From the Guidelines
Amantadine is not a recommended treatment for ADHD due to its limited efficacy and higher risk of adverse events compared to established medications. The most recent and highest quality study on pharmacological treatment options for ADHD in children and adolescents, published in 2022 in the journal Pharmacology and Therapeutics 1, does not mention amantadine as a viable treatment option. Instead, it recommends stimulants as first-line therapy and non-stimulants as second-line therapy.
Key Considerations
- Stimulants, such as methylphenidate and lisdexamfetamine, are preferred as first-line therapy due to their large effect sizes for reducing ADHD core symptoms and rapid onset of treatment effects 1.
- Non-stimulants, such as atomoxetine, guanfacine, and clonidine, are recommended as second-line therapy, with considerations for their potential advantages and disadvantages, including smaller effect sizes and specific adverse event profiles 1.
- The selection of medication should be individualized, taking into account factors such as severity of symptoms, presence of comorbidities, and patient preferences 1.
Treatment Approach
- Established medications like methylphenidate, amphetamine-based stimulants, or non-stimulants such as atomoxetine, guanfacine, or clonidine should be considered before exploring off-label options like amantadine.
- Regular monitoring and assessment of medication adherence are crucial to ensure effective treatment and minimize potential issues 1.
- Patients and healthcare providers should discuss the potential benefits and risks of amantadine, as well as alternative treatment options, to make an informed decision about its use in specific cases where traditional treatments have proven inadequate.
From the Research
Amantadine and ADHD
- Amantadine is a medication that has been studied as a potential treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) 2, 3.
- A randomized, double-blind trial compared the efficacy of amantadine to methylphenidate in children and adolescents with ADHD, and found that amantadine significantly improved symptoms of ADHD and was well tolerated 2.
- An open-label study of amantadine in children with ADHD found that it was possibly efficacious in decreasing ADHD symptoms, although its activity appeared to be more modest than that of stimulant medications 3.
- The studies suggest that amantadine may be a beneficial treatment option for children with ADHD, particularly those who may not respond to or tolerate stimulant medications 2, 3.
- However, it is noted that the current evidence is limited, and more research is needed to fully understand the efficacy and safety of amantadine as a treatment for ADHD 2, 3.
Comparison to Other Treatments
- Stimulant medications, such as methylphenidate and amphetamines, are commonly used to treat ADHD and have been shown to be effective in reducing symptoms 4, 5.
- Atomoxetine is a non-stimulant medication that has been approved for the treatment of ADHD and has been shown to be effective in improving symptoms and quality of life 4.
- Antidepressants, such as desipramine and bupropion, have also been studied as potential treatments for ADHD, particularly in adults 6.
- The choice of treatment for ADHD depends on various factors, including the individual's symptoms, medical history, and response to previous treatments 4, 5.