New frontiers in pharmacological treatment of attention-deficit hyperactivity disorder

Abstract

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. This manuscript reviews the current understanding of ADHD and evaluates treatment approaches, including emerging technologies, to improve outcomes and reduce societal impact. A comprehensive review of the literature was conducted, focusing on stimulant-based therapies, non-stimulant alternatives, and novel therapeutic devices. Clinical efficacy, safety profiles, and advancements in technology-based interventions were analyzed. Stimulant medications, such as methylphenidate and amphetamines, remain the mainstay of ADHD treatment but pose risks of abuse and dependence. Non-stimulant options, including atomoxetine and extended-release α-2 agonists like guanfacine and clonidine, provide alternatives for patients who cannot tolerate stimulants. Emerging therapeutic devices, including the Monarch eTNS System and EndeavorRx, offer innovative drug-free treatment options. The prognosis for ADHD is variable, with some individuals experiencing symptom resolution while others continue to face lifelong challenges. A multidisciplinary approach that integrates pharmacotherapy, behavioral therapy, and novel technology-based interventions holds promise for improving patient outcomes and addressing the societal impact of ADHD.

Keywords: ADHD treatment; Innovative therapies; Neurodevelopmental disorder; Non-stimulant medications; Stimulant medications.

Fig. 1

Schematic representation of DA regulation. Adapted from Mehta, T.R. et al. (Bush 2010)