New drugs for ADHD

According to Erin O’Connor Prange, MSN, CRNP, of Children’s Hospital of Philadelphia in Pennsylvania, drugs for attention deficit/hyperactivity disorder (ADHD) have been on the market for more than 45 years, beginning with methylphenidate (Ritalin), which was approved in 1955. [Editor’s note: Although not included in the Diagnostic and Statistical Manual of Mental Disorders until 1968, methylphenidate was originally prescribed for fatigue and depression.1] According to a 2016 study, about 6 million children in the United States have ADHD, Prange said. Boys are diagnosed twice as often as girls, but overall 77% of these children were receiving treatment, of which about 32% had both behavioral and drug treatment.

What is a snapshot of a child with ADHD? Prange, who was speaking at the 43rd National Conference on Pediatric Health Care in Dallas, Texas,2 in March 2022, explained that the main component of this developmental learning disorder is poor executive functioning in tasks. These include planning, time management, attention, organization and self-control. Additionally, during the months when children were learning remotely due to the COVID-19 pandemic, impaired communication, eye strain, distractions and anxiety were also reported, largely due to the struggle with virtual and blended learning.

Non-drug treatment for ADHD includes cognitive behavioral therapy, extra time to take tests, making lists (such as what to put in the school backpack), bouncy bands, and mobile chairs for offices. The newer (those that have become available within the last 5 years) and most commonly prescribed medications for the disorder include the non-stimulant viloxazine (Qelbree); for stimulants, there are now several methylphenidates (Cotempla, Adhansia, Aptensio, Jornay) and amphetamines (Dyanavel, Adzenys and Mydayis).

Before starting a patient on stimulants, the American Academy of Pediatrics recommends a thorough cardiovascular evaluation, including patient and family medical history; assessment of all medications used; and a physical examination focused on risk factors for cardiovascular disease. Prange also reviewed the side effects of stimulant medications, which include, but are not limited to, decreased appetite, trouble sleeping, headaches, weight loss, and mood swings. . She also encouraged members of the public to look for a copy of the ADHD Medication Guide, available at addwarehouse.com, which offers books, assessment products and training programs for ADHD and related conditions.

Stay tuned for the August issue of Drug Topics®, featuring an in-depth look at the latest in pediatric and adult ADHD management.

Norma A. Roth