The stimulant lisdexamfetamine improved symptoms of “sluggish cognitive tempo”—characterized by daydreaming, underactivity, and feeling spacey and lethargic—in a small trial of adults with attention-deficit/hyperactivity disorder (ADHD). Researchers published their findings online in The Journal of Clinical Psychiatry.

“Adults with ADHD and comorbid sluggish cognitive tempo had significant improvement after lisdexamfetamine vs placebo in ratings of sluggish cognitive tempo, ADHD, executive function deficits, and functional impairment,” wrote lead study investigator Lenard Adler, MD, and colleagues.

The randomized controlled trial included 38 men and women with ADHD. Participants received 4 weeks of treatment with daily lisdexamfetamine or placebo. Then, after a 2-week washout period, participants were switched to receive the active drug or placebo, whichever they did not receive during the first phase. Participants were assessed for symptoms of ADHD, sluggish cognitive tempo, deficits in executive function, and functional impairment at baseline and weekly throughout the study.

Lisdexamfetamine reduced self-reported symptoms of sluggish cognitive tempo by 30%, according to the study. In addition, the drug lowered symptoms of ADHD by 40% and significantly improved executive function deficits and functional impairment ratings compared with placebo.

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Approximately one quarter of the overall improvements in sluggish cognitive tempo were due to improvements in ADHD symptoms, researchers reported.

“These findings highlight the importance of assessing symptoms of sluggish cognitive tempo and executive brain function in patients when they are initially diagnosed with ADHD,” advised Dr Adler, a psychiatrist and director of the adult ADHD program at NYU Langone Health, New York, New York.

The study was funded by drug manufacturer Takeda Pharmaceuticals.

—Jolynn Tumolo

References

Adler LA, Leon TL, Sardoff TM, et al. A placebo-controlled trial of lisdexamfetamine in the treatment of comorbid sluggish cognitive tempo and adult ADHD. J Clin Psychiatry. 2021;82(4):20m13687. doi.org/10.4088/JCP.20m13687

Drug relieves persistent daydreaming, fatigue & brain sluggishness in adults with ADHD. News release. NYU Langone; June 29, 2021. Accessed July 2, 2021.