Key Takeaways

From the Authors As published in the article
  1. Some adults with attention-deficit/hyperactivity disorder (ADHD) experience inadequate benefit or intolerable response to currently available, US Food and Drug Administration­–approved treatments for ADHD.
  2. In this pilot study, solriamfetol, a dopamine and norepinephrine reuptake inhibitor, was dose-optimized to 75 mg or 150 mg. This regimen was well tolerated and significantly improved ADHD symptoms and clinical impression of ADHD severity in adults compared with placebo.
  3. These results support solriamfetol as a viable treatment for ADHD in adults and merit replication in further research.
Extended Takeaways
  1. Separation from placebo on clinician-rated ADHD symptoms emerged by week 3, with an AISRS mean difference of −3.4 (95% CI, −6.7 to −0.1; P = .0439), and reached −4.3 (95% CI, −7.7 to −1.0; P = .0106) by week 6.
  2. The signal was strongest for inattention: week 6 AISRS improvement favored solriamfetol by 4.0 points on the inattentive subscale (P = .001; effect size = 1.59) versus 1.4 points on the impulsive-hyperactive subscale (P = .024; effect size = 0.34).
  3. Remission-level symptom thresholds were more often reached with solriamfetol, with AISRS total score ≤ 18 in 59% versus 21% (P = .0067); the stricter threshold of 12 was met by 24% versus 3% (P = .0517).
  4. Functional and executive outcomes also improved, with GAF changing by −4.8 points; 95% CI, 3.1 to 6.6 vs −0.3 points; 95% CI, −1.4 to 2.1; P = .0006, and 69% versus 34% achieving a 0.5–standard deviation improvement on the BRIEF-A Global Executive Composite (P = .0173).
  5. Improved wakefulness does not appear to fully explain the ADHD benefit: ESS scores improved by −2.4 points (P = .0056), but change in sleepiness did not moderate AISRS improvement (P = .3735), and PSQI outcomes did not differ significantly between groups.
Read full article
Physicians Postgraduate Press, Inc. (PPP) makes no warranties about the accuracy or completeness of any information published in The Journal of Clinical Psychiatry or other PPP materials, and disclaims liability for any use or non-use of that information. Clinicians should not rely solely on these materials and should exercise their own professional judgment when making patient care decisions on an individualized basis.

Learn More About Psychedelics in Psychiatry

Explore the Collection
Neural network illustration symbolizing psychedelic research advancements

Subscribe to read
more articles

Subscribe