New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children

Diana Domnitei, Vishal MadaanDepartment of Psychiatry, Creighton University Medical Center, Omaha, NE, USAAbstract: Treatment guidelines from the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics state that stimulant medications have the most evidence for saf...

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Main Authors: Diana Domnitei, Vishal Madaan
Format: Article
Language:English
Published: Dove Medical Press 2010-05-01
Series:Neuropsychiatric Disease and Treatment
Online Access:http://www.dovepress.com/new-and-extended-action-treatments-in-the-management-of-adhd-a-critica-a4457
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author Diana Domnitei
Vishal Madaan
author_facet Diana Domnitei
Vishal Madaan
author_sort Diana Domnitei
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description Diana Domnitei, Vishal MadaanDepartment of Psychiatry, Creighton University Medical Center, Omaha, NE, USAAbstract: Treatment guidelines from the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics state that stimulant medications have the most evidence for safety and efficacy in the treatment of childhood attention deficit hyperactivity disorder (ADHD). Longer-acting stimulants are thus considered as first-line for management of ADHD symptoms. Over the years, concerns about the abuse potential of stimulants have led to the development of alternative formulations of these agents. One such recent development, lisdexamfetamine (LDX) was FDA approved for treating ADHD in children in early 2007 and in adults in early 2008. LDX is a prodrug, which when orally ingested, is converted to l-lysine and active d-amphetamine, which is responsible for its therapeutic activity. This unique formulation may lead to a possible reduction of the abuse potential, by bypassing the first-pass metabolism. In fact, a statistically significant difference for the ‘liking’ effects on the Drug Questionnaire Response has been reported with intravenous LDX compared to d-amphetamine. LDX appears to have an efficacy and tolerability profile comparable to other extended-release stimulant formulations used to treat ADHD, but reduced potential for abuse-related liking effects when compared to equivalent amounts of immediate-release d-amphetamine. The most common adverse events include decreased appetite, insomnia, upper abdominal pain, headache, irritability, weight loss, and nausea.Keywords: lisdexamfetamine, attention deficit hyperactivity disorder, adults, children
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spelling doaj.art-76a7b95d9d09471b84ee133aa3c5f4112022-12-21T22:43:31ZengDove Medical PressNeuropsychiatric Disease and Treatment1176-63281178-20212010-05-012010Issue 1273279New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and childrenDiana DomniteiVishal MadaanDiana Domnitei, Vishal MadaanDepartment of Psychiatry, Creighton University Medical Center, Omaha, NE, USAAbstract: Treatment guidelines from the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics state that stimulant medications have the most evidence for safety and efficacy in the treatment of childhood attention deficit hyperactivity disorder (ADHD). Longer-acting stimulants are thus considered as first-line for management of ADHD symptoms. Over the years, concerns about the abuse potential of stimulants have led to the development of alternative formulations of these agents. One such recent development, lisdexamfetamine (LDX) was FDA approved for treating ADHD in children in early 2007 and in adults in early 2008. LDX is a prodrug, which when orally ingested, is converted to l-lysine and active d-amphetamine, which is responsible for its therapeutic activity. This unique formulation may lead to a possible reduction of the abuse potential, by bypassing the first-pass metabolism. In fact, a statistically significant difference for the ‘liking’ effects on the Drug Questionnaire Response has been reported with intravenous LDX compared to d-amphetamine. LDX appears to have an efficacy and tolerability profile comparable to other extended-release stimulant formulations used to treat ADHD, but reduced potential for abuse-related liking effects when compared to equivalent amounts of immediate-release d-amphetamine. The most common adverse events include decreased appetite, insomnia, upper abdominal pain, headache, irritability, weight loss, and nausea.Keywords: lisdexamfetamine, attention deficit hyperactivity disorder, adults, childrenhttp://www.dovepress.com/new-and-extended-action-treatments-in-the-management-of-adhd-a-critica-a4457
spellingShingle Diana Domnitei
Vishal Madaan
New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children
Neuropsychiatric Disease and Treatment
title New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children
title_full New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children
title_fullStr New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children
title_full_unstemmed New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children
title_short New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children
title_sort new and extended action treatments in the management of adhd a critical appraisal of lisdexamfetamine in adults and children
url http://www.dovepress.com/new-and-extended-action-treatments-in-the-management-of-adhd-a-critica-a4457
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