Description
ADHD is a neurobehavioral disorder characterized by varying degrees of
inattention, hyperactivity, and impulsivity. ADHD is typically diagnosed in
childhood and affects 7–12% of the pediatric population in the United States with
the condition often enduring into adulthood.
While the precise mechanism of action of lisdexamfetamine
in treating ADHD is not known, amphetamines are believed to inhibit the
reuptake of the neurotransmitters dopamine and noradrenaline (norepinephrine),
thereby increasing their presynaptic availability and release into extraneuronal space. The prodrug is constructed by the condensation of D-amphetamine with the activated ester (N-hydroxysuccinimide) of bis-tert-butoxycarbonylprotected L-lysine. Lisdexamfetamine is ultimately generated by treatment with hydrochloric acid in dioxane.
The most common adverse events, comparable to other amphetamine formulations, were decreased appetite, insomnia, upper abdominal pain, and irritability. Lisdexamfetamine is contraindicated in patients with advanced arteriosclerosis, symptomatic cardiovascular disease, moderate-to-severe hypertension, hyperthyroidism, known hypersensitivity to the sympathomimetic amines, glaucoma, a predisposition to agitated states, and a history of drug abuse. In addition, the drug should not be administered during or within 14 days of treatment with monoamine oxidase inhibitors. It has also been noted that psychostimulants may exacerbate symptoms of pre-existing psychotic disorders, so caution and close observation are recommended in this patient population.
