Maybe a Triple Reuptake Inhibitor for ADHD: Centanafadine

Otsuka Pharmaceuticals has released Phase III study results showing that the serotonin-norepinephrine-dopamine reuptake inhibitor centanafidine is effective in treating ADHD ins adults. Further studies and FDA approval could come as soon as this year (2024). This would make it the first drug with this mechanism of action profile to be approved for treating ADHD.
Although there are no head to head trials comparing centanafidine to other medications for ADHD, a research group recently published a matching-adjusted indirect comparison study, looking at how centanafidine appears to contrasts with Vyvanse (lysdexamfetamine), Strattera (atomoxetine), and Qelbree (viloxazine). Centanafadine appears as effective as the non-stimulants, but not quite as powerful as Vyvanse in addressing ADHD symptoms. However, it appeared to have a lower risk for multiple side effects compared to any of these three alternatives.
We should learn in the months head whether these preliminary results hold up - early studies on other triple reuptake inhibitors were encouraging but not robust enough for pharmaceutical companies to continue pursuing approval. Some have cautioned that dopamine reuptake inhibitors may possess greater risks of addiction than do other non-stimulants, but this too, remains to be verified.
References:
Efficacy, Safety, and Tolerability of Centanafadine Sustained-Release Tablets in Adults With Attention-Deficit/Hyperactivity Disorder (2022)
journals.lww.c...
Assessment of centanafadine in adults with attention-deficit/hyperactivity disorder: A matching-adjusted indirect comparison vs lisdexamfetamine dimesylate, atomoxetine hydrochloride, and viloxazine extended-release (2024)
www.jmcp.org/d...
Safety and Efficacy of Centanafadine Sustained-Release in Adults With Attention-Deficit Hyperactivity Disorder: Results of Phase 2 Studies (2020)
www.dovepress....
Neurotransmitter transmitter occupancy following administration of centanafadine sustained released tablets: A phase 1 study in healthy male adults (2022)
journals.sagep...
The role of adrenergic neurotransmitter reuptake inhibitors in the ADHD armamentarium (2024)
www.tandfonlin...
General:
Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions. Subscribe if you're curious about how neuro-atypical brains can optimize their functioning in our shared, and somewhat strange, world.
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[@markmuller7962]

Before my diagnosis I've experienced a period of my life when through a strategy I was finally able to be *autonomously* productive and during that time period I was experiencing very high levels of happiness and even euphoria. These feelings are definitely something that is missing during my days on medications and my hypothesis has always been about a lack of Serotonin inhibited by the medication itself. I really wish I'll be able to experience that type of pride and happiness for my accomplishments, including the relatively smaller ones because now after 40 years undiagnosed even the small successes can be absolutely huge for me and I really want to experience that reward in Serotonin

[@agaragar21]

Your gauge measuring Pre-reward gets increased so you can then EVEN get off your butt to do something in the first place (Procrastination).....and then the accomplishment reward feels less than normal ...but otherwise could most ADHD'ers do anything without meds in the first place ? what does the word "autonomously" mean ?

[@arbaadamsavila2409]

Thank you for doing so many videos on ADHD. They're so helpful for a late-diagnosed adult. Strattera was horrible for me. Lots of side effects, almost no benefits. Wellbutrin has benefits but does not help me focus. Doc does not want to give me stimulants, unfortunately. Nice blue-green color coordination!

[@DrJohnKruse]

I'll tell Mr. Cupcake that he has a new fan.

[@visualcinemaandmusic9291]

Thank you for this detailed information and video!

[@GrayIsBlackAndWhite]

So happy I found a channel to fall asleep to. Great voice and info!

[@robertdillon9989]

From my experience, anybody who’s had a full stimulant will never take it. Just like they won’t take Strattera or anything else I offer them. They won’t even try it and insurance won’t cover a new drug.

[@jamesrob8552]

The worse side effects from drugs like this are not from acute or short-term effects. They are the effects after years or protracted withdrawal which is a type of cns dysfunction caused by long term use or caused with discontinuation of it. I hope it helps people but I've learned that studies showing low side effects doesn’t mean it won't ruin people's lives.