Lisdexamfetamine Reduces Symptoms of Cognitive Sluggishness in Adult Patients With ADHD

It is currently debated whether or not sluggish cognitive tempo—defined as a collection of symptoms that include persistent dreaminess, fatigue, and slow working speed—is part of ADHD or separate from it.

Lisdexamfetamine (Vyvanse, Takeda Pharmaceuticals) has shown early success in the reduction of sluggish cognitive tempo for 38 patients with attention-deficit hyperactivity disorder (ADHD), according to the results of a study published in the Journal of Clinical Psychiatry. It is currently debated whether or not sluggish cognitive tempo—defined as a collection of symptoms that include persistent dreaminess, fatigue, and slow working speed—is part of ADHD or separate from it.

“Our study provides further evidence that sluggish cognitive tempo may be distinct from attention deficit hyperactivity disorder and that the stimulant lisdexamfetamine treats both conditions in adults, and when they occur together,” said Lenard Adler, MD, in a press release.

The study participants received daily doses of either lisdexamfetamine or a placebo for 1 month. The investigators tracked the patients’ psychiatric health on a weekly basis through standardized tests for signs and symptoms of sluggish cognitive tempo, ADHD, and other measures of brain function. Participants then switched roles, receiving placebo if they had previously received lisdexamfetamine and vice versa.

According to the investigators, 30% of self-reported symptoms of sluggish cognitive tempo were reduced by the drug. Further, it lowered symptoms of ADHD by 40% and significantly corrected deficits in executive brain function, with fewer episodes of procrastination, improvements in keeping things in mind, and strengthened prioritization skills.

The study also demonstrated that one-quarter of the overall improvements in sluggish cognitive tempo, such as feelings of boredom, trouble staying alert, and signs of confusion, were due to improvements in symptoms of ADHD, according to the authors. They interpreted this to mean that decreases in ADHD-related incidents of physical restlessness, behaving impulsively, or moments of not paying attention were linked to of the improvements in sluggish cognitive tempo, but could not be fully credited for the improvement.

“These findings highlight the importance of assessing symptoms of sluggish cognitive tempo and executive brain function in patients when they are initially diagnosed with ADHD,” Adler said in the release.

Adler added that stimulants have previously been demonstrated to improve sluggish cognitive tempo symptoms in children with ADHD. The current study is the first to show that such treatments also work in adults, according to the authors.

REFERENCE

Drug relieves persistent daydreaming, fatigue, and brain sluggishness in adults with ADHD [news release]. EurekAlert; June 29, 2021. Accessed August 23, 2021. https://www.eurekalert.org/news-releases/861712