A Trio of JCP Reports Tracks the Latest ADHD Research

by Denis Storey
April 1, 2024 at 1:12 PM UTC

The Journal of Clinical Psychiatry has published multiple papers that reveal promising results for ADHD patients.

Clinical relevance: Three studies add to the clinical understanding of ADHD

  • U.S. ADHD diagnoses in children aged 5-17 increased since 2020, but Swedish studies show positive outcomes from traditional ADHD treatments.
  • Solriamfetol’s shows efficacy in treating adult ADHD, with improvements in symptoms, executive function, and sleepiness.
  • Omega-3 polyunsaturated fatty acids (PUFAs) might improve ADHD symptoms with long-term supplementation, while new therapies and devices offer promising alternatives for ADHD management.
  • Highlights from a session discussing a variety of effective new ADHD treatments.

Attention-deficit/hyperactivity disorder (ADHD) diagnoses among U.S. children between 5 and 17 have been steadily rising. But there’s optimism due to Swedish studies revealing unexpected benefits from traditional ADHD treatments.

As we reported, one study linked medications such as lisdexamfetamine and atomoxetine to reduced risks of psychiatric hospitalization, suicidal behavior, and workplace injuries. These findings contradict earlier concerns about adverse psychiatric outcomes tied to stimulant medications.

The Journal of Clinical Psychiatry has published other promising research results recently. Here are summaries as well as links to these studies for further review.

Does Solriamfetol Help with Adult ADHD?

The first paper, which JCP published late last year, sought to explore the efficacy and tolerability of solriamfetol as a treatment for ADHD in adults. The research focused particularly on cases where the patients struggle to tolerate standard treatments.

Conducted over six weeks, the double-blind, placebo-controlled trial involved 60 adults with ADHD. The researchers chose participants randomly to receive either solriamfetol or a placebo. The scientists then monitored them for changes in symptoms, executive function, sleepiness, and sleep patterns.

Results indicated that the patients handled the solriamfetol well, and showed no significant adverse effects on vital signs. While both groups experienced adverse events, they were generally “mild to moderate.” Solriamfetol-treated individuals showed significant improvement in ADHD symptoms compared to the placebo group, as measured by the Adult ADHD Investigator Symptom Rating Scale (AISRS).

Additionally, a higher proportion of solriamfetol-treated individuals met the criteria for clinical improvement, including reductions in AISRS scores and improved clinical global impressions.

Moreover, the research team identified a link between solriamfetol treatment and greater improvements in executive function, using the Behavior Rating Inventory of Executive Function-Adult Form (BRIEF-A) and in sleepiness, based on the Epworth Sleepiness Scale (ESS). Importantly, improvement in sleepiness did not appear to influence the improvement in ADHD symptoms.

The study suggests that solriamfetol might offer a novel and effective treatment option for adults with ADHD, particularly for those who haven’t responded well to existing treatments. But the researchers stress the need for further research to replicate these findings in larger trials and to determine optimal dosing regimens.

Finally, the study demonstrated the feasibility and efficacy of conducting clinical trials remotely, which could improve accessibility for participants in future research projects.

Omega-3 Polyunsaturated Fatty Acids Treatment Takes Time

Another study reported a meta-analysis meant to evaluate the effectiveness of omega-3 polyunsaturated fatty acids (PUFAs) in improving symptoms of ADHD while addressing inconsistencies in previous studies.

The paper included 22 randomized controlled trials (RCTs) that covered 1,789 participants and assessed the impact of omega-3 PUFAs on ADHD core symptoms compared to placebos. The analysis revealed no significant overall improvement in ADHD symptoms with omega-3 PUFA supplementation.

However, the researchers dug deeper, and subgroup analysis revealed that a treatment duration of at least four months significantly improved symptoms compared to placebo.

Additional subgroup analyses based on omega-3 PUFA dosage and composition ratios failed to show significant improvements in ADHD symptoms. But the researchers noted that any adverse effects they identified appeared to be minimal and comparable between omega-3 PUFA and placebo groups. The study suggests that while omega-3 PUFAs might not significantly improve ADHD core symptoms, long-term supplementation could offer benefits.

The team remained uncertain of the final result, and pushed for further research with larger samples and longer treatment durations to determine the optimal dosage and efficacy of omega-3 PUFAs.

Nevertheless, the study offers valuable insights for clinicians and caregivers considering omega-3 PUFAs as a treatment option for ADHD. It also emphasizes the importance of careful patient selection and consideration of treatment duration in assessing the potential benefits of omega-3 PUFA supplementation.

Despite its limitations, including moderate heterogeneity and the lack of dietary pattern information, the study does contribute to a better understanding of the role of omega-3 PUFAs play in ADHD management and highlights the need for further research in this area.

Emerging ADHD Therapies

Finally, the CME Institute of Physicians Postgraduate Press Inc. prepared and independently developed the third and final report this week.

In it, the authors discuss recent developments in ADHD research that have led to the emergence of new therapies aimed at better addressing the needs of individuals with the condition. Since 2020, several newer stimulant formulations with potential advantages over traditional options have gained regulatory approval. These formulations offer various benefits but also come with well-characterized side effects. Non-stimulant alternatives, such as atomoxetine and α2 agonists, have their own advantages and limitations, prompting the ongoing development of novel therapeutics.

New pharmacologic agents, including stimulant and non-stimulant medications, have shown promise in clinical trials. Among these are transdermal treatments, which offer benefits such as improved medication adherence and reduced risk of drug-drug interactions.

Additionally, novel non-stimulant medications like viloxazine ER have demonstrated efficacy in improving ADHD symptoms in both pediatric and adult populations.

In addition to pharmacologic interventions, several devices have been developed for ADHD treatment, with potential to augment response in patients refractory to traditional medications or as alternative treatment options. These devices include trigeminal nerve stimulation systems and digital therapeutics, which have shown promise in clinical trials.

Despite these advancements, challenges remain in ADHD management, and patients continue to face unmet needs. However, the expanding armamentarium of therapeutic options provides hope for improved outcomes and underscores the importance of considering novel interventions in clinical practice.

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