Jacquelin Esque, MD
photo: Jamie Manser
As we enter a new year, let's explore the newer pharmacological treatment options available for children and adolescents with ADHD:
Onyda XR (clonidine extended-release) is the first non-stimulant medication to come in a liquid option and is dosed daily at bedtime.
When to consider? For patients that would benefit from a long-acting alpha agonist who can’t swallow pills. Onyda XR can be used on its own or as an adjunctive treatment
to stimulants.
Xelstrym (d-amphetamine) is a long-acting amphetamine trans-dermal patch that comes in four different doses. Until the release of Xelstrym, only a methylphenidate patch was available.
When to consider? For patients who have difficulty taking oral medication and could benefit from a stimulant, as it allows for more options than just the methylphenidate patch.
Azstarys (serdexmethlyphenidate/dexmethylphenidate) combines immediate release dexmethylphenidate with a prodrug component for a smoother and more extended release.
When to consider? Smoother on/off and long length of action can be helpful when seeing afternoon crashes. Prodrug formulation also decreases abuse potential.
Still in the pipeline:
Centanafadine (not yet FDA approved) is a norepinephrine, serotonin, and dopamine reuptake inhibitor (first triple neurotransmitter reuptake inhibitor) that has had phase 3 studies indicating benefit for ADHD symptoms in children, adolescents, and adults.
When to consider? May be helpful for patients with negative side effects from stimulant medication.