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A Pilot Controlled Clinical Trial of ABT-418, a Cholinergic Agonist, in the Treatment of Adults With Attention Deficit Hyperactivity Disorder
Abstract
OBJECTIVE: Despite the increasing recognition of attention deficit hyperactivity disorder (ADHD) in adults, there is a paucity of controlled pharmacological trials. Recent reports have suggested the potential usefulness of cholinergic agents for ADHD. To this end, the authors completed a controlled study of ABT-418, a novel cholinergic activating agent, for the treatment of adults with ADHD. METHOD: This was a double-blind, placebo-controlled, randomized, crossover trial that compared a transdermal patch of ABT-418 (75 mg/day) to placebo in adults who met DSM-IV criteria for ADHD. There were two 3-week treatment periods separated by 1 week of washout. RESULTS: Of the 32 subjects enrolled in the study (88% were men; mean age = 40 years, SD = 9), 29 completed the study. At the endpoint of each active arm (last observation carried forward), a significantly higher proportion of subjects was considered improved while receiving ABT-418 than while receiving placebo (40% versus 13%). Similarly, at endpoint there was a significantly greater reduction in ADHD symptom checklist scores (28% versus 15%). Symptoms reflective of attention, and subjects with less severe ADHD, responded more robustly to ABT-418. Treatment with ABT-418 was relatively well tolerated; dizziness and nausea were the most frequently reported adverse effects. CONCLUSIONS: The results of this investigation indicate that ABT-418, a nicotinic analog, may be a potentially useful agent for the treatment of ADHD.
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“Recent studies have indicated that agonists selective for α4β2* nAChRs produce perhaps more robust and clinically more promising enhancement of attention and related cognitive abilities (Potter et al, 1999; Wilens et al, 1999; Wilens et al, 2006; Dunbar et al, 2007; Wilens and Decker, 2007).”
From Modes and models of forebrain cholinergic neuromodulation of cognition (2011) · cites this paper as Wilens et al, 1999
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Metadata
- Authors
- Wilens, T. E., Biederman, J., Spencer, T. J., Bostic, J., Prince, J., Monuteaux, M. C., Soriano, J., Fine, C., Abrams, A., Rater, M., & Polisner, D.
- Affiliations
- Harvard University (US)
- Venue
- American Journal of Psychiatry
- Published
- 1999-12-01
- Volume
- 156
- Issue
- 12
- Pages
- 1931-1937
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2149138665
- Cited by
- 230
- References
- 50
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2021: 2 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 8 · 2014: 10 · 2013: 15 · 2012: 10
- FWCI
- 8.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k20mh001175-02)
- National Institute of Mental Health (MH-01175)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- ABT-418, attention deficit hyperactivity disorder, adult ADHD, cholinergic agonists, nicotinic agonists, transdermal patch, pharmacotherapy, ADHD symptom improvement, treatment tolerability
- MeSH terms
- Administration, Cutaneous, Adult, Age Factors, Attention Deficit Disorder with Hyperactivity, Dizziness, Double-Blind Method, Female, Humans, Isoxazoles, Male, Nausea, Pilot Projects, Pyrrolidines, Anti-Anxiety Agents, Treatment Outcome, Cross-Over Studies, Cholinergic Agonists
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