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Analysis of individual items on the attention-deficit/hyperactivity disorder symptom rating scale in children and adults: the effects of age and sex in pivotal trials of lisdexafetamine dimesylate

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Weisler R, Adler LA, Kollins SH, Goodman DW, Hamdani M, Dirks B, Childress AC. Neuropsychiatric Disease and Treatment 2014:9 1–11.

Abstract

BACKGROUND:

Attention-deficit/hyperactivity disorder (ADHD) symptom presentation across age and sex has not been fully elucidated. The present post hoc analyses qualitatively explored the baseline levels of ADHD symptomatology across subgroups in two clinical trials of children and adults with ADHD to elucidate differences in participant presentation. The response to treatment was examined to determine patterns of response among items of the ADHD Rating Scale IV.

METHODS:

Exploratory post hoc analyses of ADHD Rating Scale IV item scores were conducted on data from two 4-week placebo-controlled trials in children (6-12 years) and in adults (18-55 years) with ADHD. Baseline and endpoint mean item scores were determined for subgroups defined by age (6-9, 10-12, 18-39, and 40-55 years) and sex.

RESULTS:

The baseline mean item scores were generally numerically similar for all age-by-sex subgroups. The inattention (IA) items were numerically higher than hyperactivity/impulsivity (H/I) items among older children and adults. The endpoint mean item scores were numerically lower after lisdexamfetamine dimesylate treatment for IA and H/I items in all subgroups.

CONCLUSION:

These results suggest that regardless of age or sex, baseline IA and H/I symptom profiles were comparable; however, IA vs H/I symptoms were more severe in older participants. In all age-by-sex subgroups, IA and H/I symptoms appeared to decrease after active treatment.

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Unmasking ADHD in Adults

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Goodman DW, Surman C et al. Medscape. August 2013

Overview

This activity is intended for psychiatrists, family physicians, primary care providers, internists, neurologists.

The goal of this activity is to apprise clinicians of the symptoms of adult attention-deficit/hyperactivity disorder (ADHD), the comorbidities commonly associated with the disorder, and the pharmacotherapy and nonpharmacotherapy treatment options available.

Upon completion of this activity, participants will be able to:

  1. Identify the manifestations of ADHD in adults that should initiate an evaluation
  2. Differentiate ADHD symptoms from those of comorbid psychiatric disorders
  3. Discuss evidence-based approaches to individualize treatment of adult ADHD to address comorbidities and residual ADHD symptoms and improve treatment response

[button size=’large’ color=’btn-b76lpc214h’ link=’https://www.medscape.org/viewarticle/768677′ align=’center’ block=’0′ icon=’FontAwesome/fontawesome-chevron-sign-right||color:ffffff’ shadow=’2′]Read Full Article[/button]

Artificial food colour exclusion and free fatty acid supplementation may reduce symptom severity in children with ADHD

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Goodman DW. Editorial on Sonuyga-Barke for EBMH. Evidence-Based Mental Health, Brit Med J. May 2013.

Question: Are dietary and pharmacological interventions effective for the treatment of attention deficit hyperactivity disorder (ADHD)?

Outcomes: Post-treatment change from baseline in total ADHD symptom severity as measured by ADHD-specific symptom scales (eg, the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) ADHD subscale of Conner’s Parent and Teacher Rating Scales) or if this was not available, questionnaire measures of ADHD-related dimensions (eg, inattention on Rutter parents’ and teachers’ scales) or direct observations.

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Sustained treatment effect in attention deficit hyperactivity disorder focus on long term placebo controlled randomized maintenance withdrawal and open label studies

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Goodman DW. Ther Clin Risk Manag. 2013;9:121-30.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists throughout life. Approximately two-thirds of patients with a childhood diagnosis of ADHD continue to experience clinically significant symptoms into adulthood. Nevertheless, most of these individuals consider themselves “well,” and a vast majority discontinue medication treatment during adolescence. As evidence concerning the adult presentation of ADHD becomes more widely accepted, increasing numbers of physicians and patients will face decisions about the benefits and risks of continuing ADHD treatment. The risks associated with psychostimulant pharmacotherapy, including abuse, dependence, and cardiovascular events, are well understood. Multiple clinical trials demonstrate the efficacy of psychostimulants in controlling ADHD symptoms in the short term. Recent investigations using randomized withdrawal designs now provide evidence of a clinically significant benefit with continued long-term ADHD pharmacotherapy and provide insight into the negative consequences associated with discontinuation. Because many patients lack insight regarding their ADHD symptoms and impairments, they may place a low value on maintaining treatment. Nevertheless, for patients who choose to discontinue treatment, physicians can remain a source of support and schedule follow-up appointments to reassess patient status. Medication discontinuation can be used as an opportunity to help patients recognize their most impairing symptoms, learn and implement behavioral strategies to cope with ADHD symptoms, and understand when additional supportive resources and the resumption of medication management may be necessary.

[button size=’large’ color=’btn-b76lpc214h’ link=’https://www.ncbi.nlm.nih.gov/pubmed/23576871′ align=’center’ block=’0′ icon=’FontAwesome/fontawesome-chevron-sign-right||color:ffffff’ shadow=’2′]Read Full Article[/button]

Clinical response and symptomatic remission in short- and long-term trials of lisdexamfetamine dimesylate in adults with attention-deficit/hyperactivity disorder.

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Mattingly G, Weilser RH, Young J, Adeyi B, Dirks B, Babcock T, Lasser R, Scheckner, B, Goodman, D BioMed Central Psychiatry BMC Psychiatry 2013, 13:39

Background

Despite the overall high degree of response to pharmacotherapy, consensus is lacking on how to judge clinical response or define optimal treatment/remission when treating adults with attention-deficit/hyperactivity disorder (ADHD). This study examined clinical response and symptomatic remission in analyses of 2 studies of lisdexamfetamine dimesylate (LDX) in adults with ADHD.

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Women and ADHD

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Article medically reviewed by David W. Goodman M.D. 2012

Experts suggest that attention deficit hyperactivity disorder (ADHD) affects an estimated 8 percent of school-aged children, and about two-thirds of children diagnosed with ADHD continue to show signs of the disorder into adulthood.

[button size=’large’ color=’btn-b76lpc214h’ link=’https://www.healthywomen.org/condition/attention-deficit-hyperactivity-disorder’ align=’center’ block=’0′ icon=’FontAwesome/fontawesome-chevron-sign-right||color:ffffff’ shadow=’2′]Read Full Article[/button]

Assessment of Physician Practices in Adult Attention-Deficit/Hyperactivity Disorder

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Goodman DW, Surman CB, Scherer P, Salinas G. Primary Psychiatry. February, 2012.

Objective

Adult attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder, yet only 1 in 10 affected adults receives treatment. The study objective was to assess gaps in knowledge and describe current practice patterns of primary care physicians and psychiatrists in the United States in the management of adult patients with ADHD.

[button size=’large’ color=’btn-b76lpc214h’ link=’https://www.ncbi.nlm.nih.gov/pubmed/23251858′ align=’center’ block=’0′ icon=’FontAwesome/fontawesome-chevron-sign-right||color:ffffff’ shadow=’2′]Read Full Article[/button]

Lifespan Persistence of ADHD: The Life Transition Model and Its Application

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Lifespan Persistence of ADHD: The Life Transition Model and Its Application. Atilla Turgay, MD; David W. Goodman, MD; Philip Asherson, MRCPsych, PhD; Robert A. Lasser, MD; Thomas F. Babcock, DO; Michael L. Pucci, PhD; and Russell Barkley, PhD, for the ADHD Transition Phase Model Working Group COPYRIGHT 2012 PHYSICIANS POSTGRADUATE PRESS, INC. © COPYRIGHT 2012 PHYSICIANS POSTGRADUATE PRESS, INC. J Clin Psychiatry

[button size=’large’ color=’btn-b76lpc214h’ link=’https://addadultdev2024.talondigital.com/wp-content/uploads/2012/01/Turgay_Goodman_2012_Lifespan_Persistence_of_ADHD_JCP.pdf’ align=’center’ block=’0′ icon=’FontAwesome/fontawesome-chevron-sign-right||color:ffffff’ shadow=’2′]Read Full Article[/button]

Managing ADHD Across the Lifespan in the Primary Care Setting

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David W. Goodman, MD1 Robert A. Lasser, MD2 Thomas Babcock, DO2 Michael L. Pucci, PhD3 Mary V. Solanto, PhD4. Managing ADHD Across the Lifespan in the Primary Care Setting. © Postgraduate Medicine, Volume 123, Issue 5, September 2011, ISSN – 0032-5481, e-ISSN – 1941-9260

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