Stimulant lisdexamfetamine shows efficacy for ADHD with sluggish cognitive tempo

Article by Bruce Sylvester.

Lisdexamfetamine treatment could be therapeutic for adults with attention-deficit/hyperactivity disorder (ADHD) who also have  sluggish cognitive tempo (SCT).

The findings were published on June 29, 2021 in the Journal of Clinical Psychiatry.

“Our study provides further evidence that sluggish cognitive tempo may be distinct from attention deficit hyperactivity disorder and that the stimulant lisdexamfetamine treats both conditions in adults, and when they occur together,” said lead investigator and psychiatrist Lenard Adler, MD., Adler, director the Adult ADHD Program at NYU Langone Health in New York City.

In a randomized crossover trial, 38 adults diagnosed with ADHD and SCT were enrolled,

At baseline, they were assessed for symptoms of ADHD, SCT, executive function deficits and functional impairment. They were reassessed weekly during treatment.

The subjects received 4 weeks of treatment with either lisdexamfetamine (mean = 59 mg/d) or matching placebo (mean = 66.6 mg/d), with a 2-week washout before crossover to the other arm.

Outcomes were measured with the ADHD Rating Scale and Barkley Adult ADHD Rating Scale-IV SCT subscale.

The investigators reported that lisdexamfetamine treatment reduced by 30 percent self-reported symptoms of sluggish cognitive tempo.

They also reported that the treatment lowered by over 40 percent symptoms of ADHD, with significant correction in executive brain function, fewer episodes of procrastination, improvements in keeping things in mind, and strengthening of prioritization skills.

There were no moderating effects of sex, age, race or ethnicity.

The authors concluded, “Adults with ADHD and comorbid SCT had significant improvement after LDX [lisdexamfetamine] vs placebo in ratings of SCT, ADHD, executive function deficits, and functional impairment. This is the first study to show improvement in SCT after stimulant therapy in adults with ADHD.”