Novel Agents for the Management of Pediatric and Adult ADHD

Theresa R. Cerulli, MD: Rakesh, how about other emerging studies in both pediatric and adult ADHD [attention-deficit/hyperactivity disorder] treatments? What are you most excited about?

Rakesh Jain, MD, MPH: The world of adult ADHD researchers and clinicians has been more empowered in the last decade or so. If our excitement is being shared by our colleagues listening to us, that’s great, but be ready for even more. In fact, 3 of us—Dr Andrew Cutler, Dr Mattingly, and myself—published a paper in CNS Spectrums in 2020. I encourage people to check it out. The title of that very paper is “Current and Future Nonstimulants in the Treatment of ADHD.” There are a number of them. Obviously, viloxazine is 1 we have our eyes on. Centanafadine is another compound that shows great promise, with a very different mechanism of action. There are a number of other molecules in development. Our goal is to be very excited, but let’s not forget that what we have today is pretty powerful. We should focus on our accurate identification, matching the patient with the right treatment option, and using measurement-based tools. We remain very excited for what the future holds for us.

Greg Mattingly, MD: I would add, as David also said, there are other stimulants in development. A variety of nonstimulants are in development. The 1 that’s probably going to get approval soon is viloxazine, but there are others in development. There’s a whole group of digital therapeutics in development. In these digital therapeutics, we use the world around us—digital video games, cognitive enhancers—to strengthen pathways in the brain of adults with ADHD. I have 3 trials going on of digital interventions for adults with ADHD. That’s a really promising and interesting area of the future.

Theresa R. Cerulli, MD: Thanks to all of you for this very rich and informative discussion with my friends. Before we conclude, I’d like to get final thoughts from each of you. Are there any messages you’d like to send to our audience? I also want to thank them for caring about ADHD patients and being with us. Dr Mattingly?

Greg Mattingly, MD: Thank you, everybody, for joining us. Thank you for the discussion. Most important, ADHD is there. We all see it. When you treat it, you make a big difference. These are the patients who walk in and they’re thankful. They’ll tell you the difference you’ve made in their job, in their family, in their marriage, at their school. Treatment makes a difference. It’s rewarding. Once you get used to this, you’ll be thankful that you dove into this field.

Theresa R. Cerulli, MD: Dr Goodman?

David W. Goodman, MD: I echo everything that everyone has said. What’s most important and unique about ADHD is that if you treat depression, you bring the person back to where they were. When you treat anxiety disorder, you bring them back to where they were. When you treat ADHD, you transform this person’s psychological state into a state of mind they’ve never experienced. This is an inflexion point on the trajectory of the success of their life. That’s what is unique about treating ADHD compared with some of the other psychiatric disorders.

Theresa R. Cerulli, MD: Dr Amann?

Birgit H. Amann, MD: I’ll reflect similarly. It can be such a bittersweet story when they come in and haven’t had treatment or have been only partially treated. We watch them gain confidence and self-esteem and flourish in so many aspects of their lives. It’s rewarding for them and for me. I’ll echo what my colleagues said. Thank you all for having me.

Theresa R. Cerulli, MD: Dr Jain?

Rakesh Jain, MD, MPH: Here is a good way to look at it. It’s the best of times, and it’s the best of times. There’s nothing negative to talk about in terms of adult ADHD. We have so many treatment options. We have so many pathways we can take to help these individuals. I want to thank our colleagues who are listening. In many ways, you could choose to ignore adult ADHD. You might say, “I’m busy enough. I’ve got so many other disorders to take care.” But let me share this with you. If you’ve identified and treated an adult with ADHD, the transformative power of clinical intervention is 1 of the greatest I’ve seen in my 32-year career in medicine, so I encourage you to be empowered in identifying and treating as optimally as you possibly can. It’s getting more possible with the passage of time. Before I wrap up. Teresa, I want to hear your thoughts. What are you most excited about in the world of ADHD?

Theresa R. Cerulli, MD: First, thank you all for being part of this panel. It’s much appreciated. Thank you to our viewing audience for participating. I want to emphasize that, as all of you have said, there’s so much to look forward to in this field. When I started as an ADHD specialist 20 years ago, we had very few options for treatment. We had very little understanding that there even was adult ADHD. I’ve been thrilled to be part of the process and the evolution in our understanding. I’m very excited to know that there’s much more to come.

We hope you found this HCPLive® Peer Exchange discussion to be useful and informative. We look forward to seeing you in the future. Thank you, everyone.

Transcript Edited for Clarity