A Current Update on ADHD Pharmacogenomics

Abstract

Pharmacological treatment for attention deficit hyperactivity disorder, although highly effective, presents a marked variability in clinical response, optimal dosage needed and tolerability. Clinical and neurobiological investigations have juxtaposed findings on both response to medication and etiologic factors, generating the hypothesis that genetic factors may underlie differences in treatment outcome. Over the last decade, research has focused on the catecholaminergic system to investigate a potential role of genotype on pharmacological effect. Despite an increasing number of associations reported (for methylphenidate, nine in 2005, 24 in 2008 and 52 reported in the current article), the identification of clinically relevant genetic predictors of treatment response remains a challenge. At present, additional studies are required to allow for a shift from a trial-and-error approach to a more rational pharmacologic regimen that takes into account the likelihood of treatment effectiveness at the individual level.

KEYWORDS::

• atomoxetine
• attention deficit hyperactivity disorder
• dopamine transporter gene
• methylphenidate
• pharmacogenetics

Financial & competing interests disclosure

Christian Kieling took part in a Novartis-sponsored meeting on attention deficit hyperactivity disorder in 2008. Luis A Rohde was on the speakers‘ bureau and/or acted as consultant for Eli-Lilly, Janssen-Cilag and Novartis in the last 3 years. Currently, his only industry-related activity is taking part in the advisory board/speakers bureau for Eli Lilly, Novartis and Shire (less than U$10,000 per year and reflecting less than 5% of his gross income per year). The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Luis A Rohde received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Abbott, Bristol-Myers Squibb, Eli-Lilly, Janssen-Cilag, Novartis and Shire. The authors have no other 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 apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

Christian Kieling took part in a Novartis-sponsored meeting on attention deficit hyperactivity disorder in 2008. Luis A Rohde was on the speakers‘ bureau and/or acted as consultant for Eli-Lilly, Janssen-Cilag and Novartis in the last 3 years. Currently, his only industry-related activity is taking part in the advisory board/speakers bureau for Eli Lilly, Novartis and Shire (less than U$10,000 per year and reflecting less than 5% of his gross income per year). The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Luis A Rohde received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Abbott, Bristol-Myers Squibb, Eli-Lilly, Janssen-Cilag, Novartis and Shire. The authors have no other 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 apart from those disclosed. No writing assistance was utilized in the production of this manuscript.