Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Home
Hostname: page-component-ffbbcc459-slw7l Total loading time: 1.442 Render date: 2022-03-07T14:53:43.953Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }
  • English
CNS Spectrums CNS Spectrums

Article contents

Optimizing outcomes in ADHD treatment: from clinical targets to novel delivery systems

Published online by Cambridge University Press:  03 January 2017

Gregory W. Mattingly  and
Richard H. Anderson
Gregory W. Mattingly*
Affiliation:
Washington University School of Medicine, Department of Psychiatry and Behavioral Neurosciences, St. Charles, Missouri, USA Midwest Research Group, St. Charles, Missouri, USA
Richard H. Anderson
Affiliation:
Midwest Research Group, St. Charles, Missouri, USA
*
*Address for correspondence: Gregory W. Mattingly, M.D., 4801 Weldon Spring Pkwy, St. Charles, MO 63304, USA. (Email: Greg@mattingly.com)
Get access Rights & Permissions[Opens in a new window]

Abstract

Our knowledge and understanding of the underlying neurobiology and symptomatic expression of ADHD has advanced dramatically over the past decade. Associated with these advances has been a similar explosion of new treatment options to individualize treatment for our patients.

This article will:

  • ∙ review strategies to measure ADHD symptoms and functional difficulties while seeking to achieve full symptomatic remission throughout the day

  • ∙ summarize recent findings regarding the management and prioritization of ADHD and comorbid conditions and

  • ∙ discuss the various pharmacologic treatment options with a focus on recently developed molecules and novel delivery systems

Keywords

ADHDattention deficit/hyperactivity disorderpharmacologyrating scalesreview
Type
CME Review Article
Information
CNS Spectrums , Volume 21 , Supplement S1: CME SUPPLEMENT , December 2016 , pp. 45 - 59
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This activity is supported by an unrestricted educational grant from lronshore Pharmaceuticals & Development, Inc.

References

1. Biederman, J, Mick, E, Faraone, SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry. 2000; 157(5): 816–818.CrossRefGoogle Scholar
2. Faraone, SV, Mick, E. Molecular genetics of attention deficit hyperactivity disorder. Psychiatr Clin North Am. 2010; 33(1): 159–180.CrossRefGoogle ScholarPubMed
3. Adler, LA, Goodman, DW, Kollins, SH, et al. Double-blind, placebo-controlled study of the efficacy and safety of lisdexamfetamine dimesylate in adults with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2008; 69(9): 1364–1373.CrossRefGoogle ScholarPubMed
4. Greene, RW, Biederman, J, Faraone, SV, et al. Social impairment in girls with ADHD: patterns, gender comparisons, and correlates. J Am Acad Child Adolesc Psychiatry. 2001 Jun; 40(6): 704–710.CrossRefGoogle Scholar
5. Dalsgaard, S, Østergaard, SD, Leckman, JF, Mortensen, PB, Pedersen, MG. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet. 2015; 385(9983): 2190–2196.CrossRefGoogle Scholar
6. Dalsgaard, S, Leckman, JF, Mortensen, PB, Nielsen, HS, Simonsen, M. Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: a prospective cohort study. Lancet Psychiatry. 2015; 2(8): 702–709.CrossRefGoogle ScholarPubMed
7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association; 2013.Google ScholarPubMed
8. Volkow, ND, Wang, GJ, Newcorn, JH, et al. Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Mol Psychiatry. 2011; 16(11): 1147–1154.CrossRefGoogle ScholarPubMed
9. Shaw, P, Eckstrand, K, Sharp, W, et al. Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proc Natl Acad Sci U S A. 2007; 104(49): 19649–19654.CrossRefGoogle ScholarPubMed
10. Banerjee, TD, Middleton, F, Faraone, SV. Environmental risk factors for attention-deficit hyperactivity disorder. Acta Paediatr. 2007; 96(9): 1269–1274.CrossRefGoogle Scholar
11. Zhu, J, Lee, KP, Spencer, TJ, Biederman, J, Bhide, PG. Transgenerational transmission of hyperactivity in a mouse model of ADHD. J Neurosci. 2014; 34(8): 2768–2773.CrossRefGoogle Scholar
12. Barkley, RA, Murphy, KR, Fischer, M. ADHD in Adults: What the Science Says. New York, NY: Guilford Press; 2010.Google Scholar
13. Kessler, RC, Adler, L, Barkley, R, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006; 163(4): 716–723.CrossRefGoogle ScholarPubMed
14. Wilens, TE, Biederman, J. Alcohol, drugs and attention-deficit/hyperactivity disorder: a model for the study of addictions in youth. J Psychopharmacol. 2006; 20(4): 580–588.CrossRefGoogle Scholar
15. Wigal, SB, Gupta, S, Guinta, D, Swanson, JM. Reliability and validity of the SKAMP rating scale in a laboratory school setting. Psychopharmacol Bull. 1998; 34(1): 47–53.Google Scholar
16. DuPaul, GJ, Power, TJ, Anastopoulos, AD, Reid, R. ADHD Rating Scale-IV: Checklists, Norms, and Clinical Interpretation. New York: Guilford Press; 1998.Google Scholar
17. Barbaresi, WJ. Improving care for children with ADHD: the information is just a rating scale away. Pediatrics. 2016; 137(3): e20154450.CrossRefGoogle Scholar
18. Chang, LY, Wang, MY, Tsai, PS. Diagnostic accuracy of attention-deficit/hyperactivity disorder: a meta-analysis. Pediatrics. 2016; 137(3): 2015–2749.CrossRefGoogle Scholar
19. Culpepper, L, Mattingly, G. A practical guide to recognition and diagnosis of ADHD in adults in the primary care setting. Postgrad Med. 2008; 120(3): 16–26.CrossRefGoogle ScholarPubMed
20. Guy, SC, Isquith, PK, Gioia, GA. Behavior Rating Inventory of Executive Function – Self Report version. Lutz, FL: Psychological Assessment Resources; 2004.Google Scholar
21. Wigal, SB, Wigal, TL. The laboratory school protocol: its origin, use, and new applications. J Atten Disord. 2006; 10(1): 92–111.CrossRefGoogle Scholar
22. Wilens, TE, Hammerness, P, Martelon, M, Brodziak, K, Utzinger, L, Wong, P. A controlled trial of the methylphenidate transdermal system on before-school functioning in children with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2010; 71(5): 548–556.CrossRefGoogle ScholarPubMed
23. Faraone, SV, Childress, A, Wigal, SB, et al Reliability and validity of the Daily Parent Rating of Evening and Morning Behavior Scale. J Atten Disord. In press. DOI: 10.1177/1087054715619009.Google Scholar
24. Faraone, SV, Glatt, SJ. A comparison of the efficacy of medications for adult attention-deficit/hyperactivity disorder using meta-analysis of effect sizes. J Clin Psychiatry. 2010; 71(6): 754–763.CrossRefGoogle ScholarPubMed
25. Arnold, LE. Methylphenidate vs. amphetamine: comparative review. J Atten Disord. 2000; 3(4): 200–211.CrossRefGoogle Scholar
26. Cutler, AJ, Brams, M, Bukstein, O, et al. Response/remission with guanfacine extended-release and psychostimulants in children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2014; 53(10): 1092–1101.CrossRefGoogle ScholarPubMed
27. Guy, W. Clinical global impressions. In: ECDEU Assessment Manual for Psychopharmacology Rev ed Rockville, MD: U.S. Department of Health, Education, and Welfare; Public Health Service, Alcohol, Drug Abuse and Mental Health Administration, NIMH Psychopharmacology Research Branch; 1976: 218–222.Google Scholar
28. Goodman, D, Faraone, SV, Adler, LA, Dirks, B, Hamdani, M, Weisler, R. Interpreting ADHD rating scale scores: linking ADHD rating scale scores and CGI levels in two randomized controlled trials of lisdexamfetamine dimesylate in ADHD. Primary Psychiatry. 2010; 17(3): 44–52.Google Scholar
29. Steele, M, Jensen, PS, Quinn, DMP. Remission versus response as the goal of therapy in ADHD: a new standard for the field? Clin Ther. 2006; 28(11): 1892–1908.CrossRefGoogle ScholarPubMed
30. Mattingly, G, Culpepper, L, Babcock, T, Arnold, V. Aiming for remission in adults with attention deficit/hyperactivity treatment: the primary care goal. Postgrad Med. 2015; 127(3): 323–329.CrossRefGoogle Scholar
31. Mattingly, GW, Weisler, RH, Young, J, et al. Clinical response and symptomatic remission in short and long term trials of lisdexamfetamine dimesylate. BMC Psychiatry. 2013; 13: 39.CrossRefGoogle Scholar
32. Mattingly, G, Childress, A, Nordbrock, E, Adej, A, Kupper, RJ, Weiss, M. Clinical response and symptomatic remission with Aptensio XR (methylphenidate extended realease) in children and adolescents with ADHD. Poster. Presented at: American Psychiatry Association Meeting; May 14–18, 2016; Atlanta, GA.Google Scholar
33. Sallee, FR. Early morning functioning in stimulant-treated children and adolescents with attention-deficit/hyperactivity disorder, and its impact on caregivers. J Child Adolesc Psychopharmacol. 2015; 25(7): 558–565.CrossRefGoogle Scholar
34. Whalen, CK, Henker, B, Jamner, LD, et al. Toward mapping daily challenges of living with ADHD: maternal and child perspectives using electronic diaries. J Abnorm Child Psychol. 2006; 34(1): 115–130.CrossRefGoogle Scholar
35. Mattingly, G, Surman, CB, Mao, AR, Eagan, CA, Onofrey, M, Lerner, M. Improving communication in ADHD care: results from in-office linguistic research. CNS Spectr. 2011; 16(4): 85–94.CrossRefGoogle ScholarPubMed
36. Campbell, SB, Shaw, DS, Gilliom, M. Early externalizing behavior problems: toddlers and preschoolers at risk for later maladjustment. Dev Psychopathol. 2000; 12(2): 467–488.CrossRefGoogle ScholarPubMed
37. Luman, M, Oosterlaan, J, Sergeant, JA. The impact of reinforcement contingencies on AD/HD: a review and theoretical appraisal. Clin Psychol Rev. 2005; 25(2): 183–213.CrossRefGoogle Scholar
38. Lahey, B, Applegate, B, Barkley, RA, et al. DSM-IV field trials for oppositional defiant disorder and conduct disorder in children and adolescents. Am J Psychiatry. 1994; 151(11): 1673–1685.Google Scholar
39. Antshel, KM, Zhang-James, Y, Faraone, SV. The comorbidity of ADHD and autism spectrum disorder. Expert Rev Neurother. 2013; 13(10): 1117–1128.CrossRefGoogle ScholarPubMed
40. Geller, B, Zimerman, B, Williams, M, et al. DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. J Child Adolesc Psychopharmacol. 2002; 12(1): 11–25.CrossRefGoogle Scholar
41. Biederman, J, Wozniak, J, Tarko, L, et al. Re-examining the risk for switch from unipolar to bipolar major depressive disorder in youth with ADHD: a long term prospective longitudinal controlled study. J Affect Disord. 2014; 152–154:347–351.CrossRefGoogle ScholarPubMed
42. Chen, MH, Pan, TL, Hsu, JW, et al Attention-deficit hyperactivity disorder comorbidity and antidepressant resistance among patients with major depression: a nationwide longitudinal study. Eur Neuropsychopharmacol. In press. DOI: 10.1016/j.euroneuro.2016.09.369.Google Scholar
43. Briars, L, Todd, T. A review of the pharmacological management of attention-deficit/hyperactivity disorder. J Pediatr Pharmacol Ther. 2016; 21(3): 192–206.Google ScholarPubMed
44. Childress, A, Tran, C. Current investigational drugs for the treatment of attention-deficit/hyperactivity disorder. Expert Opin Investig Drugs. 2016; 25(4): 463–474.CrossRefGoogle ScholarPubMed
45. Wigal, SB, Greenhill, LL, Nordbrock, E, et al. A randomized placebo-controlled double-blind study evaluating the time course of response to methylphenidate hydrochloride extended-release capsules in children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2014; 24(10): 562–569.CrossRefGoogle Scholar
46. Goodman, DW, Starr, HL, Ma, YW, Rostain, AL, Ascher, S, Armstrong, RB. Randomized, 6-week, placebo-controlled study of treatment for adult attention-deficit/hyperactivity disorder: individualized dosing of osmotic-release oral system (OROS) methylphenidate with a goal of symptom remission journal of clinical psychiatry. In press. DOI: 10.4088/JCP.15m10348.Google Scholar
47. Mattingly, G. Lisdexamfetamine dimesylate: a prodrug stimulant for the treatment of ADHD in children and adults. CNS Spectr. 2010; 15(5): 315–325.CrossRefGoogle Scholar
48. Findling, RL, Bukstein, OG, Melmed, RD, et al. A randomized, double-blind, placebo-controlled, parallel-group study of methylphenidate transdermal system in pediatric patients with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2008; 69(1): 149–159.CrossRefGoogle Scholar
49. Stark, JG, Engelking, D, McMahen, R, Sikes, C. A randomized crossover study to assess the pharmacokinetics of a novel amphetamine extended-release orally disintegrating tablet in healthy adults. Postgrad Med. 2016; 128(7): 648–655.CrossRefGoogle ScholarPubMed
50. Robb, AS, Findling, RL, Childress, AC, Berry, SA, Belden, HW, Wigal, SB. Efficacy, safety, and tolerability of a novel methylphenidate extended-release oral suspension (MEROS) in ADHD. J Atten Disord. In press. DOI: 10.1177/1087054714533191.Google Scholar
10
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Optimizing outcomes in ADHD treatment: from clinical targets to novel delivery systems
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Optimizing outcomes in ADHD treatment: from clinical targets to novel delivery systems
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Optimizing outcomes in ADHD treatment: from clinical targets to novel delivery systems
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *