Treatment Of Attention Deficit Hyperactivity Disorder Research Articles

Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults - National Center for Health Statistics Rapid Surveys System, United States, October-November 2023.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that develops during childhood and can last into adulthood. Data from the National Center for Health Statistics Rapid Surveys System collected during October-November 2023 were used to estimate the prevalence of ADHD diagnosis and treatment among U.S. adults. In 2023, an estimated 15.5 million U.S. adults (6.0%) had a current ADHD diagnosis based on self-report; approximately one half received the diagnosis at age ≥18 years. Approximately one third of adults with ADHD took a stimulant medication to treat their ADHD in the previous year, 71.5% of whom had difficulty getting their ADHD prescription filled because it was unavailable. Approximately one half of adults with ADHD have ever used telehealth for ADHD-related services. Telehealth might have benefits for persons with ADHD, including helping them access behavioral treatment or medication prescriptions for ADHD. This report provides national estimates of the prevalence and treatment of ADHD among U.S. adults to help guide clinical care and regulatory decision-making for ADHD among U.S. adults.

Recommendations for the Medical Treatment of ADHD in Comorbid, Substance-Related Disorders: Statement of the Joint Addiction Commission of the German Child and Adolescent Psychiatric Society and Associations

Recommendations for the Medical Treatment of ADHD in Comorbid, Substance-Related Disorders: Statement of the Joint Addiction Commission of the German Child and Adolescent Psychiatric Society and Associations Abstract: Objective: Attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) often occur together in adolescents. The available guidelines give the group of children and adolescents with ADHD and comorbid SUD little consideration. Method: The Joint Addiction Commission of the German Child and Adolescent Psychiatric Society and Associations has drawn up a statement with treatment recommendations intended to provide orientation as a best-practice approach. Results: Early treatment with stimulants in adolescents with ADHD and SUD may.

Quality of Life and Outcomes Associated with Adverse Effects in Pediatric Patients with Attention-Deficit/Hyperactivity Disorder and Their Parents/Caregivers.

Objectives: To assess quality of life and outcomes associated with adverse effects (AEs) in pediatric patients receiving pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD) and their parents/caregivers. Methods: An online survey was conducted (10/13/2023-10/20/2023) among parents/caregivers recruited from Dynata's U.S. panel who lived with a pediatric patient (6-17 years) currently treated for ADHD. Patient and parent/caregiver characteristics and outcomes were descriptively reported. Patients were considered to have AEs if they experienced symptoms/complications in the past 30 days that appeared, worsened, or remained unchanged after initiating their latest ADHD treatment. Regression analyses were used to estimate correlations between the number of AEs and key outcomes, including patients' health-related quality of life (HRQoL; based on the Pediatric Quality of Life Inventory) and parents/caregivers' work and activity impairments (based on Work Productivity and Activity Impairment: Caregiver) and mental health (based on Patient Health Questionnaire-4). Results: A total of 401 parents/caregivers from all U.S. regions completed the survey (caregiver median age: 38 years, 58.9% female; patient median age: 11 years; 37.7% female). In the 30 days prior to data collection, 66.8% of patients had AEs (overall mean: 1.2 AEs), with insomnia/sleep disturbances and decreased appetite/weight loss being the most frequently reported (14.2% and 11.7%, respectively). The number of AEs was significantly correlated with reduced patient's HRQoL (including reduced physical, emotional, and school functioning), increased parent/caregiver's work and activity impairment, and a higher likelihood of parents/caregivers having generalized anxiety disorder or major depressive disorder, respectively (all p < 0.001). Conclusions: AEs are common among pediatric patients receiving pharmacological treatment for ADHD and are associated with poorer quality of life and outcomes in pediatric patients and their parents/caregivers. Therapies with better safety profiles may help improve patient's HRQoL and parent/caregiver outcomes.

Black Mothers of Children With and Without ADHD: Relationships Among Maternal Psychopathology, Parenting Stress, and Parenting Cognitions.

Parents of children with attention-deficit/hyperactivity disorder (ADHD) endorse increased parenting stress and lower levels of parenting efficacy and satisfaction as compared to parents of children without ADHD. Additionally, maternal ADHD and depression differentiate children with and without ADHD, with children with ADHD being more likely to have a mother with psychopathology. With a focus on an understudied population, we investigated the extent to which maternal self-reported ADHD and depression were associated with self-reported parenting stress and parenting cognitions in 70 Black mothers of children with (maternal Mage = 35.52, SD = 6.49) and without ADHD (maternal Mage = 35.39, SD = 6.53) recruited from a metropolitan area in the southeastern United States. Analyses indicated that Black mothers of children with ADHD reported higher levels of parenting stress, lower levels of parenting efficacy, and lower levels of parenting satisfaction. However, there were no significant differences between groups on measures of maternal ADHD or depression. Maternal depression significantly accounted for variability in both parenting satisfaction and parenting stress beyond child ADHD and maternal education. With maternal depression in the models, the association between maternal ADHD and parenting stress and parenting satisfaction lost significance. Given the racial disparities in the treatment of ADHD, future research should focus on investigating the linkages between maternal depression, parenting stress, parenting satisfaction, and parenting behaviors in Black mothers in order to delineate whether there are cultural adaptations that may improve treatment utilization rates for child ADHD within this population.

Research Review: Pharmacological and non-pharmacological treatments for adolescents with attention deficit/hyperactivity disorder - a systematic review of the literature.

Attention Deficit/Hyperactivity Disorder (ADHD) demonstrates unique developmental manifestations in adolescence with implications for optimized, age-appropriate treatment. This 10-year update is the third in a series of systematic reviews examining the efficacy and safety of adolescent ADHD treatments. We broadly examined efficacy on ADHD symptoms, impairments, and other reported outcomes. Acute and long-term efficacy, and treatment moderators, were considered. We performed PubMed, EMBASE, and PsycINFO searches for articles published or in press from 2013 to 2024, integrated with hand search and randomized controlled trials (RCTs) identified in this series' earlier reviews. RCTs examining the safety or efficacy of interventions delivered to adolescents (ages 10.0-19.9) with a diagnosis of ADHD were included. Study characteristics were extracted and reviewed, quality of evidence was assessed using GRADE, and effect sizes were calculated for individual studies and illustrated using forest plots. Sixty-three RCTs were identified. Quality of evidence ranged from high (medication; k = 29) to very low (nutrient supplementation, neurofeedback, occupational therapy; k = 1 each). Medications demonstrated consistent strong impact on ADHD symptoms and inconsistent impact on impairment. Diverse cognitive/behavioral treatments (C/BTs) demonstrated inconsistent impact on ADHD symptoms but strong and consistent impact on impairment and executive function skills, plus moderate benefits on internalizing symptoms. No interventions demonstrated significant safety concerns. Long-term maintenance (up to 3 years post-treatment) was demonstrated for C/BTs, though moderate quality of evidence was noted because participants cannot be fully blinded to receipt of treatment. The effects of C/BTs and medication appear complementary, not duplicative. Combining medication and C/BT is advised at treatment outset to maximize engagement, maintenance, and response breadth (i.e. improving both ADHD symptoms/cognitive performance and coping skills/functional impairments). Engagement strategies (e.g. motivational interviewing) may facilitate uptake. Novel treatments do not yet demonstrate effects on ADHD symptoms or impairments in adolescents but remain a promising area for research.

Exploring the complex relationship between attention deficit hyperactivity disorder and the immune system: A bidirectional Mendelian randomization analysis

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition that can be accompanied by alterations in immune markers. However, the intricate nature of the association between ADHD and immune markers remains insufficiently elucidated. To explore the currently ambiguous causal relationship between ADHD and the immune system, we performed a bidirectional Mendelian randomization (MR) analysis of immune cell traits and ADHD under the randomized inverse variance weighting (IVW) method based on genome-wide association study (GWAS) summary data. We found ADHD increased the level of 3 immune cell traits including myeloid dendritic cells (β = 0.28, P = 0.008), monocyte (β = 0.25, P = 0.024) and granulocyte (β = 0.2, P = 0.042). We also identified 1 trait which belongs to B cell panel was a risk factor (odds ratio (OR) = 1.07, P = 0.001) for ADHD onset. Other 5 traits including CD14+ monocyte (OR = 0.98, P = 0.002), immature myeloid-derived suppressor cells (MDSC) (OR = 0.98, P = 0.003), monocyte MDSC (OR = 0.95, P = 0.005), CD33br HLA DR+ (OR = 0.97, P = 0.021) and basophil (OR = 0.96, P = 0.022) were protective factors for ADHD. Here we identified a range of causal relationships extending from ADHD to immune cell traits, underscoring the complex interaction patterns between ADHD and the immune system. Enhanced interventions for protective and risk factors may be beneficial in the prevention and treatment of ADHD.

The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder

Objective: The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). Method: This study included 842 children aged 8–12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. Results: According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. Conclusion: This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.

DFT, Structure Activity Relationship, Fukui, Wave Function, NBO, NLO, Spectral and Hole-Electron Analyses of Dexmethylphenidate

Dexmethylphenidate (DMP) is used to treat attention deficit hyperactivity disorder (ADHD) and belongs to the central nervous system (CNS) stimulant group of medicines. The physical properties of DMP were analyzed under the DFT/B3LYP/6-311++G(d,p) basis set. The ESP study reveals the electrophilic attack is possible, while FMO analysis shows that the molecule is hard, stable and an electron donor. The non-covalent interaction (NCI) study explains that van der Waals and steric repulsion forces are observed. The HEI studies indicated that this molecule has CT excitation in the S0→S5 state. The shaded surface map analysis reveals the presence of electron depletion regions in this molecule. The UV-Vis spectral analysis was carried out in various solvents. The Fukui function analysis conveys that 7C is the best domain for electrophilic attack. Theoretical IR determinations and NLO properties were also performed. The structure-activity relationship findings were performed in order to improve the docking score.

Interdisciplinary Insights and Global Perspectives on ADHD in Children: A Comprehensive Bibliometric Analysis (2014–2024)

This study used bibliometric analysis to investigate the research on Attention-Deficit/Hyperactivity Disorder (ADHD) in pediatric populations between January 2014 and January 2024. The Scopus database is utilized to gather a diverse array of scholarly research on this complex ailment. Our objective was to compile a comprehensive dataset on understanding and managing ADHD by selecting specific terms such as “ADHD in Children”, “ADHD Treatment and Management”, and “Attention-Deficit/Hyperactivity Disorder”. We utilized the advanced analytical capabilities of Biblioshiny (bibliometrix R-package) and VOSviewer (VOSviewer version 1.6.19), within our methodological framework, to do network analysis. By conducting this analysis, we were able to examine patterns in publications, author affiliations, the geographic spread of research, and identify influential texts and developing research topics. The findings underscore the collaborative endeavors of medicine, psychology, and neuroscience in tackling the physiological and psychological aspects of ADHD, with a focus on interdisciplinary contributions. The extensive global impact of ADHD research is highlighted by the significant contributions made by countries including the United States, China, the UK, the Netherlands, and Canada. Our data indicates a notable shift towards holistic strategies that encompass socioeconomic, environmental, and behavioral aspects, alongside emerging practices like the utilization of non-invasive brain stimulation techniques in research. This bibliometric study offers a comprehensive view of ADHD research by identifying significant patterns and clusters of themes. It illuminates the shifts in scientific conversation over time and identifies areas that show potential for additional research. The study advocates for ongoing collaboration across various disciplines and nations, emphasizing the significance of innovative strategies to enhance the well-being of those affected by ADHD.

Reinforcement Processing as a Predictor of Behavioral Treatment Response in the ADHD Summer Treatment Program

ABSTRACT Background Behavioral interventions for attention-deficit/hyperactivity disorder (ADHD) are well-established interventions, but not all children benefit from these approaches. One factor that may accurately predict treatment outcomes is how individuals process reinforcement. Objective The present study examined the association between reinforcement processing and treatment response to a well-established behavioral intervention for ADHD, the Summer Treatment Program (STP). Methods Participants included two cohorts of patients from a Midwest academic medical center STP (n = 47). Reinforcement processing was assessed via a parent-rated questionnaire and computerized neuropsychological tasks. Behavioral improvement was determined from weekly parent- and counselor-rated measures of children’s behavior over the course of the STP, as well as from STP behavioral data. Repeated measures mixed-linear models were used to determine associations between the reinforcement processing predictors and behavioral ratings. Results Greater parent-rated child impulsive/fun-seeking behavior was significantly associated with both greater counselor- and parent-rated behavioral difficulties. However, greater parent-rated child reward responsiveness was significantly associated with lower counselor-rated behavioral difficulties. Objective, task-based measures did not have any significant associations. Conclusions Impulsive/fun-seeking behaviors appear to be the strongest predictor of behavioral treatment response, with results suggesting that children with high rates of these behaviors might benefit from higher rates or values of positive reinforcement to outweigh the immediate reinforcement gained by negative behavior. Reward responsiveness results suggest that a match between a child’s specific reward preferences and the types of reinforcement provided by a behavioral intervention may also be important to treatment outcomes.

Agressividade e criminalidade em adultos com TDAH

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition commonly diagnosed in childhood, but which persists in about 2.5% of adults. This disorder is associated with a higher risk of developing mood disorders, anxiety, substance use, and personality disorders. Impulsivity, a central feature of ADHD, contributes to difficulty in self-control, which can lead to aggressive behaviors. Studies show that individuals with ADHD are more likely to be involved in criminal activities, and impulsivity and lack of emotional control are key factors in this relationship. Difficulties in emotional regulation and personal organization also negatively affect the interpersonal relationships and professional lives of these individuals, increasing the risk of marital separations, divorces, and problems at work. When driving, adults with ADHD are at greater risk of accidents, due to inattention and difficulties in maintaining control of the vehicle. Specific interventions, such as the appropriate use of medications and driving techniques, are recommended to mitigate these risks. Early diagnosis and treatment of ADHD, especially in adults who exhibit aggressive behaviors, are crucial. Treatment programs that combine medication with psychosocial approaches can significantly improve social functioning and reduce crime rates in this population, highlighting the importance of integrated and personalized interventions.

Examine the Effects of Atomoxtine Alone Versus Atomoxtine Combined with Risperidone at Sample of Egyptian Children Suffering from ADHD.

Background: An estimated 7% of elementary school children suffer from Attention Deficit Hyperactivity Disorder (ADHD), a mental neuro-developmental condition marked by impulsivity, hyperactivity, and lack of attention. Atomoxetine is one of the most important medications for ADHD however Risperidone has been used as a label for the treatment of ADHD. Aim: To study the Efficacy of Atomoxetine alone vs. Atomoxtine with Antipsychotic (Risperidone) in ADHD children. Subjects and Methods: 54 Egyptian children with ADHD, ranging in age from 6 to 18. They meet the DSM-IV criteria for ADHD and have been receiving therapy at Al Hussian Hospital's psychiatry clinic. Conner's 2 scale was used to evaluate each patient for ADHD. Between January and June of 2024, a study was carried out on all children receiving therapy for all forms of ADHD using either Atomoxetine alone or in combination with an antipsychotic (Risperidone). Results: When Atomoxetine was administered to 27 children, it demonstrated a moderate level of efficacy in 12 of 27 patients (44.4%) for all children with ADHD, regardless of type, but it significantly improved the inattention type of ADHD in 4 from 4 patients (100%). Given to 27 children, the combination of Atomoxetine and Risperidone demonstrated a greater effect on 24 of 27 patients with (88.9%) for all ADHD children, and it showed a discernible improvement on 9 out of 9 with (100%) for ADHD hyperactivity type. Conclusion: Patients with Attention deficit variant responded well to Atomoxetine., Patients with attentiondeficit/hyperactivity variant responded well to Atomoxetine/Antipsychotic (Risperidone) combination., Patients with Hyperactivity variants show good responses to Antipsychotics (Risperidone)., All types of ADHD are responsive to Atomoxetine or Atomoxetine / Antipsychotic (Risperidone) combination, But the Atomoxetine effect is more on the Attention deficit variant than other variants, while Antipsychotic (Risperidone) is more effective on hyperactivity and aggression.

Scheduling of methylphenidate: Preventing misuse or impeding ADHD treatment adherence?

Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, with a chronic, and potentially debilitating course if untreated. Medication adherence is poor - negatively affecting emotional, social, educational and employment outcomes. The current Schedule 6 status of methylphenidate (MPH) drives healthcare resource utilisation and costs - a potential barrier to care. This study explored stakeholders' understanding and perceptions of the potential impact of a regulatory shift in the scheduling of MPH on treatment accessibility and adherence for ADHD. Participants from multiple stakeholder groups, involved in ADHD management in South Africa, were recruited via professional networks. A qualitative analysis of semi-structured interviews with 23 stakeholders was conducted to explore their views on the utility, benefits and risks associated with rescheduling MPH. Six key themes emerged from the interviews: 'adherence', 'accessibility', 'affordability', 'stigma', 'rescheduling of MPH' and 'risk mitigation'. Core to these themes is the role of the scheduling of MPH - which can have a protective societal role, but also acts as a barrier to care for individuals with ADHD. The current Schedule 6 status of MPH is not an effective strategy to prevent misuse and diversion but negatively impacts on treatment adherence. The positive outlook from stakeholders on rescheduling MPH holds significant implications for the ADHD landscape in South Africa. It is crucial to address stigma, facilitate fundamental change in service delivery and remove structural and practical barriers to care to improve outcomes for individuals with ADHD. A framework for ADHD treatment adherence is provided.

A multi-omics study of brain tissue transcription and DNA methylation revealing the genetic pathogenesis of ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is a chronic psychiatric disease that often affects a patient's whole life. Research has found that genetics plays an important role in the development of ADHD. However, there is still a lack of knowledge about the tissue-specific causal effects of biological processes beyond gene expression, such as alternative splicing (AS) and DNA methylation (DNAm), on ADHD. In this paper, a multi-omics study was conducted to investigate the causal effects of the transcription and the DNAm on ADHD, by integrating ADHD genome-wide association data with quantitative trait loci data of gene expression, AS, and DNAm across 14 different brain tissues. The causal effects were estimated using four different two-sample Mendelian randomization methods. Finally, we also prioritized the expression of 866 genes showing significant causal effects, including COMMD5, ENSG00000271904, HYAL3, etc., within at least one brain tissue. We prioritized 966 unique genes that have statistically significant causal AS events, within at least one of the 14 different brain tissues. These genes include PPP1R16A, GGT7, TREM2, etc. Furthermore, through mediation analysis, 106 regulatory pathways were inferred where DNAm influences ADHD through gene expression or AS processes. Our research findings provide guidance for future experimental studies on the molecular mechanisms of ADHD development, and also put forward valuable knowledge for the prevention, diagnosis, and treatment of ADHD.

Role of vesicular monoamine transporter-2 for treating attention deficit hyperactivity disorder: a review.

The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) classifies attention deficit hyperactivity disorder (ADHD) as a neurodevelopmental disorder that interferes with human functioning and development. As the clinical presentation of ADHD involves a deficiency in executive function, neurocognitive deficits involving distinctive neuropathological changes must be present for clinical diagnosis. The vesicular monoamine transporter (VMAT), specifically VMAT-2, plays a role in ADHD pathogenesis. In addition, experimental data show that the stimulants (amphetamines and methylphenidate) are first-line treatments for the condition because of their extensive interaction with VMAT-2. The interactions of peptides, bupropion, and nutritional supplements with VMAT-2 receptors have been researched, but more evidence is needed to elucidate their pharmacodynamic properties. Therefore, this literature review evaluated the current pharmacological treatment modalities, peptides, and nutritional supplements for ADHD that target the VMAT-2 system. We obtained relevant studies from several platforms, including the National Center for Biotechnology, Clinical Key, Access Medicine, and PubMed. From the results of these studies, we observed that stimulants interact highly with the VMAT-2 transporter, with omega-3 fatty acids, peptides, and bupropion exerting some modulatory activity on VMAT-2. These agents should be considered for the future treatment of ADHD, although clinical-level research involving human participants is necessary.

Effect of pharmacological treatment of attention-deficit/hyperactivity disorder on later psychiatric comorbidity: a population-based prospective long-term study

BackgroundPsychiatric comorbidity is frequent among persons with attention-deficit/hyperactivity disorder (ADHD). Whether pharmacological treatment of ADHD influences the incidence of psychiatric comorbidity is uncertain.ObjectiveTo investigate associations and causal relations between pharmacological...

Economic Evaluation of a Novel Treatment of Attention-Deficit/Hyperactivity Disorder in US Motor Vehicle Drivers

Background: Attention-deficit/hyperactivity disorder (ADHD) affects approximately 4.4% of US adults. ADHD is associated with high-risk driving behavior and costly motor vehicle accidents. DYANAVEL XR (DXR) (Tris Pharma, Inc.) is a once-daily fast-acting amphetamine developed for ADHD treatment. A randomized controlled trial showed that DXR patients were 43% less likely to crash during a driving simulation than individuals taking placebo. Study outcomes suggest a DXR crash rate similar to that of a driver without ADHD, while patients treated with the current standard of care (SOC) have a 52% higher crash risk than non-ADHD drivers. Objective: The aim was to evaluate the economic benefits attributable to improved driving abilities and avoided crashes in DXR patients compared with patients treated with the SOC or those who are untreated. Methods: A cost-impact model estimated 1-year crash-related cost outcomes for DXR-treated patients compared with SOC-treated and untreated ADHD patients. SOC was assumed to consist of a combination of short-, intermediate-, and long-acting ADHD stimulant and non-stimulant medications. DXR crash risk was assumed equivalent to the non-ADHD population risk, as supported by trial data. Crash risk for untreated and SOC-treated ADHD patients were assumed to be 99% and 52% higher than the general US population, respectively. Model outcomes included the cost impact (medication- and crash-related costs) and the number of crashes, injuries, and fatalities avoided with DXR. Results: Treatment with DXR would avoid 0.82 crashes, 0.016 injuries, and 0.036 fatalities per year compared with untreated patients, and 0.036 crashes, 0.007 injuries, and 0.0001 fatalities per year compared with SOC-treated patients. Compared with a population of 25% SOC-treated patients and 75% untreated patients, DXR use would save an average of $4581 per person per year across all age groups when priced at $80 per month, assuming all SOC-treated and untreated patients utilized DXR. When the value of quality-of-life improvement is considered, savings increase over 7-fold. Discussion: Outcomes suggest that DXR may be an economically beneficial treatment compared with SOC for ADHD patients. Conclusions: The economic model showed that DXR is cost-saving compared with no treatment and SOC by reducing the number of motor vehicle crashes in the ADHD population.

Economic Evaluation of a Novel Treatment of Attention-Deficit/Hyperactivity Disorder in US Motor Vehicle Drivers.

Background: Attention-deficit/hyperactivity disorder (ADHD) affects approximately 4.4% of US adults. ADHD is associated with high-risk driving behavior and costly motor vehicle accidents. DYANAVEL XR (DXR) (Tris Pharma, Inc.) is a once-daily fast-acting amphetamine developed for ADHD treatment. A randomized controlled trial showed that DXR patients were 43% less likely to crash during a driving simulation than individuals taking placebo. Study outcomes suggest a DXR crash rate similar to that of a driver without ADHD, while patients treated with the current standard of care (SOC) have a 52% higher crash risk than non-ADHD drivers. Objective: The aim was to evaluate the economic benefits attributable to improved driving abilities and avoided crashes in DXR patients compared with patients treated with the SOC or those who are untreated. Methods: A cost-impact model estimated 1-year crash-related cost outcomes for DXR-treated patients compared with SOC-treated and untreated ADHD patients. SOC was assumed to consist of a combination of short-, intermediate-, and long-acting ADHD stimulant and non-stimulant medications. DXR crash risk was assumed equivalent to the non-ADHD population risk, as supported by trial data. Crash risk for untreated and SOC-treated ADHD patients were assumed to be 99% and 52% higher than the general US population, respectively. Model outcomes included the cost impact (medication- and crash-related costs) and the number of crashes, injuries, and fatalities avoided with DXR. Results: Treatment with DXR would avoid 0.82 crashes, 0.016 injuries, and 0.036 fatalities per year compared with untreated patients, and 0.036 crashes, 0.007 injuries, and 0.0001 fatalities per year compared with SOC-treated patients. Compared with a population of 25% SOC-treated patients and 75% untreated patients, DXR use would save an average of 80 per month, assuming all SOC-treated and untreated patients utilized DXR. When the value of quality-of-life improvement is considered, savings increase over 7-fold. Discussion: Outcomes suggest that DXR may be an economically beneficial treatment compared with SOC for ADHD patients. Conclusions: The economic model showed that DXR is cost-saving compared with no treatment and SOC by reducing the number of motor vehicle crashes in the ADHD population.

B - 61 Psilocybin as a First-Line Treatment of ADHD in Adult Populations

Abstract Objectives The first line for symptom management of attention deficit hyperactivity disorder (ADHD) is a class of medications that act on dopamine and noradrenaline receptors, which leads to symptom reduction at the cost of significant side effects. These side effects have led to community searching for alternative methods that manage ADHD symptoms in adults that lead to less side effects. Microdosing Psilocybin has emerged as a course of treatment that could provide benefits for those who may experience serious side effects to stimulant medication. Method This literature review was conducted using search terms such as, ADHD attention deficit hyperactivity disorder, psychedelic treatment, stimulant treatment of ADHD, naturalistic treatment of ADHD, 5-HT, neural plasticity. Journals that reported about the benefits and concerns of Psilocybin use for ADHD are Neurochemistry International, American College of Neuropharmacology, European Psychology, Movement and Nutrition in Health and Disease, Journal of Psychopharmacology, and Psychiatry Research. Results Research shows that not only does microdosing Psilocybin have less adverse effects than stimulant medications when being used to treat ADHD, but it also leads to an alternative method that focuses on serotonin receptors when other avenues are unsuccessful. Conclusions This poster illustrates the alternative use of Psilocybin for treatment in ADHD and highlights neurological underpinnings that may lead to explaining success. Limitations of stimulant medications are also reviewed.

B - 60 Age of ADHD Diagnosis as a Predictor of Psychiatric Symptom Reporting

Abstract Objective Childhood attention-deficit/hyperactivity disorder (ADHD) diagnosis and intervention is thought to mitigate symptom severity and to improve outcomes. Existing literature suggests those who receive later ADHD diagnoses may attribute ADHD symptomatology to personal shortcomings, contributing to a negative self-perception and higher incidence of psychopathology. We evaluated differences in psychological functioning between adults diagnosed with ADHD in childhood (&amp;lt; 12) versus those first diagnosed in adolescence or adulthood. Method Cross-sectional data from 609 patients (Mage = 28.13; Meducation = 15.69; 61.4% Female/38.6% Male; 39.9% White, 27.3% Hispanic, 16.7% Black, 10.3% Asian, 5.7% Other) undergoing neuropsychological evaluation for ADHD was examined. Psychiatric symptomatology was assessed using the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI-II). Patients were grouped by diagnostic history: (1) ADHD diagnosis in childhood and currently (&amp;lt; 12); (2) current ADHD diagnosis without childhood diagnosis; and (3) no ADHD/primary psychopathology diagnosis comparison group. Results Overall, there was a significant multivariate effect across groups (Wilks’ Lambda = 0.961, F(4,1204) = 5.971, p &amp;lt; 0.001); patients diagnosed with ADHD in childhood had significantly lower BAI and BDI-II scores than both those diagnosed later and those diagnosed with a condition other than ADHD. Conclusion(s) Individuals diagnosed with ADHD in childhood self-reported less symptoms of anxiety and depression compared to those diagnosed with ADHD later in adolescence or adulthood and those without an ADHD diagnosis. This underscores the potential importance of early identification and intervention for ADHD in mitigating subsequent symptoms of anxiety and depression.