TOPLINE:
Solriamfetol ― a medication approved for excessive daytime sleepiness caused by narcolepsy or obstructive sleep apnea ― significantly improved symptoms of attention-deficit/hyperactivity disorder (ADHD) and clinical impression of ADHD severity in a pilot study of adults with ADHD.
METHODOLOGY:
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Solriamfetol is a dopamine and norepinephrine reuptake inhibitor that shares some of the properties of current ADHD medications.
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Researchers conducted a randomized, double-blind, placebo-controlled, dose-optimization trial of 75- or 150-mg solriamfetol in 60 adults with ADHD. For nearly all of the individuals who received solriamfetol, doses increased to 150 mg after the first week.
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The primary outcome was change in scores on the Adult ADHD Investigator Symptom Rating Scale (AISRS).
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Secondary outcomes included scores on the Clinical Global Impressions (CGI) scale and standard measures of executive function, behavior, and sleep.
TAKEAWAY:
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By week 6, total AISRS score improved 25% for 52% of individuals to took solriamfetol, vs 17% of those who received placebo. Total AISRS score improved 50% by week 6 in 28% of those who took solriamfetol, vs 3.4% of those who received placebo.
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By week 6, CGI ratings of “much improved” or “very much improved” occurred in significantly more individuals who received solriamfetol than those who took placebo (45% vs 7%).
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Significantly more individuals who received solriamfetol than placebo self-reported improvements in executive function (69% vs 34%). Improvement in wakefulness was noted with solriamfetol, but that did not moderate the change in ADHD symptom burden.
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Solriamfetol was well tolerated, with no significant effect on sleep quality or blood pressure. Adverse effects that occurred at a higher rate in the treatment group than in the placebo group were typical for solriamfetol and sympathomimetic agents used for ADHD.
IN PRACTICE:
“Solriamfetol may be a safe and effective treatment for ADHD in adults. Larger studies replicating these findings could confirm the strong evidence of benefit and the tolerability of this agent as a treatment,” lead author Craig B. H. Surman, MD, director of the Clinical and Research Program in Adult ADHD, Massachusetts General Hospital, said in a statement.
SOURCE:
The study was published online October 9 in The Journal of Clinical Psychiatry.
LIMITATIONS:
Limitations include the small sample size and short 6-week duration. More women than men received solriamfetol; it’s unclear how this could have affected the results.
DISCLOSURES:
The study was an investigator-initiated trial supported by Jazz Pharmaceuticals and Axsome Therapeutics. Surman has received consultant fees, research support, and royalties from multiple companies.
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