Lisdexamfetamine dimesylate in the treatment of attention-deficit/hyperactivity disorder: pharmacokinetics, efficacy and safety in children and adolescents

Abstract

Background: Psychostimulants (methylphenidate and amphetamines) are considered first-line therapy for attention-deficit/hyperactivity disorder (ADHD). Lisdexamfetamine dimesylate (LDX) is a new psychostimulant approved for the treatment of ADHD in Brazil. The pharmacologically active fraction, d-amphetamine, is gradually released by hydrolysis of the LDX prodrug. Objectives: To perform a systematic review of the literature of the efficacy and safety of LDX in the treatment of ADHD in children and adolescents. Methods: Medline/PubMed searches for "d-amfetamine", "lisdexamfetamine" and "lisdexamfetamine dimesylate" were conducted including articles available from January 2000 to November 2013. Additional references were identified using references listed in those articles. Further data on LDX were requested from its manufacturer. Results: Thirty-one papers were found related to ADHD treatment in children and adolescents. Discussion: The therapeutic benefits of LDX in children with ADHD are achieved as early as 1.5 hours after its administration and last for up to 13 hours, with efficacy comparable or superior to that of other available psychostimulants. The literature also reports efficacy in long-term treatment, with safety and tolerability profiles comparable to those of other stimulants used for the treatment of ADHD. Most of the adverse events associated with LDX are considered to be mild or moderate in severity, with the most common being loss of appetite and insomnia.

Association between sleep pattern and pharmacological treatment in children with attention deficit disorder with hyperactivity: a systematic review

“…The sample used in this study was small, and the multifaceted nature of the findings indicated that the study’s conclusions needed to be interpreted with caution and that more studies are needed on the influence of LDX on sleep in larger samples of children with ADHD. 20 Thus, these findings were convergent with those of Mattos, 27 where its effectiveness was evidenced and adverse effects, when present, were considered mild to moderate.…”

A relevância da educação para a saúde coletiva

“…Há também o uso de outras substâncias neuroestimulantes, como a classe das anfetaminas que possui representantes como o metilfenidato, mais comumente conhecido como ritalina, e a lisdexanfetamina, cujo nome comercial é venvanse. Esta droga, por ser um pró-fármaco inativo, necessita de ser metabolizada para a sua forma ativa (d-anfetamina) por meio da hidrolise, possuindo um efeito mais prolongado a partir de uma única dose diária (MATTOS, P., 2014). Esses fármacos estimulam diversas áreas do sistema nervoso central, ativando o córtex e aumentando o nível de vigília, apesar de seus efeitos ainda estarem sendo observados.…”