Insights at the APSARD 2024 Conference

A Global Gathering for ADHD Advancements

The American Professional Society for ADHD and Related Disorders (APSARD) 2024 conference served as a pivotal moment, bringing together leading experts, educators, and clinicians in the field of ADHD. The collaboration extended beyond national borders, with international counterparts converging at the Orlando event, marking a global milestone in the understanding and care of ADHD.

Session 1: ADHD 201 – Beyond the Basics

Presented by Greg Mattingly, MD

Complexity of ADHD and Comorbid Conditions: Greg Mattingly’s session provided a comprehensive exploration of ADHD’s intricate web of comorbidities. From disordered eating to mood disorders, attendees gained valuable insights into the genetic interplay between ADHD and associated conditions. The discussion extended to the acceleration of DNA aging and the neural impact of untreated ADHD, emphasizing the importance of holistic individualized treatment.

Diagnostic Challenges and Holistic Approaches: Overlapping symptoms of cognitive difficulties, emotional challenges, and sleep-related problems, Mattingly underscored the necessity for holistic diagnostic assessments. The session emphasized the danger of assuming a single chief complaint and advocated for comprehensive evaluations to unveil the nuanced landscape of ADHD and its comorbidities.
Preventive Impact: The session culminated in a study by Joseph Biederman, MD, demonstrating the preventive power of holistic ADHD care. The research revealed that such care significantly reduced the risk of secondary negative health outcomes, including depression, anxiety disorders, and substance-related disorders.

Session 2: ADHD 201 – Special Populations

Presented by David Goodman, MD, LFAPA

Hormones and ADHD Symptom Expression: David Goodman delved into the impact of ADHD in special populations, shedding light on the role of hormones in symptom expression. Notably, the session highlighted genetic overlaps between ADHD symptoms and premenstrual exacerbations, exploring the impact of estrogen fluctuations on dopamine receptor binding.
ADHD and Aging: Implications and Findings: Goodman’s presentation also explored ADHD’s impact on aging, revealing that symptoms tend to worsen postmenopausally. A study from Israel underscored ADHD as an independent risk factor for dementia, with psychostimulant medication demonstrating a protective effect.

Session 3: ADHD 201 – Psychosocial Treatments

Presented by Margaret Sibley, PhD

Promoting Motivational Engagement: Margaret Sibley emphasized the significance of psychosocial treatments and motivational engagement for ADHD individuals. Stressing the importance of tailored interventions, the session highlighted strategies for understanding and aligning with patients’ motivations, promoting collaborative engagement.
Tools for Discussion and Collaborative Engagement: Sibley introduced practical tools, such as a motivators sheet, to facilitate discussions and break down barriers. By acknowledging small steps forward and meeting patients where they are, Sibley advocated for a patient-centric approach to psychosocial interventions.

Session 4: ADHD 201 – Stimulant Preparations

Presented by Ann Childress, MD

Navigating the World of Stimulant Medications: APSARD president Ann Childress navigated the landscape of stimulant preparations, dissecting the differences between methylphenidates and amphetamines. Exploring over 30 stimulant options, the session outlined factors influencing the transition from methylphenidate to amphetamine and introduced newer stimulant treatments.
In-Depth Exploration of Stimulant Preparations: Childress delved into the unique characteristics of various stimulant preparations, discussing delivery systems, onset and offset of action, and duration. The session unveiled emerging treatments, including a transdermal amphetamine patch and a pro drug methylphenidate preparation with evening dosing capabilities.

Session 5: ADHD 201 – Nonstimulant Medications

Presented by Jeff Newcorn, MD

Expanding Treatment Horizons with Nonstimulants: Jeff Newcorn explored the role of nonstimulant medications, offering clinicians a broader spectrum of treatment options. With four nonstimulant medications approved for ADHD, the session outlined their usage either independently or in combination with stimulant medications.
Bifurcated Response to Atomoxetine and Viloxazine’s Emergence: Newcorn discussed the varied response to atomoxetine, emphasizing its effectiveness for a significant subset of patients. The approval of viloxazine ER for both children and adults was highlighted, with studies demonstrating its faster onset and potential to reduce or eliminate the need for stimulants in a majority of patients.

Conclusion: Integrating Insights for Enhanced ADHD Care

The ADHD 201 sessions at APSARD’s 2024 conference provided a rich tapestry of insights, from understanding the intricate relationships between ADHD and comorbid conditions to exploring diverse treatment modalities. Clinicians left armed with knowledge to navigate the complexities of ADHD, underscored by a commitment to holistic care, individualized treatment, and ongoing advancements in the field. The conference marked a significant milestone in global collaboration, setting the stage for continued progress in ADHD research and care.

Reference:

Biederman, J., DiSalvo, M., Fried, R., Woodworth, K. Y., Biederman, I., & Faraone, S. V. (2019). Quantifying the Protective Effects of Stimulants on Functional Outcomes in Attention-Deficit/Hyperactivity Disorder: A Focus on Number Needed to Treat Statistic and Sex Effects. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 65(6), 784–789. https://doi.org/10.1016/j.jadohealth.2019.05.015

Childress A, et al. Viloxazine ER (Qelbree) administered with psychostimulants in children and adolescents with attention-deficit/hyperactivity disorder: topline results of a phase IV safety trial. Poster presented at Psych Congress; September 6-10, 2023; Nashville, Tennessee.

de Jong, M., Wynchank, D. S. M. R., van Andel, E., Beekman, A. T. F., & Kooij, J. J. S. (2023). Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage. Frontiers in psychiatry, 14, 1306194. https://doi.org/10.3389/fpsyt.2023.1306194

Jaholkowski, P., Shadrin, A. A., Jangmo, A., Frei, E., Tesfaye, M., Hindley, G. F. L., Haram, M., Rahman, Z., Athanasiu, L., Bakken, N. R., Holen, B., Fominykh, V., Kutrolli, G., Parekh, P., Parker, N., Rødevand, L., Birkenæs, V., Djurovic, S., Frei, O., O’Connell, K. S., … Andreassen, O. A. (2023). Associations Between Symptoms of Premenstrual Disorders and Polygenic Liability for Major Psychiatric Disorders. JAMA psychiatry, 80(7), 738–742. https://doi.org/10.1001/jamapsychiatry.2023.1137

Levine, S. Z., Rotstein, A., Kodesh, A., Sandin, S., Lee, B. K., Weinstein, G., Schnaider Beeri, M., & Reichenberg, A. (2023). Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia. JAMA network open, 6(10), e2338088. https://doi.org/10.1001/jamanetworkopen.2023.38088

Mattingly, G., MD. (2024, January 25). Late breaking news from APSARD 2024 Conference. Psychiatric Times. https://www.psychiatrictimes.com/view/late-breaking-news-from-apsard-2024-conference

Newcorn, J. H., Sutton, V. K., Weiss, M. D., & Sumner, C. R. (2009). Clinical responses to atomoxetine in attention-deficit/hyperactivity disorder: the Integrated Data Exploratory Analysis (IDEA) study. Journal of the American Academy of Child and Adolescent Psychiatry, 48(5), 511–518. https://doi.org/10.1097/CHI.0b013e31819c55b2

Price, M. Z., & Price, R. L. (2023). Extended-Release Viloxazine Compared with Atomoxetine for Attention Deficit Hyperactivity Disorder. CNS drugs, 37(7), 655–660. https://doi.org/10.1007/s40263-023-01023-6

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