Pilot Study Finds Solriamfetol Beneficial for Adults With ADHD

The wakefulness-promoting drug solriamfetol may be an effective treatment for the management of attention-deficit/hyperactivity disorder (ADHD) in adults, according to a pilot study published in the Journal of Clinical Psychiatry.

“Although there are currently safe and effective treatments for ADHD, they are not effective for all individuals with ADHD or tolerated well by all patients,” said corresponding author Craig B. Surman, MD, director of the Clinical and Research Program in Adult ADHD at Massachusetts General Hospital and associate professor of psychiatry at Harvard Medical School, Boston, Massachusetts. “Our findings offer hope of a new method of supporting the daily challenges that individuals with ADHD face.”

The double-blind pilot study included 60 adults with ADHD randomized to 75 mg or 150 mg of solriamfetol, which is approved for the treatment of excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea, or to placebo for 6 weeks. The Adult ADHD Investigator Symptom Rating Scale (AISRS) served as the primary outcome measure. Other measures used in the study included a patient-reported ADHD symptom scale, the Clinical Global Impressions scale (CGI), and the patient-rated Behavior Rating Inventory of Executive Function-Adult Form.

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A greater proportion of patients taking solriamfetol showed improvement on all of the scales by the end of the study, researchers reported. For example, 45% of patients treated with solriamfetol had CGI scores indicating much or very much improved and AISRS scores reduced 25% or more, compared with 6.9% of patients taking placebo. Patients treated with solriamfetol also had greater improvement in total AISRS scores.

Solriamfetol had no significant effect on average heart rate, blood pressure, or sleep quality per the Pittsburgh Sleep Quality Index, according to the study. Adverse events that occurred more often with solriamfetol than placebo included decreased appetite, headache, gastrointestinal symptoms, insomnia, increased energy, cardiovascular symptoms, and neurologic symptoms.

“Our results suggest that solriamfetol may be a safe and effective treatment for ADHD in adults,” said Dr Surman. “Larger studies replicating these findings could confirm the strong evidence of benefit and the tolerability of this agent as a treatment.”

References

Surman CBH, Walsh DM, Horick N, DiSalvo M, Vater CH, Kaufman D. Solriamfetol for attention-deficit/hyperactivity disorder in adults: a double-blind placebo-controlled pilot study. J Clin Psychiatry. 2023;84(6):23m14934

Clinical trial demonstrates benefits of solriamfetol for adults with ADHD. News release. Massachusetts General Hospital; October 9, 2023. Accessed October 16, 2023.