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Focus on Lisdexamfetamine: A Review of its use in Child and Adolescent Psychiatry.

ABSTRACT: To summarize and review published literature regarding lisdexamfetamine and its use in child and adolescent psychiatry.A LITERATURE REVIEW WAS CONDUCTED USING THE PUBMED SEARCH TERM: 'lisdexamfetamine' with limits: Human trials, English language, All Child (aged 0-18 years). Additional articles were identified from reference information and poster presentation data.Lisdexamfetamine (Vyvanse®) is a prodrug formulation of dextroamphetamine used for the treatment of Attention Deficit/Hyperactivity Disorder (ADHD). Conversion of lisdexamfetamine to active dextroamphetamine occurs via hydrolytic enzymes located on erythrocytes, and leads to an onset of action within 1-2 hours post-dose, and duration of up to 13 hours. Administration of lisdexamfetamine via nasal or intravenous routes did not result in significant elevation of drug liking scores in known stimulant abusers, suggesting low potential for abuse. Lisdexamfetamine has been available in the United States since 2007, but was only recently approved by Health Canada for use in children 6 to 12 years of age. There are five randomized controlled trials with lisdexamfetamine in children and adolescents showing efficacy for treatment of ADHD. In addition, several open-label trials and case reports were identified. The adverse effect profile of lisdexamfetamine is similar to that observed with other long-acting amphetamine formulations.Lisdexamfetamine is a novel long-acting stimulant formulation with efficacy for treatment of ADHD and low abuse potential due to its prodrug formulation.

SUBMITTER: Elbe D

PROVIDER: S-EPMC2962544 | biostudies-other | 2010 Nov

REPOSITORIES: biostudies-other

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Focus on Lisdexamfetamine: A Review of its use in Child and Adolescent Psychiatry.

Elbe Dean D Macbride Angela A Reddy Dorothy D

Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent 20101101 4

<h4>Objective</h4>To summarize and review published literature regarding lisdexamfetamine and its use in child and adolescent psychiatry.<h4>Method</h4>A LITERATURE REVIEW WAS CONDUCTED USING THE PUBMED SEARCH TERM: 'lisdexamfetamine' with limits: Human trials, English language, All Child (aged 0-18 years). Additional articles were identified from reference information and poster presentation data.<h4>Results</h4>Lisdexamfetamine (Vyvanse®) is a prodrug formulation of dextroamphetamine used for ...[more]

PMID: 21037922

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Project description:BackgroundMental health disorders are a leading cause of medical disabilities across an individual's lifespan. This burden is particularly substantial in children and adolescents because of challenges in diagnosis and the lack of precision medicine approaches. However, the widespread adoption of wearable devices (eg, smart watches) that are conducive for artificial intelligence applications to remotely diagnose and manage psychiatric disorders in children and adolescents is promising.ObjectiveThis study aims to conduct a scoping review to study, characterize, and identify areas of innovations with wearable devices that can augment current in-person physician assessments to individualize diagnosis and management of psychiatric disorders in child and adolescent psychiatry.MethodsThis scoping review used information from the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search of several databases from 2011 to June 25, 2021, limited to the English language and excluding animal studies, was conducted. The databases included Ovid MEDLINE and Epub ahead of print, in-process and other nonindexed citations, and daily; Ovid Embase; Ovid Cochrane Central Register of Controlled Trials; Ovid Cochrane Database of Systematic Reviews; Web of Science; and Scopus.ResultsThe initial search yielded 344 articles, from which 19 (5.5%) articles were left on the final source list for this scoping review. Articles were divided into three main groups as follows: studies with the main focus on autism spectrum disorder, attention-deficit/hyperactivity disorder, and internalizing disorders such as anxiety disorders. Most of the studies used either cardio-fitness chest straps with electrocardiogram sensors or wrist-worn biosensors, such as watches by Fitbit. Both allowed passive data collection of the physiological signals.ConclusionsOur scoping review found a large heterogeneity of methods and findings in artificial intelligence studies in child psychiatry. Overall, the largest gap identified in this scoping review is the lack of randomized controlled trials, as most studies available were pilot studies and feasibility trials.

Project description:Antipsychotics are often prescribed to children and adolescents, mostly off-label. We aimed to assess adherence to recommendations of guidelines for antipsychotic prescription. We reviewed 436 medical records from 155 clinicians from 26 clinics within three Dutch child and adolescent psychiatry organizations (n = 398 outpatient, n = 38 inpatient care). We assessed target symptoms, diagnostic process, prior and concomitant treatment, and consideration of contra-indications. Multiple logistic regression assessed the role of age, sex, and psychiatric diagnosis on adherence to three main recommendations: to (1) prescribe antipsychotics only after other treatments proved insufficient, (2) always combine antipsychotics with psychosocial interventions, and (3) not prescribe multiple antipsychotics simultaneously. Most patients received off-label antipsychotics. Main target symptoms were inattention/hyperactivity (25%), aggression (24%), and other disruptive behaviors (41%). Most patients underwent diagnostic evaluation before the first prescription; however, screening of contra-indications was low (0.2-19%). About 84% had previously received psychosocial treatment and 48% other psychoactive medication, but 9% had not received any treatment. Notably, only 37% continuously received concomitant psychosocial treatment. Simultaneous use of multiple antipsychotics occurred in 3.2%. Younger children were at higher risk of non-adherence to guideline recommendations regarding prior and concomitant treatment, children with autism spectrum disorder or attention-deficit/hyperactivity disorder more likely not to receive concomitant psychosocial treatment. Sex did not significantly affect adherence. Our findings implicate insufficient adherence to important recommendations regarding antipsychotic use in children and adolescents. Especially younger children are at higher risk of receiving suboptimal care. There is an urgency to consistently offer psychosocial interventions during antipsychotic treatment.

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Focus on Lisdexamfetamine: A Review of its use in Child and Adolescent Psychiatry.

Publications

Focus on Lisdexamfetamine: A Review of its use in Child and Adolescent Psychiatry.

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