Narcolepsy medications may be effective for ADHD in adults

A drug approved to treat excessive daytime sleepiness may help ease symptoms of attention-deficit/hyperactivity disorder (ADHD) in adults, according to a small pilot study. not getting relief from currently available treatments.

Solriamfetol is a non-stimulant medication approved for the treatment of narcolepsy (sudden episodes of sleepiness) and obstructive sleep apnea (marked by cessation of breathing during sleep). ).

“The pilot study is promising, but more 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 an associate professor of psychiatry at Harvard Medical School, in Boston.

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

The drugmakers, Jazz Pharmaceuticals and Axsome Therapeutics, funded the study.

In the United States, up to 10 million adults have ADHD. Children and adults with attention-deficit/hyperactivity disorder (CHADD) may have difficulty paying attention, be impulsive, and have trouble with executive functions such as analysis, organization, and planning – problems that may hinder success at school, work or in personal relationships. .

Currently, ADHD in adults is treated with a combination of medication and behavioral therapy. Medications include stimulants such as Adderall and Ritalin and non-stimulants. “Not everyone can tolerate the medications available, so the more options there are, the better for adults with ADHD,” Surman says.

Solriamfetol increases dopamine and norepinephrine, chemicals in the brain that help control sleep and alertness. Existing ADHD medications also target these brain chemicals.

Mild side effects include decreased appetite, headache, insomnia, and stomach upset. But very few people stop taking the drug due to these side effects, he said.

Solriamfetol does not affect heart rate or blood pressure. “Stimulants tend to increase heart rate and blood pressure. At the doses we tested, we observed beneficial effects without altering heart rate and blood pressure,” Surman noted. This is important because ADHD medications are meant to be taken long term.

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

Surman said treating adult ADHD involves “medication and skills.” Pharmacological and behavioral interventions work together to help reduce symptoms and improve daily functioning.

“Behavioral therapies are homework, and people with ADHD will have difficulty doing homework without appropriate treatment,” he said.

The study was published October 9 in the journal Journal of clinical psychiatry.

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

“Its mechanism of action is similar to drugs used in ADHD,” said Anbarasan, who had no connection to the new study.

The drug is as effective as stimulants and appears to be more effective than non-stimulant drugs based on this study, she said, although this is not a direct comparison. “If these results hold up in other studies, this would be the first non-stimulant ADHD medication that appears to be comparable to stimulants,” Anbarasan noted.

There are other benefits to having options like non-stimulant medications, she said.

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