Treatment Landscape for the Management of ADHD - Episode 19

Treating ADHD: Current Unmet Needs


Theresa Cerulli, MD: Tim, what are some of the other unmet needs in this area?

Timothy E. Wilens, MD: Ann, who is doing a lot of that work, really highlights the pluses and minuses of each of the medicines in development and what they’re going after. Despite having extended-release preparations of the stimulants and non-stimulants, we still need something there that covers ADHD [attention deficit hyperactivity disorder] across the day—really, around-the-clock coverage.

For example, coverage from when you wake up in the morning to when you go to bed at night. You have coverage through the day. You can go to sleep, and you can eat. They’re working on this. They’re trying to figure something out for ADHD but also for co-occurring issues like anxiety, which Andy was talking about earlier. But what about executive functioning? These are kids or adults who have problems with organization, time management, cognitive skills. Or kids may have a disruptive disorder. You were hearing about SPN-812 [viloxazine hydrochloride], which may be helpful for those kids, for example.

Is there also a broader spectrum of coverage of ADHD that covers some of those areas as well? That continues to be an area of real interest. Companies are looking to say, “Does this agent work in this area?” Because this is really what clinicians want.

Finally, you heard Ann beautifully summarize some of the abuse-deterrent agents. The bottom line is that stimulants are highly effective for ADHD. They’re still the most effective agents. We need to get stimulants into people safely. What’s the safest way to do that, especially if we’re relegated to using shorter-acting stimulants?

You know, some people can’t tolerate the extended-release options. They have too many mood symptoms, for example. If we’re going to use these stimulants, what’s the safest way to get them in? Especially in young adults, who are more likely to misuse and divert. Rather than hide from that, let’s just lean into it and come up with agents that you can’t snort or sniff for example, which make up 40% of misuse. So that’s another area of unmet need.

Transcript Edited for Clarity