No Evidence of Cognitive Impairment With Lisdexamfetamine Dimesylate in ADHD

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The components of the Cambridge Neuropsychological Test Automated Battery cognitive assessment include delayed matching to sample, spatial working memory, stop signal task, and reaction time.
The components of the Cambridge Neuropsychological Test Automated Battery cognitive assessment include delayed matching to sample, spatial working memory, stop signal task, and reaction time.

Children and adolescents with attention-deficit/hyperactivity disorder administered dose-optimized lisdexamfetamine dimesylate showed no condition-related cognitive impairment over a 2-year period, according to the results of a study published in CNS Drugs.

Cognition assessments of delayed matching with sample, special working memory, stop signal task, and reaction time from children and adolescents receiving dose-optimized lisdexamfetamine dimesylate for 104 weeks were compared with baseline measurements. Importantly, there was no comparison arm for this study. 

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Among the 314 participants receiving lisdexamfetamine dimesylate, no clinically significant cognitive deterioration was seen in delayed matching with sample, spatial working memory, stop signal task, or reaction time over the 2-year period. Potentially clinically significant improvements in delayed matching with sample, spatial working memory, and stop signal task were detected from 6 months throughout study conclusion. However, because of the lack of a comparison arm, definitive conclusions cannot be drawn. Reaction times for study participants remained close to baseline throughout the study duration.

Of 314 participants, 191 participants ultimately completed the study. The most common reasons for discontinuation were participant withdrawal (13.1%) and adverse events (12.4%). However, the nature and prevalence of adverse events were not reported in the present study.

The study investigators noted, “The present study provides evidence that [lisdexamfetamine dimesylate] treatment is not associated with the deterioration of cognitive function in children and adolescents with [attention-deficit/hyperactivity disorder].” They added that the potentially positive effects in cognitive assessments warrant further investigation.

Reference

Coghill D, Banaschewski T, Bliss C, Robertson B, Zuddas A. Cognitive function of children and adolescents with attention-deficit/hyperactivity disorder in a 2-year open-label study of lisdexamfetamine dimesylate [published online January 30, 2018]. CNS Drugs. doi:10.1007/s40263-017-0487-z

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