Relationship of ADHD Symptoms and Global Illness Severity in Adults Treated with Lisdexamfetamine Dimesylate
Abstract
Unlabelled The relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms and global clinical assessment of functionality is complex. This post-hoc analysis explores this relationship and suggests implications for patient assessment in clinical practice. Adults with ADHD on a stable lisdexamfetamine dimesylate (LDX) dose for ≥ 6 months were enrolled in a double-blind, placebo-controlled, randomized withdrawal study. Participants entered a 3-week open-label phase continuing their prior LDX dose and were then randomized to placebo or the same LDX dose for a 6-week, double-blind, randomized withdrawal phase. ADHD symptom distribution was measured by the ADHD Rating Scale IV (ADHD-RS-IV) with Adult Prompts total score reflecting DSM-IV-TR ADHD symptom criteria and severity by Clinical Global Impressions-Severity (CGI-S) ratings at study entry and at end of study. Of 123 participants enrolled in the open-label phase, 116 were included in the randomized withdrawal phase (placebo, n = 60; LDX, n = 56). As reported in a prior publication, mean (standard deviation) ADHD-RS-IV total score change from baseline (week 3) to end of study (randomized-withdrawal phase) was 16.8 (11.80) for placebo and 1.6 (8.63) for LDX. At end of study, for placebo and LDX, 5.0% and 32.1% of participants, respectively, had a CGI-S = 1, 11.7% and 35.7% had a CGI-S = 2, 11.7% and 17.9% had a CGI-S = 3, 33.3% and 7.1% had a CGI-S = 4, 35.0% and 7.1% had a CGI-S = 5, and 3.3% and 0% had a CGI…
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Another post hoc analysis of the AWE study noted that LDX significantly improved overall QOL at study end point compared with baseline, and no significant differences were observed in either age or sex.
“Another post hoc analysis of the AWE study assessed improvements in QOL using patient-reported AIM-A, a QOL assessment consisting of 4 global items, 5 multi-item subscales compromising 6 domains and 5 economic impact items, and noted that LDX significantly improved overall QOL at study end point compared with baseline, and no significant differences were observed in either age or sex.”
From Review of Lisdexamfetamine Dimesylate in Adults With Attention-Deficit/Hyperactivity Disorder (2017) · cites this paper as [38]
In a post hoc analysis of the Brams et al study, compared with participants maintained on stable LDX dose during withdrawal, higher ADHD-RS-IV and higher CGI-S ratings were observed in participants switched to placebo.
“Compared with those participants who were maintained on their stable LDX dose during the withdrawal phase, higher ADHD-RS-IV and higher CGI-S ratings were observed in the participants switched to the placebo.”
From Review of Lisdexamfetamine Dimesylate in Adults With Attention-Deficit/Hyperactivity Disorder (2017) · cites this paper as [39]
In that post hoc analysis, as CGI-S scores increased, ADHD symptoms increased, with a positive linear relationship among ADHD symptoms and global illness ratings.
“As the CGI-S scores increased (ie, worsened), so did the ADHD symptoms, with a positive linear relationship among ADHD symptoms and global illness ratings, correlating a dependence factor between the two.”
From Review of Lisdexamfetamine Dimesylate in Adults With Attention-Deficit/Hyperactivity Disorder (2017) · cites this paper as [39]
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Review of Lisdexamfetamine Dimesylate in Adults With Attention-Deficit/Hyperactivity Disorder
Najib, J., Wimer, D., Zeng, J., Lam, K. W., Romanyak, N., Paige Morgan, E., & Thadavila, A. (2017) · Journal of Central Nervous System Disease · doi:10.1177/1179573517728090 · Cited by 17 · see citing works
- Authors
- Weisler, R. H., Babcock, T., Adeyi, B., & Brams, M.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Takeda (United States) (US)
- Corresponding author
- Weisler, Richard H.
- ORCID
- Brams, Matthew
- Venue
- Postgraduate Medicine
- Publisher
- Informa UK Limited
- Published
- 2014-09
- Volume
- 126
- Issue
- 5
- Pages
- 31-41
- ISSN
- 0032-5481 (ISSN-L)
- 1941-9260
- OpenAlex
- W1980653245
- Cited by
- 2
- References
- 12
- Citations by year
- 2026: 1 · 2017: 1
- FWCI
- 0.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Postgraduate Medicine (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
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- attention deficit hyperactivity disorder, lisdexamfetamine dimesylate, ADHD symptoms, ADHD Rating Scale-IV, ADHD symptom severity, drug withdrawal, stimulant medication, adult ADHD, functional impairment assessment
- MeSH terms
- Lisdexamfetamine Dimesylate, Adolescent, Adult, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Dextroamphetamine, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Male, Middle Aged, Recurrence, Severity of Illness Index, Young Adult
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