Strattera. Adderall. Concerta. Ritalin.
They’re all commonly-prescribed medications for treating attention deficit hyperactivity disorder symptoms, and all are still on the market. But some new ones recently became available to the public, while yet another ADHD medication is currently seeking FDA approval. Each attempts to provide children and adults with the benefit of a once-daily, longer-lasting drug and do away with the need to take more than one dose throughout the day in order to maintain the medication’s consistency — and therefore, effectiveness.
[See: Hoarding, ADHD, Narcissism: Inside the Minds of History’s Great Personalities.]
Dr. Rakesh Jain, clinical professor in the department of psychiatry at Texas Tech University School of Medicine in Midland, Texas, served as an investigator for the ADHD drug, Mydayis, which became available for use in the U.S. in August. He explains that when discussing ADHD medication with patients, it was clear that people wanted something that provided a longer duration of symptom coverage. Taking medication twice a day can be challenging for anyone, he says, but may be especially so for people with ADHD, who sometimes struggle with forgetfulness in the first place. Additionally, he explains that if the second dose is taken too late in the day, it’s not unusual for sleep difficulties to arise. With Mydayis, “up to 16 hours of coverage in the average patient was detected,” Jain says, expressing that its long-term coverage is “ideal” and what he feels many people with this disorder have been waiting for.
FDA Drug Approval a Rigorous Process
Another medication, Dasotraline, while not yet on the market as it’s currently seeking FDA approval, is also said to provide long-term, sustained adult and pediatric ADHD symptom improvement with just one pill. Details about Dasotraline suggest that it may provide benefits for upwards of 24 hours, with the added ability to potentially help adults struggling with binge eating disorder, which the National Eating Disorder Association states involves consuming large quantities of food “but without behaviors to prevent weight gain, such as self-induced vomiting.”
The company behind Dasotraline, Sunovion Pharmaceuticals Inc., notes on its website that the drug is currently at phase 3 in the FDA approval process. The FDA drug approval process is lengthy and rigorous, involving several stages before a drug is available to the public. Phase 3 pertains to clinical research, which the FDA describes as “studies, or trials, that are done in people.” Phase 4 entails FDA review in which a team may take upwards of 10 months to approve a drug.
Having a Variety of ADHD Medications Available Is Important
“I’m hoping to welcome Dasotraline into my armament,” Jain says, adding that it’s always good to have new treatment methods available. “No one medication will solve all of my patient’s difficulties,” he says. “If a medication works well for one individual, then that is the right one for them. If someone only needs assistance for 8 or 9 hours, thank goodness for that mediation.” He emphasizes that new and pending ADHD medications aren’t about a one-size-fits-all approach. “It’s not a matter of one perfect medication,” Jain says. “My patients and I are a team, strengthened by the range of treatment options available.” For example, he notes that there is an ADHD medication available that has demonstrated up to 24-hours of symptom improvements — the nonstimulant, Strattera. Mydayis, while also long-lasting, is a stimulant. “One may work for some but not for others,” he says, reinforcing his point that there isn’t one pill that suits everyone.
[See: 8 Things You Didn’t Know About Counseling.]
The National Institute of Mental Health notes that stimulants and nonstimulants are two kinds of medications commonly prescribed as part of an ADHD treatment plan, often along with psychotherapy, education and training. A stimulant, NIMH explains, “increases the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention.” Nonstimulants may be prescribed if stimulants aren’t effective for an individual, if there are “bothersome side effects” from a stimulant or in combination with a stimulant to optimize symptom improvements.
Thomas E. Brown, director of the Brown Clinic for Attention and Related Disorders in Manhattan Beach, California, agrees that what works for one person may not work for another. “Some people burn through their medication more quickly than another person might,” he says, adding that just because a medication says it lasts a certain number of hours, doesn’t mean it will last for that exact amount of time for every person. “There’s individual variability in response to medications,” he says. “Also, when it comes to dosing, weight or age isn’t always an accurate factor — how sensitive the body is to it is.”
Brown also says people should not discount generic ADHD medication. In his book, “Outside the Box: Rethinking ADD/ADHD in Children and Adults,” he writes: “Many generic formulations of medications work just as well for most people as do the more expensive brand-name medications.” Still, variations among people can occur; he notes that “there may be differences in how quickly or slowly the medication is released. There may also be differences in nonactive components such as the ingredients in the packing inside the pill or its coating.”
Another ADHD stimulant medication, which received FDA approval in September, is Adzenys ER (amphetamine), an extended-release liquid suspension. Chief Commercial Officer Thomas P. McDonnell of Neos Therapeutics Inc. says this is expected to be available commercially in early 2018. Adzenys ER, he says, provides the same benefits as the company’s Adzenys XR-ODT — an extended release disintegrating tablet that launched in May 2016 — except that Adzenys ER is in liquid form. Both are intended for use in people age 6 and older. With the recent launch of the company’s extended-release orally disintegrating tablets for ADHD patients 6 to 17 years old — Cotempla XR-ODT (methylphenidate) — McDonnell says the company has more options available for patients with ADHD.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
While Jain says nonpharmacological ADHD treatment methods such as exercise, proper sleep, cognitive behavioral therapy and coaching “as add-ons can absolutely be an option,” the most effective way to help with moderate to severe ADHD is with medication. “It should be the principal treatment,” he says.
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What New Drugs Are in the Pipeline to Treat ADHD? originally appeared on usnews.com
