- Federal regulators have expanded the use of the drug viloxazine for use in adults with attention deficit hyperactivity disorder (ADHD).
- It’s the first novel non-stimulant treatment for adults with ADHD in 20 years.
- Experts say the medication will be most useful in adults who have addiction issues or can’t tolerate the side effects of the current stimulants prescribed for ADHD treatment.
The U.S. Food and Drug Administration has approved a new drug for the treatment of attention deficit hyperactivity disorder (ADHD) in adults.
The approval of the drug, a viloxazine extended-release capsule under the brand name Qelbree, is the first novel non-stimulant for ADHD therapy to be approved for adults in 20 years.
“The gold standard for treatment of ADHD is a class of medications known as stimulants. This class is helpful in approximately 70 percent of patients. However, for some, it is not effective and others cannot tolerate the side effects of the medication,” Chrissy R. Glenn, DO, a psychiatrist at The University of Kansas Health System, told Healthline.
“For these patients, non-stimulant medications may be a better choice,” she explained. “The availability of non-stimulant medications is limited, particularly in the adult population. Having another option for our adult population is fantastic in my opinion. It is always helpful to have more options to treat our patients.”
About 10 million adults in the United States have ADHD.
In adults, the condition may produce a variety of symptoms, including forgetfulness, trouble maintaining attention, trouble with organization, fidgeting, restlessness, excessive talking, and interrupting others.
This may result in problems at work or in personal or family relationships.
Medication is one treatment option that can assist in the management of ADHD in adults. It can help adults with focus and may also reduce impulsive behavior.
“Sometimes adults find great relief by trying out medications like this,” said David Merrill, Ph.D., a psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California.
“We have a lot of adults who are seeking treatment for ADHD, but they may or may not have the same underlying biology as found in children,” Merrill told Healthline. “This is where this new medication offers promise. It’s not habit-forming. It doesn’t have the potential for abuse. It’s not a controlled substance. This is in contrast to classic stimulants, which of course are schedule 2 medications which are highly regulated because of the potential for abuse.”
Viloxazine is a norepinephrine reuptake inhibitor.
Norepinephrine is a chemical in the brain that helps with behavior control. The medication works by increasing levels of norepinephrine in the brain, which can assist in managing behavior.
Key among the benefits of viloxazine is that it isn’t a stimulant, and offers an alternative for those who may be at risk of addiction or substance misuse.
“Those traditional stimulants like Ritalin, Adderall, Dexedrine tend to have much stronger physiologic effects in terms of blood pressure changes, potential for anxiety as a side effect… insomnia. Really, the physiologic stimulation of stimulants can be quite difficult. Whereas this new improved drug, hopefully, you would expect to be more tolerable to be more benign for adults to try,” Merrill said.
Glenn says the drug will also be useful in addressing many of the symptoms caused by ADHD.
“This medication could help the core symptoms of ADHD, including inattentiveness (difficulty concentrating or paying attention), hyperactivity (restlessness, difficulty sitting still, need to move), and impulsivity (doing or saying things without thinking of the consequences),” she said.
In clinical trials, those who took viloxazine daily experienced an improvement in symptoms early on in their treatment.
Improvements in both hyperactivity and impulsivity were seen in the group who took viloxazine.
Both Glenn and Merrill say they would prescribe the drug to their adult patients, but the cost may be a concern for some.
“One of the biggest issues we run into with prescribing branded medication is costs. Insurance does not always cover these medications, but most manufacturers offer coupon cards,” Glenn noted.