Lisdexamfetamine mesilate -: Treatment of attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a common, complex neuropsychiatric and behavioral disorder characterized by inattention, distractibility, hyperactivity and impulsivity. There are currently two classes of approved agents for ADHD: psychostimulants (e.g., methylphenidate and amphetamine) and the nonstimulant atomexetine. Psychostimulants appear to be the most effective agents, with improvement observed in the majority of patients. However, these agents are associated with a high liability for addiction and abuse. In an attempt to reduce this high risk, a series of d-amphetamine prodrugs were synthesized, from which lisdexamfetamine mesilate (NRP-104, SPD-489, Vyvanse (TM)) emerged. Lisdexamfetamine is inactive until hydrolyzed in the digestive tract, after which it exhibits a prolonged duration of action. Moreover, the agent appears to have less abuse potential than d-amphetamine. Lisdexamfetamine was approved by the FDA in February 2007 for the treatment of ADHD in children, and it is being evaluated clinically for use in adults.