's empathy, adaptability, and communication strengths, thereby highlighting its potential to significantly improve ADHD care. The study points to ChatGPT's capacity to transform therapy practices through personalized and responsive patient care. However, it also notes the need for enhancements in privacy, cultural sensitivity, and interpreting nonverbal cues for ChatGPT's effective healthcare integration. Our research advocates for merging technological innovation with a comprehensive understanding of patient needs and ethical considerations, thereby aiming to pioneer a new era of AI-assisted therapy. We emphasize the ongoing refinement of AI tools like ChatGPT to meet ADHD therapy and patient care requirements more effectively.

A systematic review of the benefits and mechanisms of family-based mind-body therapy programs targeting families of children and adolescents with attention-deficit/hyperactivity disorder

Growing evidence indicates that family-based mind-body therapy programs (FMBTs) act as an important alternative for attention-deficit/hyperactivity disorder (ADHD) treatment in the youth with minimal side-effects. Moreover, FMBTs contribute to improving the family functioning of those affected by ADHD. To summarize and analyze the benefits and mechanisms, an extensive literature search of the EBSCOhost, PubMed, Web of Science, and Scopus databases was conducted to identify eligible studies. Fifteen studies published between 2010–2023 were reviewed. The included FMBTs were implemented with 850 children/adolescents and 996 parents/caregivers, of whom 201 parent couples attended the programs together with their children. All included FMBTs adopted mindfulness/meditation as the core practice to enhance the participants’ mental focus and attention, and were designed for long-term engagement, with six including parent–child joint session(s). Positive changes were observed in both children and adolescents, including improvements in ADHD symptoms, behavioral problems, executive function, and school performance. Additionally, parents experienced positive changes in ADHD traits/symptoms, mental health, and parenting behaviors. Furthermore, FMBTs were found to enhance family functioning by delivering mindful strategies to family, restoring psychological capacity and interpersonal skills in family members, and improving parent–child relationships. The reviewed FMBTs demonstrated high levels of feasibility and participant satisfaction. The factors and issues potentially influencing the effectiveness and feasibility of FMBTs are also discussed. The findings indicate that FMBT holds promise as an ADHD treatment option in home settings. Future efforts may focus on optimizing the design of FMBTs to better address the diverse needs of families in varying circumstances.

Memory loss induced by lisdexamfetamine in the rat: A behavioral, electrophysiological, and histopathological Study

Lisdexamfetamine (LDX) is one of the drugs commonly used to treat attention deficit hyperactivity disorder (ADHD). However, its neurological side effects, particularly on cognition, are not fully understood. The present study focused on memory in rats treated with four weeks of LDX injection. We compared LDX-treated rats with control ones, using several methods to evaluate the behavioral responses and electrophysiological, molecular, and histological properties in the hippocampus. Our findings demonstrated that subchronic administration of LDX impaired behavioral performance in all memory assessment tests (Y maze, Morris Water Maze, and Shuttle box). Although LDX did not alter population spike (PS) amplitude, it increased the field excitatory postsynaptic potential (fEPSP) slope of evoked potentials of LTP components. Also, in addition to an increase in expression of caspase-3 in the hippocampus, which indicates the susceptibility to apoptosis in LDX-treated rats, the number of microglia and astrocytes went up significantly in the LDX group. Moreover, Sholl's analysis showed an increase in the soma size and total process length in both hippocampal astrocytes and microglia. Overall, because of these destructive effects of LDX on the hippocampus, which is one of the critical memory-related areas of the brain, the findings of this investigation provide evidence to show the disruption of memory-related variables following the LDX. However, more research is needed to clarify it.

Recent updates on treatment patterns in patients with treated attention-deficit/hyperactivity disorders from a nationwide real-world database in South Korea.

The prevalence of attention-deficit/hyperactivity disorder (ADHD) is steadily increasing across Korea. We analyzed ADHD patients with ADHD medications (Rx) characteristics and treatment patterns compared to patients without Rx and identified the differences between pediatric-/adult- and active-/transient-patients with Rx. Using a nationwide claims dataset from 2020 to 2021, we conducted a prevalence-based cross-sectional study and analyzed the recent patients' characteristics and patterns among ADHD patients. Among 132 017 ADHD patients with Rx, differences from 20 312 without Rx across all characteristics except sex. We found significant differences in characteristics and treatment patterns between pediatric-/adult- and active-/transient-patients with Rx. Age-specific sex ratios notably diverged in pediatric patients (61.2%), but remained similar in adults, revealing significant psychiatric comorbidities differences. Active-patients peaked at 6-11 years (41.4%), while transient-patients at 18-30 years (36.1%). Predominantly, methylphenidate (89.7%), atomoxetine (27.8%), and clonidine (2.8%) were prescribed, with 85% experiencing treatment changes within methylphenidate formulations. In pediatric patients, extended-release methylphenidate was preferred (56.1%), adults favored oral delivery system methylphenidate (71.5%), and active-patients had higher treatment rates than transient-patients across all patterns, with low monotherapy rates. This study provides epidemiologic insights into recent characteristics and treatment patterns of ADHD patients with Rx in Korea, providing valuable evidence for identifying those actively receiving ADHD treatment in future healthcare policy decisions.

The Impact of Integrating a Low-Lectin Diet with Traditional ADHD Treatments on Gut Microbiota Composition and Symptom Improvement in Children - A Cohort Study.

This study aimed to investigate the impact of implementing a low-lectin diet on gut microbiota composition and symptom amelioration in pediatric patients diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). A total of 58 children (ages 7-15 years), meeting the criteria for ADHD were recruited. In addition to standard medication treatment, participants in the experimental group with a low-lectin diet, while those in the control group received standard medication treatment alone. Clinical outcomes were assessed through evaluations conducted by physicians and teachers, implementation of the Conners Parent Rating Scales, and analysis of gut microbiota composition. The results revealed significant improvements in symptom reduction and attention allocation rate within the experimental group, surpassing those observed in the control group. Specifically, the experimental group exhibited lower physician ratings, teacher ratings, and attention allocation rate compared to the control group. Moreover, analysis of gut microbiota composition identified notable distinctions between the two groups. These findings provide compelling evidence and valuable guidance supporting the integration of a low-lectin diet as an adjunctive intervention for managing ADHD.

Guanfacine for the Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents with Down Syndrome: A Retrospective Chart Review.

Study Design: Retrospective case series. Objectives: The objective of this study was to provide naturalistic data on the use of guanfacine for the treatment of attention-deficit/hyperactivity disorder (ADHD) in a clinically referred sample of youth with Down syndrome (DS). Methods: The medical records of children and adolescents with DS who received guanfacine for the treatment of ADHD from a multidisciplinary neurodevelopmental disorder clinic between September 1, 2011, and September 10, 2021, were reviewed. Demographic and clinical characteristics, guanfacine dose and treatment duration, and adverse effects were recorded. Clinical Global Impression Scale (CGI) scores for ADHD symptom severity (S) and improvement (I) were retrospectively assigned by a child and adolescent psychiatrist based on review of the clinic notes. Response to guanfacine was defined as completion of at least 12 weeks of treatment and a Clinical Global Impression Improvement subscale rating ≤2 (1 = "very much improved" or 2 = "much improved"). Results: Twenty-one patients were eligible for inclusion, of whom 17 (81%) completed at least 12 weeks of guanfacine. Ten of the 21 patients (48%; 95% confidence interval [CI]: 28%-68%) responded to treatment. The median time on guanfacine treatment covered by the clinic notes was 50.4 weeks, with a range of 0.3 weeks to 7.5 years. Thirteen patients (62%) remained on guanfacine at the time of their most recent clinic note. Nine patients had adverse events documented in their clinic notes (43%; 95% CI: 24%-63%), most commonly sleepiness (n = 7) and constipation (n = 2). Conclusion: About half of patients with DS responded to guanfacine for the treatment of ADHD and many tolerated long-term use. Study limitations primarily relate to the retrospective nature of the study and small sample size.

Advances in the Psychosocial Treatment of ADHD in Children and Teens

Major attention-deficit/hyperactivity disorder (ADHD) treatment advances have occurred in addressing functional impairments associated with the condition. Work to understand how the core symptoms of inattention and hyperactivity/impulsivity hinder family, school, and social functioning has been conducted. This work has created approaches with proven or promising efficacy in altering the life course of young persons afflicted with this chronic condition. This review describes well-established methods and newly emerging treatments for reducing the impact of ADHD on the home, school, social, and emotional lives of ADHD youth. [ Psychiatr Ann . 2024;54(3):e88–e93.]

The Use of Transcranial Magnetic Stimulation in Attention Optimization Research: A Review from Basic Theory to Findings in Attention-Deficit/Hyperactivity Disorder and Depression.

This review explores the pivotal role of attention in everyday life, emphasizing the significance of studying attention-related brain functions. We delve into the development of methodologies for investigating attention and highlight the crucial role of brain neuroimaging and transcranial magnetic stimulation (TMS) in advancing attention research. Attention optimization theory is introduced to elucidate the neural basis of attention, identifying key brain regions and neural circuits involved in attention processes. The theory further explores neuroplasticity, shedding light on how the brain dynamically adapts and changes to optimize attention. A comprehensive overview of TMS is provided, elucidating the principles and applications of this technique in affecting brain activity through magnetic field stimulation. The application of TMS in attention research is discussed, outlining how it can be employed to regulate attention networks. The clinical applications of TMS are explored in attention-deficit/hyperactivity disorder (ADHD) and depression. TMS emerges as an effective clinical treatment for ADHD, showcasing its potential in addressing attention-related disorders. Additionally, the paper emphasizes the efficacy of TMS technology as a method for regulating depression, further underlining the versatility and therapeutic potential of TMS in clinical settings. In conclusion, this review underscores the interdisciplinary approach to attention research, integrating neuroimaging, neuroplasticity, and TMS. The presented findings contribute to our understanding of attention mechanisms and highlight the promising clinical applications of TMS in addressing attention-related disorders. This synthesis of theoretical and practical insights aims to propel further advancements in attention research and its therapeutic applications.

Синдром дефіциту уваги з гіперактивністю в дітей віком 6-8 років як медико-соціальна проблема

One of the medical and social problems that are considered urgent today is the need to improve the health of children with disorders of mental development, including attention deficit hyperactivity disorder (ADHD). Purpose - to conduct a systematic analysis of scientific sources regarding the etiopathogenesis, clinical manifestations, and joint practical work of doctors, social workers, and teachers regarding ADHD in children 6-8 years old. Domestic and international studies prove that the treatment of ADHD in children should be comprehensive, include recommendations on regime and lifestyle, drug therapy, and practical recommendations from an educational component. A multidisciplinary approach to determine clinical-psychopathological and clinical-psychological regularities of the mental development of children with ADHD is relevant. A feature of such children is high activity, inability to focus on one thing, short-temperedness. But such a condition can be corrected if treatment is started as early as possible. The cause of the development of the disorder can be: complications during pregnancy (this includes early toxicosis, preeclampsia, intrauterine hypoxia of the fetus), complications during childbirth (premature, rapid); low body weight of the child at birth or suffered serious diseases during the first year of life; the presence of bad habits in a pregnant woman, hard work or work in harmful conditions during the period of bearing the fetus. The main signs of attention deficit hyperactivity disorder in children 6-8 years old are as follows: inattention; hyperactivity; impulsiveness. The main symptoms of ADHD can also be accompanied by accompanying symptoms: difficulties in learning, even despite high intellectual abilities; tics; quick fatigue; the presence of phobias, anxiety and depression; autism; sleep problems; speech or behavior disorders. Scientists consider the features of intellectual development of children with ADHD to be voluntary regulation of mental activity, cognitive functions, speech, voluntary motor activity, insufficient development of perceptual-gnostic and emotional spheres. No conflict of interests was declared by the author.

ADHD medications use and risk of mortality and unintentional injuries: a population-based cohort study

We assessed the association between the use of medications for attention-deficit/hyperactivity disorder (ADHD) and the risk of all-cause mortality and unintentional injuries leading to emergency department (ED) or hospital admission in individuals aged ≤24 years with ADHD. We conducted a population-based retrospective cohort study between 2000 and 2021 using Quebec health administrative data. Individuals were followed from the first ADHD diagnosis or ADHD medication claim until turning 25, death, or study end. Exposure was defined as mutually exclusive episodes of ADHD medication use and/or coverage under the public provincial drug plan (PDP): 1) covered and not treated with ADHD medication; 2) covered and treated with ADHD medication; and 3) not covered under the PDP. The risk of all-cause mortality and unintentional injuries associated with exposure episodes was estimated using multivariable survival analyses. The cohort included n = 217 192 individuals aged 1–24 years with a male to female ratio of close to 2:1. Compared to non-medication use, episodes of ADHD medication use, overall, were associated with reduced all-cause mortality (adjusted hazard ratio, aHR 0.61, 95% CI 0.48–0.76) and unintentional injury leading to ED (0.75, 0.74–0.77) or hospitalisation (0.71, 0.68–0.75). Episodes of stimulants were associated with a lower risk of all-cause mortality and reduced risk of unintentional injuries, while episodes with non-stimulants and with both stimulants and non-stimulants concomitantly were associated with reduced risk of unintentional injuries, but not of all-cause mortality. Although residual confounding cannot be excluded, stimulants may have a protective effect in terms of risk of all-cause mortality and both stimulants and non-stimulants for ADHD may reduce the risk of unintentional injuries. The findings of the current study should inform clinical decision making on the choice of starting a pharmacological treatment for ADHD, when a balance needs to be struck between expected benefits and possible risks.

Current status and future development of digital therapeutics

Background: Digital therapeutics, evidence-based software applications, offer preventive measures for various diseases and enhance healthcare accessibility and change. This article explores the current status and future trajectory of these devices.Current Concepts: Digital therapeutics prioritize a patient-centered approach. Historically, healthcare relied heavily on prescribed treatments during hospital visits. However, these devices provide objective data on patient symptoms through real-time digital monitoring. They also foster advancements in biotechnology and information technology, leading to improved patient care through technologies like artificial intelligence and virtual reality apps. Rigorous clinical trials are crucial for these devices, and integrating digital technology is proving increasingly efficient, particularly for decentralized clinical trials. Despite initial promise, challenges abound. While an international leader in this sector gained U.S. Food and Drug Administration approval, it recently filed for bankruptcy. Similarly, companies employing gaming techniques for attention deficit hyperactivity disorder treatment experienced lackluster performance. In Korea, the domestic digital therapeutics ecosystem stagnates with limited new approvals. High dropout rates and low user engagement remain major hurdles. Addressing these issues requires a design focused on user experience and motivation.Discussion and Conclusion: Digital therapeutic devices, coupled with digital monitoring, are poised to revolutionize healthcare into a patient-centered ecosystem. Establishing this ecosystem demands collaboration among patients, medical professionals, developers, and regulatory agencies. Continuous regulatory innovation, such as shortening the medical device evaluation process from 390 days to 80 days, is vital for progress.

Viloxazine: A New Non-Stimulant Treatment for Attention-Deficit/Hyperactivity Disorder (ADHD)


 IntroductionViloxazine is an antidepressant medication classified as an SNRI (serotonin and norepinephrine reuptake inhibitor). In April 2021, it received FDA approval in the United States for the treatment of ADHD in children aged 6 to 17. Subsequently, in May 2022, it was also approved for the treatment of adults with ADHD [1]. Viloxazine, available in extended-release capsules, represents novel non-stimulant medication option for patients with ADHD.Aim of the studyOur aim was to review the viloxazine in the fields of ADHD treatment, summarize current knowledge and analyze the first treatment results.
 
 
 Methods and materialsA review of the literature available in the PubMed database was performed, using the key words: „Viloxazine" ; „ADHD treatment" ; „ADHD”, „attention deficit hyperactivity disorder”, „attention deficit hyperactivity disorder treatment”; „ADHD non-stimulant treatment”; „ADHD non-stimulant”; „ADHD non-stimulant drugs”, „SPN-812”
 
 
 ConclusionViloxazine presents a promising non-stimulant alternative for ADHD treatment with more favorable pharmacokinetics, new way of possible administration and fewer adverse effects, particularly within the cardiovascular system, than other available ADHD medication options. While these findings are encouraging, continual research is imperative to establish the long-term safety profile.

Sex Differences in ADHD: Review and Priorities for Future Research.

In childhood, attention-deficit/hyperactivity disorder (ADHD) is diagnosed three to 16 times more frequently in males compared to females, yet in adulthood, nearly equivalent numbers of males and females are diagnosed with ADHD. Relatively few studies have prioritized examination of sex differences in ADHD even though sex differences may have critical implications for the identification and treatment of ADHD in females and males. This review highlights current research on sex differences in ADHD across the lifespan that has emerged from cross-sectional and prospective longitudinal studies of youth, adult-ascertained samples, and registry studies. Accumulating research suggests that both males and females with ADHD experience widespread impairment across the lifespan. Some evidence of sex differences emerged, although effects have generally been modest in size. Continued research that includes females and males with ADHD is needed to clarify the nature of sex differences in ADHD. Research that focuses on equitable identification of ADHD in males and females, disentangles the effects of sex and gender, probes underlying mechanisms of sex differences, and addresses the clinical impact of sex differences in ADHD must be prioritized.

Longitudinal Patterns of Community-Based Treatment Utilization Among Ethnically and Racially Diverse Adolescents with Attention-Deficit/Hyperactivity Disorder.

Background: Attention-deficit/hyperactivity disorder (ADHD) treatment utilization among adolescents is highly variable. This article describes pharmacological and nonpharmacological treatment utilization in a community sample of primarily Latinx and/or Black adolescents with ADHD (N = 218), followed longitudinally for 4 years, from early adolescence until approximately age 17 (M = 16.80, standard deviation = 1.65). Methods: Electronic surveys administered between 2012 and 2019 queried parent and youth reports of medication initiation, persistence, diversion, and misuse, as well as reasons for desistence. Nonpharmacological treatment utilization (including complementary and alternative treatments) was also measured. Results: Results indicated that: (1) the majority of the sample sought treatment for ADHD in their community, (2) rates of psychosocial treatment utilization were higher than medication utilization, (3) approximately half of the medicated sample discontinued community-administered ADHD medication during the follow-up period, most frequently citing tolerability issues and concerns that they were "tired of taking" medication, and (4) medication misuse consisted of youth diversion and parent utilization of teen medication, but both were reported at low rates. Race/ethnicity did not predict treatment utilization patterns, but lower family adversity and psychiatric comorbidity predicted persistence of medication use over time. Conclusions: ADHD treatment engagement efforts for Latinx and/or Black adolescents might link treatment to goals valued by the youth, address concerns related to medication tolerability, and promote secure monitoring of medication. Nonpharmacological treatments for ADHD may be more palatable to Latinx and Black youth with ADHD, and efforts to engage youth with ADHD in treatment should consider offering medication and psychosocial treatment options.

Child and Parent Mindfulness-Based Training Versus Medication for Childhood ADHD: A Randomised Clinical Trial

ObjectivesMedication is the predominant treatment for childhood attention-deficit hyperactivity disorder (ADHD) but has side effects and limited longer-term effects. Mindfulness for children and their parents could be an alternative as it targets children’s core symptoms and supports parents. This study compared the effectiveness of a family mindfulness-based intervention to methylphenidate in children with ADHD.MethodWe conducted a randomised controlled trial (RCT) and a preference trial (PT) for families who refused randomisation. Mindfulness (“MYmind”) consisted of 2-months weekly group-based 1.5-hr mindfulness sessions for children and parallel mindful parenting for their parents, plus a follow-up session 2 months later. Medication concerned 4-months short-acting methylphenidate. Intention-to-treat (ITT) and per-protocol (PP) analyses were performed using multilevel modelling. Both parents and adolescents (not children) completed questionnaires on child ADHD pre-treatment, and at 2-, 4-, and 10-months follow-up, whereas teachers and blind observers completed these questionnaires at pre-treatment and 2-months follow-up only. Similarly, neuropsychological attention measures were administered pre-treatment and at 2-months follow-up only.ResultsIn the RCT, 91 children with ADHD (Mage=11.29, range 9–18, 71% boys), 172 parents (91 mothers, 81 fathers), 81 teachers, and 85 observers participated, and in the PT, 29 children (Mage=11.57, 55% boys), 52 parents (28 mothers, 24 fathers), 24 teachers, and 26 observers. Medication was more effective than family mindfulness at 2 and 4 months on multi-informant questionnaires but not on objective (neuropsychological and blind observer) measures. Differences between treatments diminished at mid-term even though in the medication group treatment was continued after 2 months while the mindfulness training was already finished at 2 months. Differences between treatment groups disappeared at 10 months, but note that in the long-term, children from the mindfulness arm started taking medication and vice versa, so that we cannot be sure to what extent the long-term results are caused by mindfulness, medication, or its combination. Findings in the PT and according to PP analyses were similar. Note moreover that 1 in 4 children (26%) discontinued taking medication during the first 2 months versus almost no families (2%) discontinued mindfulness, suggesting that mindfulness was more easily accepted.ConclusionsOverall, although mindfulness alone might not be sufficient for some families, family mindfulness training in general can be considered a non-pharmacological alternative or addition in the treatment of childhood ADHD.Preregistrationhttps://onderzoekmetmensen.nl/nl/trial/22179, 11.10.2013.