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Clinical Trials Test New Avenues for Treating ADHD

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ADHD treatment and management

Attention deficit hyperactivity disorder is a neurodevelopmental disorder that affects attention span, focus, and behavior. It usually affects children and teens but can continue to adulthood. ADHD affects more boys than girls. It can impact children’s school performance and has also been associated with substance misuse and other mental disorders. Although there is no cure available for ADHD, early diagnosis and a good treatment and education plan can help manage the condition to a great extent.

Risk Factors for ADHD

The causes and risk factors for ADHD is not fully understood. However, some factors have been identified that increases the likelihood of the child developing ADHD:
  • The child’s genetic history
  • The mother smoking, drinking, or using drugs during pregnancy
  • Exposure to environmental toxins (such as lead) during pregnancy
  • Exposure to environmental toxins at a very young age
  • Low birth weight
  • Brain injuries
 

Clinical Features of ADHD

It is difficult to spell out the symptoms of ADHD, as many symptoms could very easily be normal childhood behavior. In general, ADHD symptoms are divided into two types: attention-related, and hyperactivity-related.

Attention-related:
  • Difficulty focusing
  • Difficulty following instructions
  • Difficulty completing tasks
  • Making careless mistakes
  • Daydreaming
  • Losing personal items frequently
  • Difficulty organizing daily tasks
  • Difficulty remembering daily tasks

Hyperactivity-related:
  • Difficulty staying still
  • Difficulty playing quietly
  • Talking excessively
  • Trouble waiting for their turn
  • Frequently interrupting others
 

Diagnosing ADHD

Diagnosing ADHD can be difficult because it is difficult to ascertain whether symptoms are normal childhood behavior or ADHD related. Doctors will make an assessment of the child’s mental and physical health to ensure that the symptoms are not caused by other factors, such as an underlying health issue, a different mental health disorder, or problems in the child’s surroundings.  Feedback from teachers and parents is incorporated during the assessment. In the United States, doctors refer to the American Psychiatric Association’s guidelines to diagnose ADHD.

Treatment and Management of ADHD

There is no cure for ADHD, but a combination of medication and counseling can help manage the symptoms to a great deal. Behavioral therapy is usually the first treatment method recommended before medication is introduced. This could include therapy, family therapy, skills training, special education, parent training, and school-based intervention.

Medication may also be prescribed, such as stimulants to improve attention span and control hyperactive behavior. Stimulants such as amphetamine, dexmethylphenidate, dextroamphetamine, and methylphenidate may be prescribed.

Treatment Modalities Currently Undergoing Clinical Trials

PDC-1421: A clinical trial to test the effectiveness of a new drug PDC-1421 for adults with Attention Deficit Hyperactivity Disorder is ongoing. Researchers hope to find that the administration of the drug will result in a substantial reduction in ADHD symptoms within eight weeks of starting the trial.

Centanafadine: Centanafadine is a drug that was developed to treat ADHD. A clinical trial to test its effectiveness, safety, and tolerability in children between the ages of 4 to 12 years who have been diagnosed with ADHD is underway. The trial wants to see whether centanafide can improve concentration in children with ADHD, and also test different doses of the drug to see which dose would be the most appropriate.

Tai Chi and exercise: A study to test whether Tai Chi can improve attention span in young adults with ADHD is underway. Adults aged 18 to 23 years who have been diagnosed with ADHD will be divided into three groups. One group will receive standard ADHD care alongside Tai Chi classes, another group will receive standard ADHD care alongside exercising, while the third group will only receive standard ADHD care. Researchers expect to find that Tai Chi and exercise can improve concentration and also reduce other ADHD symptoms.

Guanfacine and Lisdexamfetamine: Lisdexamfetamine is a stimulant drug, and guanfacine is a non-stimulant. Both drugs have been approved by the FDA for treating children with ADHD. Both drugs have been found to be effective in treating ADHD. However, it is not yet fully understood how the drugs actually treat the disorder. A clinical trial to explore the effects of guanfacine and lisdexamfetamine on brain chemical composition is underway. Children aged 6 to 17 years who have been diagnosed with will be enrolled in the trial. The participants will be divided into two groups; both groups will have MRI scans of their brains taken before the trial begins. One group will be administered guanfacine for six weeks; another will be administered lisdexamfetamine for the same time period. At the end of the period, MRI scans will again be taken of the participants’ brains to see the impact the drugs have had on their brain chemistry.

Daily report cards: A study to test whether having daily report cards in schools is an effective means of supporting children with ADHD as compared to business as usual in school is underway. Children aged 5 to 14 years who have been diagnosed with ADHD will be enrolled in the study. The children will be randomly assigned into two groups, where the daily report card intervention will be employed for one group while it will be business as usual at school for another group. Researchers predict that the daily report card intervention will improve academic performance in children with ADHD.

 
References:

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing. pp. 59–65.

Sroubek A, Kelly M, Li X (February 2013). "Inattentiveness in attention-deficit/hyperactivity disorder"

Krain AL, Castellanos FX (August 2006). "Brain development and ADHD". Clinical Psychology Review. 26 (4): 433–44.

Tenenbaum RB, Musser ED, Morris S, Ward AR, Raiker JS, Coles EK, Pelham WE (April 2019). "Response Inhibition, Response Execution, and Emotion Regulation among Children with Attention-Deficit/Hyperactivity Disorder"

Bidwell LC, McClernon FJ, Kollins SH (August 2011). "Cognitive enhancers for the treatment of ADHD"

Cortese S (September 2012). "The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know". European Journal of Paediatric Neurology. 16 (5): 422–33.

Erskine HE, Norman RE, Ferrari AJ, Chan GC, Copeland WE, Whiteford HA, Scott JG (October 2016). "Long-Term Outcomes of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder: A Systematic Review and Meta-Analysis". Journal of the American Academy of Child and Adolescent Psychiatry. 55 (10): 841–50.

Tiesler, Carla M. T.; Heinrich, Joachim (21 September 2014). "Prenatal nicotine exposure and child behavioural problems"

     

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This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. CenTrial Data Ltd. does not take responsibility for possible health consequences of any person or persons reading or following the information in this educational content. Treatments and clinical trials mentioned may not be appropriate or available for all trial participants. Outcomes from treatments and clinical trials may vary from person to person. Consult with your doctor as to whether a clinical trial is a suitable option for your condition.