Clinical Medicine Insights: Therapeutics

ADHD is the most common neuropsychiatric disorder affecting children and adolescents, and may cause impairment in many domains of social and occupational functioning. Despite proven efficacy of existing treatments, recent focus has been on the development of newer, once-daily medications. Lisdexamfetamine (LDX) was first released in 2007 and is approved for the treatment of ADHD in ages 6 and above. LDX is a uniquely formulated stimulant, a prodrug which requires an enzymatic hydrolytic reaction to be converted to active dextroamphetamine. LDX has a longer duration of action compared to other stimulants and has less potential to be misused or abused. LDX has repeatedly demonstrated improvement in ADHD symptoms compared to placebo, and seems to be at least as effective as other stimulants. LDX still carries the risks and disadvantages of other stimulants and may be more expensive than other stimulants. LDX can be expected to be increasingly used as a first-line agent for the treatment of ADHD.