Beyond stimulants: a systematic review of randomised controlled trials assessing novel compounds for ADHD.

Beyond stimulants: a systematic review of randomised controlled trials assessing novel compounds for ADHD.

Publication date: Jun 05, 2019

Introduction Despite stimulants being highly efficacious in short-term randomised controlled trials (RCTs), not all patients respond or can successfully tolerate them. A number of novel non-stimulant options are currently in the pipeline for the treatment of ADHD. Areas covered The authors conducted a systematic review of RCTs registered in ClinicalTrials.gov in the past five years (January 2014 and February 2019), supplemented by searches in PubMed, Web of Science, and drug manufacturers websites to find recent RCTs on novel non-stimulant ADHD medications. Expert opinion The authors found 28 pertinent RCTs of compounds acting on a variety of biological targets, including Dasotraline, Viloxazine (SPN-812), Centanafadine SR (CTN SR), OPC-64005, Fasoracetam (NFC-1, AEVI-001), Metadoxine (MDX), Vortioxetine, Tipepidine Hibenzate, Oxytocin, Sativex (delta-9-tetrahydrocannabinol (THC) plus cannabidiol), Mazindol, and Molindone hydrochloride (SPN-810). Given the high effect size found in RCTs of stimulants in terms of efficacy on ADHD core symptoms, it is unlikely that these novel agents will show better efficacy than stimulants, at the group level. However, they may offer comparable or better tolerability. Additionally, agents acting on etiopathophysiological targets disrupted in specific subgroups of patients with ADHD will move forward the pharmacotherapy of ADHD from a “one size fits all” to a “precision medicine” approach.

Nageye, F. and Cortese, S. Beyond stimulants: a systematic review of randomised controlled trials assessing novel compounds for ADHD. 04759. 2019 Expert Rev Neurother.

Concepts Keywords
ADHD Amines
Cannabidiol Randomized controlled trial
CTN Stimulant
Hydrochloride Tetrahydrocannabinol
MDX Pemoline
NFC Childhood psychiatric disorders
OPC Methylphenidate
Oxytocin Amphetamine
Pharmacotherapy Medicine
Pipeline Psychoactive drugs
Precision Medicine ADHD
PubMed Pharmacotherapy
Randomised Controlled Trials
Sativex
Stimulant
Stimulants
Tetrahydrocannabinol
THC
Tolerability

Semantics

Type Source Name
gene UNIPROT DEAF1
drug DRUGBANK Viloxazine
drug DRUGBANK Dasotraline
disease DOID ADHD
gene UNIPROT EHD1
drug DRUGBANK Mazindol
drug DRUGBANK Tropicamide
gene UNIPROT WAS
drug DRUGBANK Cannabidiol
drug DRUGBANK Dronabinol
drug DRUGBANK Oxytocin
gene UNIPROT PPP1R9B
gene UNIPROT SPN
drug DRUGBANK Vortioxetine

Original Article

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