Viloxazine Is a New Option to Treat ADHD in Children

Saro Arakelians, PharmD

The norepinephrine reuptake inhibitor indicated for patients aged age 6 to 17 years recently received FDA approval.

Attention deficit hyperactivity disorder (ADHD) is a chronic health condition that affects many individuals in the United States (U.S.), including children.

The estimated number of children diagnosed with ADHD in 2016 was about 6.1 million, which includes about 390,000 age 2 to 5 years; 2.4 million in age 6 to 11 years; and 3.3 million age 12 to 17 years, according to the CDC.1

Boys are more likely to be diagnosed with this disease than girls, at a rate of 12.9% compared with 5.6% in girls.1 About 30% of children with ADHD have anxiety, and about 50% have behavioral problems.1

Many patients with ADHD struggle with controlling impulsive behavior and paying attention. Some develop problems, such as difficulty maintaining relationships, low-self-esteem, and poor performance at work and in school.2 When it comes to signs and symptoms of ADHD,Symptoms of inattentiveness can include becoming easily distracted, being forgetful in daily routine activities, failing to follow instructions, having poor organizational skills, and making careless mistakes.3

As the children with ADHD get older, symptoms may improve, or these individuals may find ways to cope with the disease.2

Treatment for ADHD includes behavioral therapies and medications. Behavioral therapies can include parent training, as well as school-related interventions and training sessions, while medication options include nonstimulants and stimulants.1

Stimulants are often first-line treatment for patients with ADHD. Amphetamines and methylphenidate are both widely used treatment options.

Nonstimulants are also recommended for those that do not see the full benefit from stimulant medications. Examples of medications in this category are atomoxetine, clonidine, and guanfacine. The most common and popular ADHD medications available in the United States include amphetamine extended release, amphetamine sulfate, atomoxetine, dexmethylphenidate, dextroamphetamine, lisdexamfetamine dimesylate, and methylphenidate. Some new additions to the market include 2 forms of methylphenidate HCI: Adhansia XR and Jornay PM. Both are stimulant medications approved recently by the FDA for use in both adult and pediatric patients. Most of these medications target the norepinephrine levels in the brain and improve the neurotransmitters’ connectivity and function.4

Vviloxazine (Qelbree), is a new treatment option, approved in the United States in April 2021. This drug is a norepinephrine reuptake inhibitor indicated for patients aged 6 to 17 years. It is taken once a day, with or without food. It may cause drowsiness, so these patients should not operate heavy machinery while taking this medication, until they know how they will react. Viloxazine can cause decreased appetite, irritability, nausea, tiredness, trouble sleeping, and vomiting. It is available in dosages of 100, 150, and 200mg. Finally, concomitant use of this drug with monoamine oxidase inhibitors and cytochrome P450 1A2 substrates are contraindicated.⁵

With new options on the market, such as viloxazine, patients with ADHD have treatment options and regimens that can help them function better.

References

1. CDC. Data and statistics about ADHD. Updated November 16, 2020. Accessed May 17, 2021. https://www.cdc.gov/ncbddd/adhd/data.html

2. Mayo Clinic. Attention-deficit/hyperactivity disorder (ADHD) in children. Accessed May 17, 2021. https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889

3. Vyvanse. Understanding ADHD symptoms in adults. Accessed May 17, 2021. https://www.vyvansepro.com/adhd/diagnosing-adults?utm_medium=cpc&utm_source=google&utm_campaign=TAK%257CVyvanse%257CADHD%257CHCP%257C%257C%257CSymptoms_Healthcare+Demo&utm_term=symptoms+of+adhd_exact&utm_content=Symptom+-+General+-+ADHD&gclid=CjwKCAjwnPOEBhA0EiwA609ReYTUSeeAfaJjOfHPYpxjRDdvyiEM-PlHBhY2OfHB4cbbcqCeAJdprBoCd8wQAvD_BwE&gclsrc=aw.ds

4. Silver L. ADHD medications for adults and children: ADD stimulants, nonstimulants & more. ADDitude. Updated April 21, 2021. Accessed May 17, 2021. https://www.additudemag.com/adhd-medication-for-adults-and-children/

5. Qelbree. Supernus Pharmaceuticals Inc; 2021. Accessed May 17, 2021. https://www.supernus.com/sites/default/files/Qelbree-Prescribing-Info.pdf