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Adult attention deficit hyperactivity disorder: a comprehensive review

Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, with only 2–3% prevalence into adulthood. The epidemiology and proposed causes of ADHD are multifactorial, including genetic, prenatal and environmental influences. The diagnosis of ADHD is often complicated by masking c...

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Autores principales: Williams, Ozge C., Prasad, Sakshi, McCrary, Amanda, Jordan, Erica, Sachdeva, Vishi, Deva, Sheryl, Kumar, Harendra, Mehta, Jayati, Neupane, Purushottam, Gupta, Aditi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205222/
https://www.ncbi.nlm.nih.gov/pubmed/37228994
http://dx.doi.org/10.1097/MS9.0000000000000631
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author Williams, Ozge C.
Prasad, Sakshi
McCrary, Amanda
Jordan, Erica
Sachdeva, Vishi
Deva, Sheryl
Kumar, Harendra
Mehta, Jayati
Neupane, Purushottam
Gupta, Aditi
author_facet Williams, Ozge C.
Prasad, Sakshi
McCrary, Amanda
Jordan, Erica
Sachdeva, Vishi
Deva, Sheryl
Kumar, Harendra
Mehta, Jayati
Neupane, Purushottam
Gupta, Aditi
author_sort Williams, Ozge C.
collection PubMed
description Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, with only 2–3% prevalence into adulthood. The epidemiology and proposed causes of ADHD are multifactorial, including genetic, prenatal and environmental influences. The diagnosis of ADHD is often complicated by masking coping mechanisms, an overlap of symptoms with other, more commonly diagnosed disorders. Traditionally, it has been treated with stimulant medications. Non-stimulant options often target norepinephrine and dopamine regulation and are preferred in cases of comorbid substance use disorder, anxiety and other complicating factors, due to an improved side-effect profile and patient preference. They include atomoxetine and viloxazine. The latter, Viloxazine, in the form of extended-release capsules, is the first novel, non-stimulant option approved for adults with ADHD, in the past two decades. Its therapeutic effects are predominantly produced by its action as a norepinephrine reuptake inhibitor and may also modulate the serotonergic system. Viloxazine is relatively safe and effective in treating other disorders such as depression, anxiety, epilepsy and substance use disorder. Its pharmacokinetics includes metabolization by CYP enzymes. As antiepileptics inhibit CYP1A2, therefore, a special consideration would be needed, when co-administering with anti-epileptic drugs. Similarly, individuals with liver or cardiovascular disease and a personal or family history of bipolar disorder require close monitoring, while on this medication. A thorough review of the history, mechanism of action, pharmacokinetics and drug–drug interactions has been presented here, with special attention on treatment in adults with comorbid conditions. This study conducted an all-language literature search on Medline, Cochrane, Embase, and Google Scholar until December 2022. The following search strings and Medical Subject Headings (MeSH) terms were used: “Viloxazine,” “ADHD,” “Stimulants,” and “adult ADHD.” We explored the literature on the growing knowledge of Viloxazine. A thorough review of the history, mechanism of action, pharmacokinetics, and drug–drug interactions are reviewed here with special attention on treatment in adults with comorbid conditions.
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spelling pubmed-102052222023-05-24 Adult attention deficit hyperactivity disorder: a comprehensive review Williams, Ozge C. Prasad, Sakshi McCrary, Amanda Jordan, Erica Sachdeva, Vishi Deva, Sheryl Kumar, Harendra Mehta, Jayati Neupane, Purushottam Gupta, Aditi Ann Med Surg (Lond) Reviews Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, with only 2–3% prevalence into adulthood. The epidemiology and proposed causes of ADHD are multifactorial, including genetic, prenatal and environmental influences. The diagnosis of ADHD is often complicated by masking coping mechanisms, an overlap of symptoms with other, more commonly diagnosed disorders. Traditionally, it has been treated with stimulant medications. Non-stimulant options often target norepinephrine and dopamine regulation and are preferred in cases of comorbid substance use disorder, anxiety and other complicating factors, due to an improved side-effect profile and patient preference. They include atomoxetine and viloxazine. The latter, Viloxazine, in the form of extended-release capsules, is the first novel, non-stimulant option approved for adults with ADHD, in the past two decades. Its therapeutic effects are predominantly produced by its action as a norepinephrine reuptake inhibitor and may also modulate the serotonergic system. Viloxazine is relatively safe and effective in treating other disorders such as depression, anxiety, epilepsy and substance use disorder. Its pharmacokinetics includes metabolization by CYP enzymes. As antiepileptics inhibit CYP1A2, therefore, a special consideration would be needed, when co-administering with anti-epileptic drugs. Similarly, individuals with liver or cardiovascular disease and a personal or family history of bipolar disorder require close monitoring, while on this medication. A thorough review of the history, mechanism of action, pharmacokinetics and drug–drug interactions has been presented here, with special attention on treatment in adults with comorbid conditions. This study conducted an all-language literature search on Medline, Cochrane, Embase, and Google Scholar until December 2022. The following search strings and Medical Subject Headings (MeSH) terms were used: “Viloxazine,” “ADHD,” “Stimulants,” and “adult ADHD.” We explored the literature on the growing knowledge of Viloxazine. A thorough review of the history, mechanism of action, pharmacokinetics, and drug–drug interactions are reviewed here with special attention on treatment in adults with comorbid conditions. Lippincott Williams & Wilkins 2023-04-12 /pmc/articles/PMC10205222/ /pubmed/37228994 http://dx.doi.org/10.1097/MS9.0000000000000631 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Reviews
Williams, Ozge C.
Prasad, Sakshi
McCrary, Amanda
Jordan, Erica
Sachdeva, Vishi
Deva, Sheryl
Kumar, Harendra
Mehta, Jayati
Neupane, Purushottam
Gupta, Aditi
Adult attention deficit hyperactivity disorder: a comprehensive review
title Adult attention deficit hyperactivity disorder: a comprehensive review
title_full Adult attention deficit hyperactivity disorder: a comprehensive review
title_fullStr Adult attention deficit hyperactivity disorder: a comprehensive review
title_full_unstemmed Adult attention deficit hyperactivity disorder: a comprehensive review
title_short Adult attention deficit hyperactivity disorder: a comprehensive review
title_sort adult attention deficit hyperactivity disorder: a comprehensive review
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205222/
https://www.ncbi.nlm.nih.gov/pubmed/37228994
http://dx.doi.org/10.1097/MS9.0000000000000631
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