Drug relieves persistent daydreaming, fatigue, and brain sluggishness in adults with ADHD — ScienceDaily

Early results from tests of a drug that stimulates brain activity have shown that it can reduce symptoms of slow cognitive tempo in 38 people with attention deficit hyperactivity disorder (ADHD).

A combination of symptoms, including persistent dreaminess, fatigue and slow-working pace, sluggish mental tempo, has been a topic of debate as to whether it is part or separate from ADHD.

Researchers from NYU Grossman School of Medicine (Icahn School of Medicine Mount Sinai) conducted the study and found that lisdexamfetamine (sold under the name Vyvanse), reduced 30 percent self-reported symptoms of sluggish cognition. It also reduced ADHD symptoms by over 40%. The stimulant lisdexamfetamine (sold as Vyvanse) significantly corrected executive brain function deficits, such as fewer episodes and better recall, improved prioritization skills, and improved procrastination.

Publishing in the Journal of Clinical PsychiatryOnline June 29, the study also found that one-quarter the overall improvements in sluggish cognition tempo, such symptoms as boredom, trouble staying awake and signs of confusion were due to ADHD symptoms.

The team concluded that the decreases in ADHD-related incidents such as physical restlessness, behaving inimpulsively, and/or moments not paying attention were related to some but certainly not all of the improvements to sluggish cognitive pace.

“Our study further supports the notion that sluggish cognitive speed may be different from attention deficit hyperactivity disorder, and that stimulant lisdexamfetamine treats both in adults and when they occur together,” said Lenard Adler MD, lead investigator of the study and psychiatrist.

Adler, who is the director of NYU Langone Health’s adult ADHD programme, said that stimulants have been only shown to improve ADHD symptoms in children. He says that the NYU Langone Mount Sinai team’s findings are the first to prove that such treatments work in adults.

Adler, a professor in the Departments of Psychiatry and Child and Adolescent Psychiatry of NYU Langone, says sluggish cognition tempo is likely a subset of symptoms that can be seen in patients with ADHD and other psychiatric disorders. It is not clear if sluggish cognition tempo is a separate psychiatric condition or if stimulant medications can improve it in patients with ADHD.

Some experts have attempted to distinguish sluggish cognitive pace from other types of cognitive tempo, but critics claim that more research is needed.

Adler says, “These findings highlight how important it is to assess symptoms of sluggish cognition tempo and executive function in patients who are initially diagnosed as ADHD.”

A number of volunteers were given daily doses of lisdexamfetamine and placebo sugar pills for the duration of the study. The study was funded by Takeda Pharmaceuticals, a drug manufacturer from Cambridge, Mass. The researchers then closely monitored their mental health weekly through standard tests for ADHD signs and symptoms, as well as other measures of brain function. Participants in the study switched roles. The placebo-treated half of the participants started taking daily doses lisdexamfetamine while the placebo-treated half began taking the drug.

Sunovion Pharmaceuticals has granted Adler research and grant support. Adler has also been a paid consultant to these businesses, as well as Bracket, SUNY and the National Football League and Major League Baseball. Since 2004, he has received royalty payments from NYU for adult ADHD diagnostics and training materials. All of these relationships are managed in accordance to NYU Langone policies and procedures.

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