New Drugs Help Child ADHD, Adult ADHD

May 21, 2003 -- Inattentive, hyperactive, and uncontrollably impulsive -- that's attention deficit hyperactivity disorder (ADHD). Literally millions fight a daily battle against it.

For years, Ritalin and other stimulant drugs were the only drugs that quelled the symptoms -- the difficulty focusing, the restlessness, the disorganization -- that mark child ADHD and adult ADHD.

In recent years, drug developers have provided more options. Adderall-XR (a mixture of amphetamines) is FDA-approved for child ADHD only -- and in just one dose a day. Strattera -- the first nonstimulant ADHD treatment -- is the first and only FDA-approved drug for ADHD in adults; it's also approved for children and adolescents.

The FDA approves a drug for a specific condition -- and for certain groups of people -- after it is fully evaluated for its effectiveness and safety. However, once the drug is approved, doctors can prescribe it for any condition or person, if they feel that it would work. This usage is known as off-label prescribing.

Study results on these two drugs were presented this week at the American Psychiatric Association annual meeting held in San Francisco.

Adderall XR

A two-year multicenter trial of Adderall XR -- involving 560 children -- found that, on average, the children had significant improvement in symptoms, control, and quality of life with continuous long-term treatment. On average, the children showed a 35% improvement in symptoms. The effects lasted for up to 12 hours after children took the pills. Children also had better scores in school functioning, peer relationships, leisure time, and home life, reports Mark Chandler, MD, a neuropsychiatrist with the University of North Carolina at Chapel Hill.

A four-week study involving 248 patients with adult ADHD showed similar results. The higher the dose of Adderall XR, the greater the degree of symptom control. In fact, the majority of the adults taking Adderall XR also showed significant improvements on a social adjustment scale, which measures functioning in social and work environments.

The effect was evident at week one, lasted the length of the study, and was effective for at least 12 hours every day, reports Richard H. Wiesler, MD, professor of psychiatry at the University of North Carolina School of Medicine at Chapel Hill.

"So many with adult ADHD have this disorder, but it's very under-diagnosed and under-treated," says Weisler. "It's very rewarding to watch adults who were marginal academically in college or high school become really good students. We saw lot of people turnaround. A lot of people really did kind of blossom. " Both Adderall studies were funded by Shire Pharmaceuticals, Adderall's maker.

Strattera

Another study looked at the effects of Strattera on adults. How it works is not completely understood. It has a role in a brain chemical known as norepinephrine, maintaining the chemical's effect on regulating attention and impulsivity.