Attention deficit hyperactivity disorder (ADHD) is not just a problem for kids. Nearly 4% of adults, or about 8 million Americans, continue to experience the symptoms of ADHD in their work and personal lives, sometimes with devastating results.
For some adults, ADHD may have been a well-known, life-long struggle. For others, the increased responsibilities of adulthood may have brought previously undiagnosed ADHD to the fore as work deadlines slipped, spouses expressed frustration with inattentiveness or late payment charges accrued.
Current first-line treatment for ADHD relies on central nervous system stimulants such as methylphenidate or amphetamine salts, both of which have the potential for abuse and may cause side effects such as nervousness, insomnia, tics and decreased appetite. Both types of stimulants prevent the reuptake of both norepinephrine and dopamine. Because they control symptoms for just four to eight hours, patients typically need multiple doses during the day.
A second-line drug, atomoxetine, is a selective norepinephrine reuptake inhibitor. Fewer patients respond to atomoxetine than stimulants. Common side effects include constipation, dry mouth, insomnia, erectile dysfunction, palpitations, painful menstruation, hot flashes and urinary tract abnormalities. Patients on atomoxetine should also be monitored for signs of liver damage and children and teens on the medication have an increased risk of suicidal thinking.
In December, researchers presented promising results from a four week clinical trial of a new drug, dasotraline, in treating adult ADHD at the Annual Meeting of the American College of Neuropsychopharmacology. Dasotraline blocks pre-synaptic dopamine and norepinephrine transporters. It has an extended half-life that indicates it may provide therapeutic benefit with once a day dosing.
Participants in the clinical trial demonstrated statistically significant improvements in symptoms at both 4 mg and 8 mg dosages on the ADHD Rating Scale-Version IV total score as well as the inattentiveness and hyperactivity/impulsivity subscales compared to placebo. The most common side effects were insomnia, anxiety and panic attacks.
A second clinical trial of dasatroline in adult ADHD is currently underway and is enrolling patients locally. The randomized, double blind, multicenter outpatient study will assign participants to daily doses of 4 mg or 6 mg of dasotraline or placebo for an eight-week treatment period.
If you have a patient who may benefit from treatment of ADHD and is between the ages of 18 and 55, learn more about the dasatroline study.
Northwest Behavioral Research Blog 