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Cited by 43Attention Deficit Hyperactivity DisorderPharmaceutical studies and practicesNeuroethics, Human Enhancement, Biomedical Innovations

Long-acting stimulants for treatment of attention-deficit/hyperactivity disorder: a focus on extended-release formulations and the prodrug lisdexamfetamine dimesylate to address continuing clinical challenges

Open access
López, Frank A., Leroux, Jacques R.·2013·ADHD Attention Deficit and Hyperactivity Disorders
DOI 10.1007/s12402-013-0106-xPMC PMC3751218
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Abstract

Individuals with attention-deficit/hyperactivity disorder (ADHD) show pervasive impairments across family, peer, and school or work functioning that may extend throughout the day. Psychostimulants are highly effective medications for the treatment of ADHD, and the development of long-acting stimulant formulations has greatly expanded the treatment options for individuals with ADHD. Strategies for the formulation of long-acting stimulants include the combination of immediate-release and delayed-release beads, and an osmotic-release oral system. A recent development is the availability of the first prodrug stimulant, lisdexamfetamine dimesylate (LDX). LDX itself is inactive but is cleaved enzymatically, primarily in the bloodstream, to release d-amphetamine (d-AMP). Several clinical trials have demonstrated that long-acting stimulants are effective in reducing ADHD symptoms compared with placebo. Analog classroom and simulated adult workplace environment studies have shown that long-acting stimulants produce symptom reduction for at least 12 h. Long-acting stimulants exhibit similar tolerability and safety profiles to short-acting equivalents. While variations in gastric pH and motility can alter the availability and absorption of stimulants released from long-acting formulations, the systemic exposure to d-AMP following LDX administration is unlikely to be affected by gastrointestinal conditions. Long-acting formulations may also improve adherence and lower abuse potential compared with their short-acting counterparts. The development of long-acting stimulants provides physicians with an increased range of medication options to help tailor treatment for individuals with ADHD.

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  • Long-acting preparations may minimize the daily peaks and troughs of therapeutic effects associated with shorter acting agents and may minimize the potential for rebound symptoms later in the day.

    “long-acting preparations may minimize the daily peaks and troughs of therapeutic effects associated with the shorter acting agents and also minimize the potential for rebound symptoms later in the day”

    From Review of Lisdexamfetamine Dimesylate in Adults With Attention-Deficit/Hyperactivity Disorder (2017) · cites this paper as [10]

    The Introduction (page unavailable) says short-acting stimulants can leave fragmented coverage and that long-acting formulations were developed to relieve symptoms throughout the day without repeat dosing. This supports the claim about reducing fluctuations in therapeutic coverage, but our copy does not say that long-acting preparations minimize later-day rebound symptoms. (LLM, conf=0.83)

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Research works printed but not linked: 1

  1. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) 2000 Washington DC American Psychiatric Association

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Authors
López, F. A., & Leroux, J. R.
Affiliations
Hôpital Rivière-des-Prairies (CA)
Corresponding author
Leroux, Jacques R.
ORCID
López, Frank A.
Venue
ADHD Attention Deficit and Hyperactivity Disorders
Publisher
Springer Science and Business Media LLC
Published
2013-04-06
Volume
5
Issue
3
Pages
249-265
ISSN
  • 1866-6116 (ISSN-L)
  • 1866-6647
DOI
10.1007/s12402-013-0106-x
PMC
PMC3751218
OpenAlex
W2110748995
Cited by
43
References
94
Citations by year
2026: 4 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 10 · 2016: 6 · 2015: 2 · 2014: 2
FWCI
0.45
Type
journal article
Language
en
Open access
Licence
Locations
  • ADHD Attention Deficit and Hyperactivity Disorders (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neuroethics, Human Enhancement, Biomedical Innovations
Keywords
attention deficit hyperactivity disorder, long-acting stimulants, sustained-release formulation, lisdexamfetamine dimesylate, prodrugs, osmotic-release oral system, d-amphetamine, medication adherence, abuse liability, gastrointestinal absorption, pharmacokinetics
MeSH terms
Lisdexamfetamine Dimesylate, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Delayed-Action Preparations, Dextroamphetamine, Humans, Prodrugs, Medication Adherence

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