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Solriamfetol for ADHD

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Solriamfetol for ADHD

Solriamfetol is a dopamine reuptake inhibitor and noradrenaline reuptake inhibitor. It also acts as a serotonin reuptake inhibitor to a negligible extent:1

  • Dopamine IC50: 2.9 μM
  • Noradrenaline IC50: 4.4 μM
  • Serotonin IC50: > 100

Brand name: Sunosi®

Solriamfetol is approved by the FDA as a drug for narcolepsy.
Initial studies have investigated the possible effect of solriamfetol on ADHD.

Effect:2

  • 45% achieved strong or very strong improvement in CGI and at least 25% improvement in AISRS, compared to 6.9% in the placebo group
  • greater improvement in total AISRS values from week 3 to week 6
  • significantly more frequent improvement of the T-score in the BRIEF-A Global Executive Composite by 0.5 standard deviations
  • greater mean change in GAF score (-4.8 compared to -0.3 in the placebo group)
  • greater mean change in the MASRS total score
  • greater improvement in the ESS score
  • PSQI values unchanged

Compatibility:2

  • Solriamfetol was well tolerated
  • no significant change in
    • Heart rate
    • systolic blood pressure
    • diastolic blood pressure
    • no increase in adverse events
  • at least 10 percentage points more frequently than with placebo
    • reduced appetite
    • Headache
    • gastrointestinal complaints
    • Insomnia
    • increased energy consumption
    • cardiovascular and neurological complaints

An individual case report describes a good effect of in a 15-year-old boy with ADHD, in whom atomoxetine, methylphenidate, augmented clonidine and venlaflaine had been ineffective. Within 4 weeks, academic performance had improved remarkably. The inattention subscale of the Vanderbilt test decreased from 8/9 before the treatment to 1/9. There were no side effects.3
Solriamfetol was dosed

  • 3 days 37.5 mg in the morning
  • 1.5 weeks 75 mg
  • 3 days 112.5 mg
  • 150 mg
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