Solriamfetol ― a medication approved for excessive daytime sleepiness caused by narcolepsy or obstructive sleep apnea ― significantly improved symptoms of attention-deficit/hyperactivity disorder (ADHD) and clinical impression of ADHD severity in a pilot study of adults with ADHD.
Solriamfetol is a dopamine and norepinephrine reuptake inhibitor that shares some of the properties of current ADHD medications.
Researchers conducted a randomized, double-blind, placebo-controlled, dose-optimization trial of 75- or 150-mg solriamfetol in 60 adults with ADHD. For nearly all of the individuals who received solriamfetol, doses increased to 150 mg after the first week.
The primary outcome was change in scores on the Adult ADHD Investigator Symptom Rating Scale (AISRS).
Secondary outcomes included scores on the Clinical Global Impressions (CGI) scale and standard measures of executive function, behavior, and sleep.
By week 6, total AISRS score improved 25% for 52% of individuals to took solriamfetol, vs 17% of those who received placebo. Total AISRS score improved 50% by week 6 in 28% of those who took solriamfetol, vs 3.4% of those who received placebo.
By week 6, CGI ratings of "much improved" or "very much improved" occurred in significantly more individuals who received solriamfetol than those who took placebo (45% vs 7%).
Significantly more individuals who received solriamfetol than placebo self-reported improvements in executive function (69% vs 34%). Improvement in wakefulness was noted with solriamfetol, but that did not moderate the change in ADHD symptom burden.
Solriamfetol was well tolerated, with no significant effect on sleep quality or blood pressure. Adverse effects that occurred at a higher rate in the treatment group than in the placebo group were typical for solriamfetol and sympathomimetic agents used for ADHD.
"Solriamfetol may be a safe and effective treatment for ADHD in adults. Larger studies replicating these findings could confirm the strong evidence of benefit and the tolerability of this agent as a treatment," lead author Craig B. H. Surman, MD, director of the Clinical and Research Program in Adult ADHD, Massachusetts General Hospital, said in a statement.