Attention Deficit Hyperactivity Disorder: A Drug Can Relieve Persistent Daydreaming, Fatigue, and Brain Sluggishness in Adults

Attention deficit hyperactivity disorder (ADHD.):  Tests of a drug known to stimulate brain activity have shown early success in reducing symptoms of sluggish cognitive tempo in 38 men and women with ADHD.

A collection of symptoms including persistent dreaminess, fatigue, and slow-working speed, sluggish cognitive tempo has been a subject of debate over whether it is part of, or separate from, ADHD.

Researchers at NYU Grossman School of Medicine and Icahn School of Medicine at Mount Sinai who led the study say the stimulant lisdexamfetamine (sold as Vyvanse) reduced by 30 percent self-reported symptoms of sluggish cognitive tempo. It also lowered by over 40 percent symptoms of ADHD and significantly corrected deficits in executive brain function, with fewer episodes of procrastination, improvements in keeping things in mind, and strengthened prioritization skills.

Publishing in the Journal of Clinical Psychiatry online June 29, the study also showed that one-quarter of the overall improvements in sluggish cognitive tempo, such as feelings of boredom, trouble staying alert, and signs of confusion, were due to improvements in symptoms of ADHD.

The team interpreted that outcome to mean that decreases in ADHD-related incidents of physical restlessness, behaving impulsively, and/or moments of not paying attention were linked to some but not all of the improvements in sluggish cognitive tempo.

“Our study provides further evidence that sluggish cognitive tempo may be distinct from attention deficit hyperactivity disorder and that the stimulant lisdexamfetamine treats both conditions in adults, and when they occur together,” says lead study investigator and psychiatrist Lenard Adler, MD.

Adler, who directs the adult ADHD program at NYU Langone Health, says until now stimulants have only been shown to improve sluggish cognitive tempo symptoms in children with ADHD. The NYU Langone-Mount Sinai team’s findings, he adds, are the first to show that such treatments also work in adults.

A professor in the Departments of Psychiatry and Child and Adolescent Psychiatry at NYU Langone, Adler says sluggish cognitive tempo is likely a subset of symptoms commonly seen in some patients with ADHD and other psychiatric disorders. However, it remains unclear if sluggish cognitive tempo is a distinct psychiatric condition on its own and if stimulant medications will improve sluggish cognitive tempo in patients without ADHD.

Some specialists have been seeking to qualify sluggish cognitive tempo as distinct, but critics say more research is needed to settle the question.

“These findings highlight the importance of assessing symptoms of sluggish cognitive tempo and executive brain function in patients when they are initially diagnosed with ADHD,” says Adler.

For the study, funded by the drug manufacturer, Takeda Pharmaceuticals of Cambridge, Mass., several dozen volunteer participants received daily doses of either lisdexamfetamine or a placebo sugar pill for one month. Researchers then carefully tracked their psychiatric health on a weekly basis through standardized tests for signs and symptoms of sluggish cognitive tempo, ADHD, as well as other measures of brain function. Study participants then switched roles: The one-half who had been taking the placebo started taking daily doses of lisdexamfetamine, while the other half who had been on the drug during the study’s first phase started taking the placebo.

Adler has received grant and/or research support from Sunovion Pharmaceuticals, Enymotec, Shire Pharmaceuticals (now part of Takeda), Otsuka, and Lundbeck. He has also served as a paid consultant to these companies, in addition to Bracket, SUNY, the National Football League, and Major League Baseball. He has also received royalty payments since 2004 from NYU for adult ADHD diagnostic and training materials. All of these relationships are being managed in accordance with the policies and procedures of NYU Langone.

Besides Adler, other NYU Langone researchers involved in the study are Terry Leon, MS, RN; Taylor Sardoff, BA; and Michael Silverstein, MS. Other investigators include Beth Krone, PhD; and Jeffrey Newcorn, MD, at Icahn School of Medicine at Mount Sinai in New York City; and Stephen Faraone, PhD, at SUNY Upstate Medical University in Syracuse, NY.

 

Hot this week

Jupiter Endovascular Reports | 1st U.S. Patient Treated with Jupiter Shape-shifting Thrombectomy Device

“Navigation challenges during endovascular procedures are often underappreciated and have led to under-adoption of life-saving procedures, such as pulmonary embolectomy. We have purpose-built our Endoportal Control technology to solve these issues and make important endovascular procedures accessible to more clinicians and their patients who can benefit from them,” said Carl J. St. Bernard, Jupiter Endovascular CEO. “This first case in the U.S. could not have gone better, and appears to validate the safety and performance we are seeing in our currently-enrolling European SPIRARE I study.”

Avery Dennison Medical Introduces Ipdated SilFoam Lite: Sustainability, MDR Certification & Performance Improvements

The newly enhanced SilFoam Lite delivers superior efficiency and reliability, bringing improved fluid handling capabilities and improved tack. These improvements make the product ideal for customers seeking quality, high-performance solutions in wound care notes Avery Dennison Medical.

Voluntary Recall Notifying Medtronic Insulin Pump Users of Potential Risks of Shortened Pump Battery Life

Medtronic plc voluntarily issued a field action starting on July 31, 2024, notifying global customers of its MiniMed™ 600 series or 700 series insulin pumps to follow their pump's built-in alerts and alarms for battery status and to contact Medtronic if they observe changes in the battery life of their pump

Medtronic Expands AiBLE Spine Surgery Ecosystem with New Technologies and Siemens Healthineers Partnership

New advancements in the AiBLE Spine Surgery ecosystem build upon the company's commitment to procedural innovation and execution

Axlab, Danish Medtech Pioneer, expands to US with Advanced Robotic Tissue Sectioning for Pathology Laboratories

Kris Rokke, National Sales Director for Axlab in the US. "My team and I are extremely excited and honored about this unique opportunity to also offer this advanced technology to labs across the US and thus contribute to the pathology labs of tomorrow."