Pemoline Therapy in College Students with Attention Deficit Hyperactivity Disorder: A Retrospective Study

Abstract

Pemoline, a dopamine agonist, is effective in children with attention deficit hyperactivity disorder (ADHD), but its efficacy in adults is unknown. The authors studied the efficacy and safety of pemoline, using retrospective chart review of treated students with ADHD over a 2-year period. Forty students met diagnostic and treatment criteria; pemoline was associated with much improved or very much improved Clinical Global Impression symptoms scores in 70% of the students during a treatment period of 14 or more days. Severity of illness scores dropped from 4.11 to 3.01 between baseline and subsequent evaluation. Nine evaluable patients had adverse events, most commonly headaches, insomnia, and decreased appetite. Five additional students, who failed to meet the treatment-duration criterion, terminated because of severe initial insomnia. The authors concluded that pemoline is effective and safe in students with ADHD and has a lower abuse potential than methylphenidate and dextroamphetamine, the other two widely used, structurally dissimilar compounds, but controlled studies may be necessary before any final conclusions are reached.

ADHD in college students: Developmental findings

“…Also, several nonstimulant medications (e.g., atomoxetine) have been found to significantly reduce ADHD symptoms in adults [Wilens, 2003]. Surprisingly, only one study has examined stimulant medication response specifically in college students, with Heiligenstein et al [1996] finding a positive treatment response for a majority of students treated with this medication. This study used a retrospective research design and so there are no double-blind, placebo-controlled studies available for any medication treatment for this population.…”

Binding of uptake blockers to the neuronal dopamine transporter: further investigation about cationic and anionic requirements

“…In relation with this function, the DAT plays a pivotal, yet not exclusive, role in the reinforcing properties of drugs of abuse (Ritz et al 1987;Madras et al 1989;Kuhar et al 1991;Rocha et al 1998). On the other hand, mutations in the DAT gene are suggested to be associated with several behavioral disorders (Rowe et al 1998;Swanson et al 1998), and blockers of the neuronal uptake of catecholamines are useful therapeutic agents for narcolepsy and attention deficit hyperactive disorder (Heiligenstein et al 1996). Consequently, a better knowledge of the mechanisms underlying DAT functioning remains a primary goal to achieve.…”

Efficacy of Stimulants in Adult ADHD

“…13, 14 One trial involving 35 adults contained two 4-week treatment periods separated by a 2-week washout period. 13 Patients suffered chron-…”