What value do norepinephrine/dopamine dual reuptake inhibitors have to the current treatment of adult attention deficit hyperactivity disorder (ADHD) treatment armamentarium?
Abstract
Attention deficit/hyperactivity disorder (ADHD) is defined as a persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development. ADHD is the most common neurodevelopmental disorder diagnosed in childhood and persists into adolescence and adulthood in 40%-70% of cases [1]. In adults, hyperactivity usually improves, while executive dysfunctions (such as inattention, disorganization, and impaired working memory), behavioral and emotional impulsivity, and emotional dysregulation (ED) persist or even worsen, resulting in reduced quality of life and impaired interpersonal, occupational, and social functioning. Additionally, most adults with ADHD have numerous psychiatric comorbidities and complications, such as alcohol/substance use, mood, anxiety, eating, impulse control, and personality disorders [2], which are often the reason why patients seek psychiatric care. In many cases, ADHD symptoms are not even recognized because psychiatric comorbidities complicate the clinical picture, making the diagnostic process more difficult. Finally, in a substantial proportion of cases, psychiatric comorbidity (e.g. a severe psychotic mood episode, severe addictive disorders, etc.) constitutes a therapeutic priority. However, the coexisting symptoms of ADHD can strongly influence the clinical picture and drug response and should always be considered during treatment management. Although multiple neurotransmitters seem to be involved in the…
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