Clinical utility of ADHD symptom thresholds to assess normalization of executive function with lisdexamfetamine dimesylate treatment in adults
Abstract
Objectives This analysis assessed the relationship of various cutoff scores of the ADHD Rating Scale IV (ADHD-RS-IV) to levels of improvement in ADHD-related executive function (EF), measured by the Brown ADD Scale for Adults (BADDS), which may provide a measure of clinically meaningful EF improvement after ADHD treatment. Methods Post hoc analysis of a 4-week, open-label, dose-optimization phase in a double-blind, placebo-controlled study of lisdexamfetamine dimesylate (LDX) in adults with ADHD. The BADDS for Adults, a validated, normed, self-report measure of EF in ADHD, provides a qualitative measure to rate treatment progress. The ADHD-RS-IV assesses current symptom status based on DSM-IV criteria. Postbaseline ADHD-RS-IV scores were categorized according to four cutoff criteria of symptom remission: (1) ADHD-RS-IV total score ≤ 18; (2) ADHD-RS-IV total score ≤ 10; (3) no ADHD-RS-IV item scored >1; and (4) ADHD-RS-IV total score ≤ 18 and ≤ 2 items per subscale with a score of 2. Sensitivity and specificity of criteria for identifying participants with optimal BADDS scores were assessed using receiver operating characteristics (ROC). Safety evaluation included treatment-emergent adverse events (TEAEs). Results At endpoint, 85/127 participants had optimal BADDS scores. Linear ANOVA indicated limited overlap between BADDS and ADHD-RS-IV scores (r (2) = 0.20; P Conclusion Criteria 2 and 3 had satisfactorily high sensitivity, but no criteria had adequate specificity. AUC compa…
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In a post hoc analysis of the AWE study, at study end point BADDS total and cluster scores were significantly reduced from baseline (P < .0001), 62.7% had BADDS total <50, and 78.9% reliably improved versus 1.4% reliably worsened.
“At study end point, BADDS total and cluster scores were significantly reduced compared with baseline (P < .0001), and 62.7% of participants had a BADDS total score <50 with 78.9% reliably improved compared with 1.4% reliably worsened.”
From Review of Lisdexamfetamine Dimesylate in Adults With Attention-Deficit/Hyperactivity Disorder (2017) · cites this paper as [41]
BADDS scores predict clinical diagnosis of ADHD and multiple ADHD medication trials use the BADDS to assess symptom severity and improvement.
“BADDS scores predict clinical diagnosis of ADHD [36] and multiple ADHD medication trials use the BADDS to assess symptom severity and improvement [16,37–39].”
From Treating new-onset cognitive complaints after risk-reducing salpingo-oophorectomy: A randomized controlled crossover trial of lisdexamfetamine (2024) · cites this paper as [39]
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Review of Lisdexamfetamine Dimesylate in Adults With Attention-Deficit/Hyperactivity Disorder
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- Authors
- Brown, T. E., Brams, M., Gasior, M., Adeyi, B., Babcock, T., Dirks, B., Scheckner, B., & Wigal, T.
- Affiliations
- Yale University (US)
- Bayou City Research, Houston, TX, USA
- Shire Development Inc., Wayne, PA, USA
- University of California, Irvine (US)
- Corresponding author
- Brown, Thomas E.
- Venue
- Current Medical Research and Opinion
- Publisher
- Informa Healthcare
- Published
- 2011-10-01
- Volume
- 27
- Issue
- sup2
- Pages
- 23-33
- ISSN
- 0300-7995 (ISSN-L)
- 1473-4877
- OpenAlex
- W2087643483
- Cited by
- 24
- References
- 20
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 3 · 2020: 1 · 2017: 2 · 2015: 5 · 2014: 4 · 2013: 2 · 2012: 2
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Medical Research and Opinion (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- adult ADHD, lisdexamfetamine dimesylate, executive function, ADHD Rating Scale-IV, treatment response assessment, sensitivity and specificity, stimulant medication, treatment-emergent adverse events, dose optimization, treatment-emergent mania
- MeSH terms
- Lisdexamfetamine Dimesylate, Adolescent, Adult, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Dextroamphetamine, Double-Blind Method, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, ROC Curve, Young Adult, Executive Function
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