A drug that currently treats excessive daytime sleepiness due to narcolepsy or obstructive sleep apnea could be repurposed to relieve debilitating symptoms of attention deficit hyperactive disorder (ADHD) in adults.
Researchers at Massachusetts General Hospital (MGH) have released the results of their six-week clinical trial that looked at how solriamfetol affected 60 ADHD patients aged 18-65, and the data shows promise for new, alternative treatments for the neurodevelopmental disorder.
Solriamfetol, which is on prescription as Sunosi, is a selective dopamine and norepinephrine reuptake inhibitor (DNRI), which works on the brain’s neurotransmitters in a similar way to stimulants such as amphetamines (Adderall, Vyvanse, for example) and methylphenidate (Ritalin). However, studies show that stimulants can also cause short-term spikes in the risk of heart attack, stroke and heart arrhythmias, as well as other issues for those with high blood pressure.
“Our results suggest that solriamfetol may be a safe and effective treatment for ADHD in adults,” said lead author Dr Craig Surman, director of adult ADHD research at MGH and Associate Professor of Psychiatry at Harvard Medical School. “Although there are currently safe and effective treatments for ADHD, they are not effective for all individuals with ADHD or tolerated well by all patients.”
In the Phase 3 randomized trial, 60 adults with DSM-5 Criteria diagnosed ADHD were either given solriamfetol (75 or 150 mg) or a placebo for six weeks. Patients were interviewed throughout the trial, and various aspects of the treatment were gauged using the Adult ADHD Investigator Symptom Rating Scale (AISRS), the Clinical Global Impressions (CGI) scale, the Global Assessment of Functioning (GAF), the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Behavior Rating Inventory of Executive Function-Adult Form (BRIEF-A), and a modified Adult ADHD Self-Report Scale (MASRS).
Between week three and six, those on either solriamfetol dosage had higher AISRS scores than the placebo cohort, and at the end of the trial, a “significant” number of patients taking the drug showed vastly improved executive functioning. Importantly, the drug showed no significant impact on sleep quality, heart rate or blood pressure. Adverse side effects were minor and in line with other ADHD treatments, including decreased appetite, headache and some gastrointestinal concerns.
Given the complexities of adult ADHD, with treatment made even more difficult if limited by stimulant intolerance, the results of this study show there’s huge potential in pivoting an already approved drug in order to provide more options. Adult ADHD has also been linked to many other diseases.
“Larger studies replicating these findings could confirm the strong evidence of benefit and the tolerability of this agent as a treatment,” said Dr Surman. “Our findings offer hope of a new method of supporting the daily challenges that individuals with ADHD face.”
The study was published in the Journal of Clinical Psychiatry.
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