Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects both children and adults. It can present as persistent patterns of inattention, hyperactivity, and impulsivity. Managing ADHD often requires a comprehensive approach, including behavioral therapy and medications. There are multiple drug classes available to treat ADHD. In April 2021, the Food and Drug Administration (FDA) approved a medication, viloxazine, for the treatment of ADHD in pediatric patients 6 to 17 years of age. This blog will explore viloxazine’s role in ADHD treatment, how it works, and considerations for use.
Understanding ADHD
ADHD is characterized by symptoms such as difficulty sustaining attention, excessive fidgeting, and impulsive behavior. These symptoms can interfere with academic, occupational, and social functioning. Traditional treatment options include stimulant medications like methylphenidate and amphetamines, as well as non-stimulant medications such as atomoxetine and guanfacine.
How Does Viloxazine Work?
The way that viloxazine works to treat ADHD is unclear. However, it is thought to work through preventing the reuptake of norepinephrine. By increasing the levels of norepinephrine in the brain, viloxazine may help improve attention and reduce hyperactivity and impulsivity. Viloxazine may also modulate serotonin. Unlike traditional stimulant medications, viloxazine does not have the same potential for abuse and is associated with a different side effect profile. Viloxazine offers a non-stimulant option for pediatric patients who may not respond well to other treatments. It is supplied as extended release capsules that can be taken by mouth once daily.
Effectiveness of Viloxazine for ADHD
Studies showed that patients treated with viloxazine experienced significant improvements in core ADHD symptoms, including inattention, hyperactivity, and impulsivity, compared to those receiving a placebo.
Considerations for Use:
- Prescription Requirement: Viloxazine is available by prescription only and should be used under the guidance of a healthcare provider. It is not a controlled substance.
- Individualized Treatment: Treatment plans should be tailored to each patient’s specific needs, taking into account factors such as age, symptom severity, and response to other medications.
- Drug-Drug Interactions: Viloxazine cannot be taken with certain other medications. Your full medication regimen should be assessed by a healthcare provider before viloxazine therapy is started. Make sure to report all medications you are taking, including over-the-counter medications and supplements to your doctor.
- Potential Side Effects: Viloxazine is generally well-tolerated, but it can cause side effects in some individuals. Common side effects may include insomnia, decreased appetite, fatigue, headache, and gastrointestinal upset. It’s important for patients to communicate with their healthcare provider about any side effects they experience to ensure appropriate management and adjustments to the treatment plan.
Also, see our blog ADHD Medication Comparison: Stimulants vs Non-Stimulants
Conclusion
Viloxazine is one option in the arsenal of ADHD treatments. It offers patients a non-stimulant alternative with a unique mechanism of action. As with any medication, it is important for patients to work closely with their healthcare providers to develop a personalized treatment plan that meets their specific needs and to monitor for any potential side effects. With the FDA approval of viloxazine for ADHD, pediatric patients with ADHD have another tool to help manage their symptoms and improve their quality of life.
Resources:
1) QELBREE (viloxazine extended-release capsules) [package insert]. Rockville, MD: Supernus Pharmaceuticals, Inc; 2021.
2) Robinson CL, Parker K, Kataria S, Downs E, Supra R, Kaye AD, Viswanath O, Urits I. Viloxazine for the Treatment of Attention Deficit Hyperactivity Disorder. Health Psychol Res. 2022 Sep 23;10(3):38360. doi: 10.52965/001c.38360. PMID: 36168642; PMCID: PMC9501833.
3) Mathew BM, Pellegrini MV. Viloxazine. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576423/
