作者: Wirrell, Elaine C ; Wong-Kisiel, Lily C. ; Nickels, Katherine C ; Fine, Anthony ; Nickels, Katherine C. ; Wirrell, Elaine C. ; Vanderwiel, Saskia L. ; Jones, Brandon ; Vanderwiel, Saskia L ; Mandrekar, Jay ; Wong-Kisiel, Lily C

INTRODUCTION:

Children with childhood absence epilepsy (CAE) are deemed to be at higher risk of attention deficit hyperactivity disorder (ADHD), however the magnitude of that risk has not been assessed in a population-based study.

METHODS:

The Rochester Epidemiology Project database was used to identify children with a new diagnosis of CAE while resident in Olmsted County, MN between 1980-2018. For each case, four age- and sex-matched controls without epilepsy were identified. Records of cases and controls screening positive for ADHD were reviewed to confirm this diagnosis. Those with comorbid ADHD and CAE were further assessed to determine if the ADHD diagnosis preceded or followed the epilepsy diagnosis, as well as the impact of ADHD treatment on possible seizure exacerbation and long-term epilepsy course.

RESULTS:

Forty-one cases of CAE were identified and matched to 164 controls. ADHD was diagnosed in 17 children (41.5 %) with CAE and 12 controls (7.3 %) (p < 0.001). Compared to those without epilepsy, the diagnosis of ADHD in CAE was more likely to be made by a mental health professional than a primary care provider (p = 0.047). ADHD in CAE typically followed the diagnosis of CAE and in 7/17 cases, was diagnosed after remission of epilepsy and discontinuation of antiseizure medication. There was no difference in the proportion of cases or controls treated with ADHD medication (16/17 cases and 12/12 controls). Both groups had high likelihood of favorable response to ADHD medication and no child with CAE experienced seizure exacerbation with ADHD treatment.

CONCLUSIONS:

ADHD was 5.7-fold more common in CAE then in children without epilepsy in our population-based study. Treatment with stimulants is highly effective and not associated with worsening of seizures. Primary care providers must be vigilant to carefully screen this population for ADHD.

2024-11-01·Asian Journal of Psychiatry

Global burden of ADHD medication-associated cardiovascular disease, 1967–2023: A comparative analysis using the WHO pharmacovigilance database

Article

作者: Acharya, Krishna Prasad ; Park, Jaeyu ; Kim, Hyeon Jin ; Cho, Hanseul ; Jeong, Yi Deun ; Lee, Hayeon ; Hwang, Jiyoung ; Kang, Jiseung ; Yon, Dong Keon ; Udeh, Raphael ; Boyer, Laurent ; Fond, Guillaume ; Lee, Kyeongmin ; Hwang, Hui-Jeong

BACKGROUND:

Despite the widespread use of attention-deficit hyperactivity disorder (ADHD) medications and their known sympathomimetic effects on the cardiovascular system, cardiovascular risk assessment of these medications using comprehensive global data is limited. This study investigated the association between individual ADHD medications and cardiovascular disease (CVD) using global pharmacovigilance data.

METHODS:

Reports from the World Health Organization international pharmacovigilance database were utilized (1967-2023; total reports, n=131,255,418). Reporting odds ratios (ROR), and information components (IC) were calculated to evaluate the association between each medication and specific CVDs.

RESULTS:

We identified 13,344 CVD cases related to ADHD medications out of 146,489 cases of all reports on ADHD medications. Cumulative reports on ADHD medications have shown a steady increase, notably in adults since 2010. ADHD medications were associated with a higher risk of CVD overall (ROR [95 % CI], 1.60 [1.58-1.63]; IC [IC_0.25], 0.63 [0.60]), with a higher association observed in females than in males. Among specific CVDs, all drugs were associated with an increased risk of torsade de pointes/QT prolongation, cardiomyopathy, and myocardial infarction. Conversely, heart failure, stroke, and cardiac death/shock were exclusively associated with amphetamines. Lisdexamfetamine showed a weaker association with all CVDs compared to amphetamines, and methylphenidate exhibited the lowest overall association with CVD. Atomoxetine had the second-highest association with torsade de pointes/QT prolongation.

CONCLUSIONS:

The associations between CVDs and ADHD medications vary, with amphetamines posing a higher risk, while lisdexamfetamine and methylphenidate exhibit better safety profiles.

2024-05-01·Bipolar disorders

Efficacy and safety of established and off‐label ADHD drug therapies for cognitive impairment or attention‐deficit hyperactivity disorder symptoms in bipolar disorder: A systematic review by the ISBD Targeting Cognition Task Force

Review

作者: Guglielmo, Riccardo ; Miskowiak, Kamilla W ; Lafer, Beny ; Hasler, Gregor ; Gallagher, Peter ; López-Jaramillo, Carlos ; Balanzá-Martínez, Vicent ; Lewandowski, Kathryn E ; Vieta, Eduard ; Porter, Richard J ; Martinez-Aran, Anabel ; Obel, Zacharias K ; Kessing, Lars V ; Douglas, Katie ; Bonnin, Caterina Del Mar ; Purdon, Scot E ; Bowie, Christopher R ; Dols, Annemieke ; Sumiyoshi, Tomiki ; Burdick, Katherine E ; Schaffer, Ayal ; Young, Allan H ; Van Rheenen, Tamsyn E ; Torres, Ivan J ; Stokes, Paul R A ; Carvalho, Andre F ; McIntyre, Roger S ; Yatham, Lakshmi N

Abstract:

Background:

Abnormalities in dopamine and norepinephrine signaling are implicated in cognitive impairments in bipolar disorder (BD) and attention‐deficit hyperactivity disorder (ADHD). This systematic review by the ISBD Targeting Cognition Task Force therefore aimed to investigate the possible benefits on cognition and/or ADHD symptoms and safety of established and off‐label ADHD therapies in BD.

Methods:

We included studies of ADHD medications in BD patients, which involved cognitive and/or safety measures. We followed the procedures of the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) 2020 statement. Searches were conducted on PubMed, Embase and PsycINFO from inception until June 2023. Two authors reviewed the studies independently using the Revised Cochrane Collaboration's Risk of Bias tool for Randomized trials.

Results:

Seventeen studies were identified (N = 2136), investigating armodafinil (k = 4, N = 1581), methylphenidate (k = 4, N = 84), bupropion (k = 4, n = 249), clonidine (k = 1, n = 70), lisdexamphetamine (k = 1, n = 25), mixed amphetamine salts (k = 1, n = 30), or modafinil (k = 2, n = 97). Three studies investigated cognition, four ADHD symptoms, and 10 the safety. Three studies found treatment‐related ADHD symptom reduction: two involved methylphenidate and one amphetamine salts. One study found a trend towards pro‐cognitive effects of modafinil on some cognitive domains. No increased risk of (hypo)mania was observed. Five studies had low risk of bias, eleven a moderate risk, and one a serious risk of bias.

Conclusions:

Methylphenidate or mixed amphetamine salts may improve ADHD symptoms in BD. However, there is limited evidence regarding the effectiveness on cognition. The medications produced no increased mania risk when used alongside mood stabilizers. Further robust studies are needed to assess cognition in BD patients receiving psychostimulant treatment alongside mood stabilizers.

100 项与 ADHD(Aelis Farma) 相关的药物交易

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