Narcolepsy medication may be effective for ADHD in adults

An already approved drug for excessive daytime sleepiness may help relieve symptoms of attention-deficit/hyperactivity disorder (ADHD) in adults that aren’t relieved by available treatments, according to a small pilot study.

Solriamfetol is a non-stimulant medication approved for the treatment of drowsiness caused by narcolepsy (sudden sleep attacks) and obstructive sleep apnea (marked by interruptions in breathing during sleep).

“The pilot study is very promising, but additional research is needed before this drug can be recommended or approved for adults with ADHD,” said study author Dr. Craig Surman. He is director of the Adult ADHD Clinical and Research Program at Massachusetts General Hospital and associate professor of psychiatry at Harvard Medical School, Boston.

For the study, 60 adults with ADHD took 75 or 150 milligrams of solriamfetol or a placebo for six weeks. They were asked about ADHD symptoms throughout the study and completed self-reports. At the end of the study, more people taking solriamfetol showed improvement in ADHD symptoms than those taking the placebo.

The drug’s makers, Jazz Pharmaceuticals and Axsome Therapeutics, funded the study.

Up to 10 million adults in the United States have ADHD. They may have difficulty paying attention, impulsivity, and difficulty with executive functions such as analyzing, organizing, and planning—problems that can hinder success in school, work, or life. personal relationships, according to children and adults with attention-deficit/hyperactivity disorder (CHADD). .

Currently, ADHD in adults is treated with a combination of medication and behavioral therapy. Medications include stimulant medications like Adderall and Ritalin and nonstimulants. “Not everyone tolerates the medications available, so the more options, the better for adults with ADHD,” Surman said.

Solriamfetol increases dopamine and norepinephrine, brain chemicals that help control sleep and wakefulness. Medications available for ADHD also target these brain chemicals.

Mild side effects included decreased appetite, headache, insomnia, and stomach problems. But few people stopped taking the drug because of these side effects, he said.

Solriamfetol had no effect on heart rate or blood pressure. “Stimulants tend to increase heart rate and blood pressure. At the doses we tested, we saw beneficial effects with no changes in heart rate or blood pressure,” Surman noted. This is important because ADHD medications are taken long term.

ADHD in adults doesn’t receive as much attention as ADHD in children, but it can have pronounced effects on health and quality of life. “Adults with untreated ADHD lead last-minute, reactive lives that can impact what time they go to bed or what they eat during a busy week, all of which can affect their health,” he explained.

Treatment for ADHD in adults includes “pills and skills,” Surman said. Medications and behavioral interventions work together to relieve symptoms and improve daily functioning.

“Behavioral therapies are a must, and people with ADHD have difficulty doing their homework if they are not treated adequately,” he said.

The study was published October 9 in the Journal of Clinical Psychiatry.

It makes sense that this drug shows promise in treating ADHD in adults, said Dr. Deepti Anbarasan, clinical associate professor of psychiatry and neurology at NYU Langone Health in New York.

“Its mechanism of action is similar to that of drugs used in the treatment of ADHD,” said Anbarasan, who has no connection to the new research.

The drug was about as effective as stimulants and appeared to be more effective than nonstimulant medications, based on this study, although it was not a direct comparison, she said. “If these results pan out in further studies, this would be the first non-stimulant medication for ADHD that appears to be somewhat comparable to stimulants,” Anbarasan noted.

There are other benefits to having options such as non-stimulants, she said.

“There is a shortage of stimulants right now, and stimulants are considered controlled substances, so you can only get a 30-day supply of them,” Anbarasan said. This means monthly top-ups; Non-stimulant ADHD medications are not subject to such strict rules.