Nicotine Agonist Provides Modest Symptom Reduction for Adult ADHD

In a proof-of-concept clinical trial, the highest dose of a novel nicotine agonist shows efficacy, but more effective medications are still needed.

Despite their substantial efficacy, stimulant treatments for attention-deficit/hyperactivity disorder (ADHD) pose safety and abuse or diversion risks for some patients. Because ADHD is associated with alterations in the nicotinic acetylcholine receptor system, researchers conducted a manufacturer-funded, proof-of-concept, dose-finding, crossover, clinical trial to examine the efficacy of four doses (1, 2, and 4 mg daily and 4 mg twice daily [BID]) of a selective α4β2 nicotine receptor agonist (ABT-894), atomoxetine (40 mg BID), and placebo in 243 adults with ADHD. Treatment occurred in two 4-week periods separated by a 2-week washout period.

Compared with placebo, both the 4-mg-BID nicotine agonist dose and atomoxetine produced greater reduc…

Reviewing Author

Peter Roy-Byrne, MD

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Peter Roy-Byrne, MD

Disclosures

Editorial BoardsUpToDate