trinklek
commented
5 years ago Problem: several antidepressants that affect norepinephrine and dopamine may be useful to treat ADHD in adults or children when stimulants are not used. Bupropion, one such medication, is currently in the phenotype for ADHD. Selective serotonin reuptake inhibitors (SSRIs), which have no effect on norepinephrine or dopamine, currently are in the phenotype definition for ADHD but are not used to treat this condition except in patients with comorbid anxiety or depression. Venlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI), is not currently in the phenotype definition for ADHD but should be considered if other similar medications (e.g., SSRIs, bupropion) are also being considered for this definition. Venlafaxine has been studied for ADHD with variable success; however, it is possible that it still may be used in children, adolescents, and adults for ADHD treatment.
Supportive literature: https://www.ncbi.nlm.nih.gov/pubmed/9231317, https://www.ncbi.nlm.nih.gov/pubmed/8626348, https://www.ncbi.nlm.nih.gov/pubmed/22252909
Potential solution: consider adding venlafaxine to phenotype definition for ADHD. Thoughts, @trinklek? I completely agree that the SSRIs should NOT be included in the phenotype definition and that bupropion should be included. I need to review the literature RE: venlafaxine more. Based only on the links you mention, I would not include venlafaxine in the phenotype definition because the evidence is very limited and it would be used very infrequently for ADHD. However, if we are testing different phenotype definitions, it isn't a bad idea to see how inclusion of venlafaxine is included.
Problem: several antidepressants that affect norepinephrine and dopamine may be useful to treat ADHD in adults or children when stimulants are not used. Bupropion, one such medication, is currently in the phenotype for ADHD. Selective serotonin reuptake inhibitors (SSRIs), which have no effect on norepinephrine or dopamine, currently are in the phenotype definition for ADHD but are not used to treat this condition except in patients with comorbid anxiety or depression. Venlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI), is not currently in the phenotype definition for ADHD but should be considered if other similar medications (e.g., SSRIs, bupropion) are also being considered for this definition. Venlafaxine has been studied for ADHD with variable success; however, it is possible that it still may be used in children, adolescents, and adults for ADHD treatment.
Potential solution: consider adding venlafaxine to phenotype definition for ADHD.
Thoughts, @trinklek?