Drug Relieves Persistent Daydreaming, Fatigue, and Brain Sluggishness in Adults With ADHD

Summary: Lisdexamfetamine, a drug known to stimulate brain activity, reduces symptoms of sluggish cognitive tempo in adults with ADHD.

Source: NYU Langone

Tests of a drug known to stimulate brain activity have shown early success in reducing symptoms of sluggish cognitive tempo in 38 men and women with attention deficit hyperactivity disorder (ADHD.)

A collection of symptoms including persistent dreaminess, fatigue, and slow-working speed, sluggish cognitive tempo has been a subject of debate over whether it is part of, or separate from, ADHD.

Researchers at NYU Grossman School of Medicine and Icahn School of Medicine at Mount Sinai who led the study say the stimulant lisdexamfetamine (sold as Vyvanse) reduced by 30 percent self-reported symptoms of sluggish cognitive tempo. It also lowered by over 40 percent symptoms of ADHD and significantly corrected deficits in executive brain function, with fewer episodes of procrastination, improvements in keeping things in mind, and strengthened prioritization skills.

Publishing in the Journal of Clinical Psychiatry online June 29, the study also showed that one-quarter of the overall improvements in sluggish cognitive tempo, such as feelings of boredom, trouble staying alert, and signs of confusion, were due to improvements in symptoms of ADHD.

The team interpreted that outcome to mean that decreases in ADHD-related incidents of physical restlessness, behaving impulsively, and/or moments of not paying attention were linked to some but not all of the improvements in sluggish cognitive tempo.

“Our study provides further evidence that sluggish cognitive tempo may be distinct from attention deficit hyperactivity disorder and that the stimulant lisdexamfetamine treats both conditions in adults, and when they occur together,” says lead study investigator and psychiatrist Lenard Adler, MD.

Adler, who directs the adult ADHD program at NYU Langone Health, says until now stimulants have only been shown to improve sluggish cognitive tempo symptoms in children with ADHD. The NYU Langone-Mount Sinai team’s findings, he adds, are the first to show that such treatments also work in adults.

A professor in the Departments of Psychiatry and Child and Adolescent Psychiatry at NYU Langone, Adler says sluggish cognitive tempo is likely a subset of symptoms commonly seen in some patients with ADHD and other psychiatric disorders. However, it remains unclear if sluggish cognitive tempo is a distinct psychiatric condition on its own and if stimulant medications will improve sluggish cognitive tempo in patients without ADHD.

Some specialists have been seeking to qualify sluggish cognitive tempo as distinct, but critics say more research is needed to settle the question.

“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,” says Adler.

This shows the outline of two heads and tree branches representing neurons in the brain
A collection of symptoms including persistent dreaminess, fatigue, and slow-working speed, sluggish cognitive tempo has been a subject of debate over whether it is part of, or separate from, ADHD. Image is in the public domain

For the study, funded by the drug manufacturer, Takeda Pharmaceuticals of Cambridge, Mass., several dozen volunteer participants received daily doses of either lisdexamfetamine or a placebo sugar pill for one month. Researchers then carefully tracked their psychiatric health on a weekly basis through standardized tests for signs and symptoms of sluggish cognitive tempo, ADHD, as well as other measures of brain function.

Study participants then switched roles: The one-half who had been taking the placebo started taking daily doses of lisdexamfetamine, while the other half who had been on the drug during the study’s first phase started taking the placebo.

Adler has received grant and/or research support from Sunovion Pharmaceuticals, Enymotec, Shire Pharmaceuticals (now part of Takeda), Otsuka, and Lundbeck. He has also served as a paid consultant to these companies, in addition to Bracket, SUNY, the National Football League, and Major League Baseball. He has also received royalty payments since 2004 from NYU for adult ADHD diagnostic and training materials. All of these relationships are being managed in accordance with the policies and procedures of NYU Langone.

Besides Adler, other NYU Langone researchers involved in the study are Terry Leon, MS, RN; Taylor Sardoff, BA; and Michael Silverstein, MS. Other investigators include Beth Krone, PhD; and Jeffrey Newcorn, MD, at Icahn School of Medicine at Mount Sinai in New York City; and Stephen Faraone, PhD, at SUNY Upstate Medical University in Syracuse, NY.

About this ADHD research news

Source: NYU Langone
Contact: David March – NYU Langone
Image: The image is in the public domain

Original Research: The findings will appear in Journal of Clinical Psychiatry

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  1. Yeah, I wonder the same thing. They say they evaluate how it affects executive function and working slowly, but these are known effects of ADHD and Lisdexamphetamine has been part of treating it for years, I thought the things being tested here we’re already known.

  2. This story seems like paid marketing more than anything. Why does the story bury the fact that the study was paid for by the manufacturer? Furthermore, I agree with Kevin’s point. Vyvanse is a stimulant medication, which we’ve known has significant effects on concentration for decades. Overall, the publishing of this study makes me doubt the trustworthiness of neurosciencenews.com, especially considering there is no mention of how they are funded on their website. Simply making the statement, “no funds have been taken from governments, grants, pharmaceutical companies, big businesses, banks, schools, or others with possibly conflicting interests, to help with this site at any time” means nothing as it can take money from wealthy individuals who are on the boards of large organizations or in government. Unfortunately, we can no longer take people or companies at their word as there are far too many powerful incentives to lie.

    1. I understand why you feel that way, but check this out. I’ve been diagnosed with A.D.D. at an early age and my symptoms from childhood and still somewhat to this day have been sluggish, inattentive mind wondering dreaminess, fatigue, and slow-working speed as the research describes. I’ve always wondered why my A.D.D. symptoms were very different from that of my classmates and peers with the same diagnosis. While they would be super talkative have trouble sitting still, become laser focused into movies and video games, and focus better with music on I was quite the opposite. Not only that but our response to our medications was totally different. Adderall and Ritalin makes me energized, and excited, like someone without A.D.D. who takes it, while it made them mellowed out, or sleepy. My symptoms and their symptoms are not the same, but they manifest the same problems. That doesn’t mean they should be treated the same in my opinion. I would like to see more research go into this potential subtype of learning deficit that I am suspicious I might have. Ironically thats one of the main reasons I come onto this website, to hopefully find out what the latest findings are when it comes to on Attention Deficit research hoping to hear there is a treatment for this subtype besides Speed and Strattera.

  3. So I was diagnosed when I was like 24 when it was still called ADD and my drs now just say I dont have the H part of the ADHD but I DEFINITLY have the slowness, procrastination and all the stuff mentioned in the article and ive been on adderall but it doesnt seem to help much. I’m wondering, without the H part of ADHD and without the cognitive tempo sluggishness, what other symptoms for ADHD are left? If there arent really any others then it looks like the c. Tempo problem might really be a lone issue. I cant keep jobs because despite doing Superbowl in school growing up and being highly intelligent, I can never keep up. Not with anything. Absolutely EVERYTHING takes me twice as long as it does everyone else and its ruining my life. I also have depression/bipolar 2, the dr I have now isnt even sure but ive had that since I was 14 so I used to think the SSRIs made me feel slow and stupid but who knows! No 1 ever knows anything for sure except that I’m not getting the help I need to be even CLOSE to performing the way I used to my whole life in school and at other jobs where I used to excel and be promoted after a month (when I was like 15 so maybe its because I was just really mature then as compared to other 15 yr olds? I dont know!) But keep researching pls so I can have my life back b4 I’m 50. My exec functioning needs help and id love to be able to, for once, keep up with anybody I work with. If I even try to work ever again. I may have given up traditional work cuz I cant survive and I may go for (this word took me 6 min to think of btw cuz my memory is shot cuz of adhd) disability.

    1. It’s really rude to say that. Some ppl like myself, that have adhd have to try different amphetamines since not all of them help specific adhd related issues such as sluggishness. Not all amphetamines are created equal and not all just “help you concentrate”. Concentration also wasn’t the main focus of this article if you actually read it. It’s addressing slowness and inability to think or move quickly. It’s actually a very frustrating problem to deal with, esp when your psychiatrist tells you that there’s no proof that symptom is your adhd, and it’s prob something else since there’s not enough studies to relate slowness and adhd.

    2. Dude, they are saying the exact opposite you dumb dumb lol. Did you even read the article?? They said no stimulant so far has been able to treat ADHD AND cognitive slowness in adults or whatever except this ONE. It’s probably why my adderall never helped me work much faster or helped me much cuz I dont have the H part of the ADHD. Why they lumped add and adhd together I’ll never know. I have fatigue, procrastination, boredom, daydreaming and all that but I’m definitly not hyperactive. I was diagnosed when it was still called ADD. I also have other mental illnesses. I did awesome in school until I started getting symptoms, or they became noticable anyway like in highschool but I just thought it was my antidepressants fogging up my brain. Now I lose every job I cuz I can never keep up despite having a 141 IQ and having been in advanced classes. I cant even do stupid, pay nothing jobs and keep up with college kids and I’m 37. No matter how fast I feel like I’m going, its always too slow. I wish they had figured all this out 20 yrs ago :(

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