Emerging drugs for the treatment of attention-deficit hyperactivity disorder (ADHD)

ABSTRACT

Introduction

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting up to 5.3% of children and 2.5% of adults depending on the country considered. Current pharmacological treatments for ADHD are based on stimulant or non-stimulant medications, targeting dopaminergic and noradrenergic systems in the frontal cortex and dopaminergic system in the basal ganglia. These drugs are effective and safe for the majority of patients, whereas about 20% of treated patients do not tolerate current therapies or experience insufficient efficacy. The adequate treatment of ADHD is necessary to allow a proper social placement and prevent the acquisition of additional, more severe, comorbidities.

Areas covered

We conducted a review of the scientific literature and of unpublished/ongoing clinical trials to summarize the advances made in the last 10 years (2010–2020) for the pharmacological treatment of ADHD. We found many pharmacological mechanisms beyond dopaminergic and noradrenergic ones have been investigated in patients.

Expert opinion

Some emerging drugs for ADHD may be promising as add-on treatment especially in children, amantadine to enhance cognitive functions and tipepidine for hyperactivity/impulsivity. Stand-alone emerging treatments for ADHD include viloxazine and dasotraline, which will soon have more clinical data available to support market access requests.

KEYWORDS:

• ADHD
• emerging drugs
• innovative drugs
• pharmacological therapy

Article highlights

• ADHD is a neurodevelopmental disorder affecting up to 5.3% of children and 2.5% of adults.

• About 20% of treated patients do not tolerate current therapies or experience insufficient efficacy.

• Amantadine to enhance cognitive functions and tipepidine for hyperactivity/impulsivity may be promising as add-on treatment, especially in children.

• Stand-alone emerging treatments for ADHD include viloxazine and dasotraline, both in children and adults.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have received research support, writing support, has participated in advisory boards, or been a consultant and/or speaker for Allergan, Emalex Biosciences, Takeda, Lundbeck, Pearson, Akili Interactive, Arbor Pharmaceuticals, Cingulate Therapeutics, Ironshore Pharmaceuticals, Forest Laboratories, Aevi Genomic Medicine, Neos Therapeutics, Neurovance, Otsuka, Pfizer, Purdue Pharma, Adlon Therapeutics, Rhodes Pharmaceuticals, Sunovion, Tris Pharma, KemPharm, Supernus Pharmaceuticals, NLS Pharma and Jazz Pharmaceuticals. They also are the recipient of a U.S. Food and Drug Administration Grant. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This work was supported by the Italian Ministry of Health (Ricerca Corrente, to MP and MN) grants that are gratefully acknowledged. The funding public institution had no role in any part of the work.