Lisdexamfetamine dimesylate (vyvanse), a prodrug stimulant for attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric condition that affects both children and adults. In a representative sample of children 8 to 15 years of age in the U.S., approximately 9% met the criteria for ADHD, as specified in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).1 In cross-national surveys, the prevalence of ADHD among children in other countries ranged from 5.8% in Canada to 11.2% in India.2 In children with ADHD, symptoms may be manifested as significant social, emotional, and academic problems, including low self-esteem, poor peer relationships, delinquency, and substance abuse. The persistency of ADHD from childhood into adulthood is often underappreciated. Increasingly, the literature clearly demonstrates that ADHD symptoms, particularly those of inattention and many associated impairments, persist into adulthood in a high proportion of cases.3–5 Approximately 65% of people with childhood ADHD continue to exhibit symptoms as adults.6 Results of the National Comorbidity Survey Replication (NCSR), the first definitive epidemiologic study of ADHD, estimated the prevalence of ADHD to be 4.4% among adults in the U.S., but only 10.9% of adults with ADHD had received treatment for it in the previous 12 months.7 In the World Health Organization World Mental Health Survey Initiative, which included respondents 18 to 44 years of age in 10 countries, estimates of ADHD prevalence averaged 3.4%, ranging from 1.2% in Spain to 7.3% in France.8 The validity of ADHD as a disorder in adults has been supported by evidence from studies of clinical correlates, family history, treatment response, and laboratory measures.9 Heritability plays a role, with 76% of ADHD cases having a genetic component.10 Neuroanatomic studies in children with ADHD have shown delayed maturation in the prefrontal cortex, an area known to be involved with executive function and working memory.11 Furthermore, structural imaging studies in children and adults with ADHD have identified smaller volumes in the frontal cortex, cerebellum, and subcortical structures.12 The effects of ADHD on deportment and school performance in children are well established. However, an analysis of the impact of ADHD on workplace productivity and costs to employers has focused on the need to increase the diagnosis and treatment of ADHD in adults.13 The study, conducted by Kessler et al. at a large manufacturing firm and published in 2009, found that ADHD was associated with a 4% to 5% reduction in on-the-job productivity, the equivalent of losing 10 to 12 work days in a 250-day work year. The cost to employers for lost work performance was estimated to be $4,336 per employee with ADHD, which translates to $8,241 per 100 workers, assuming a conservative 1.9% prevalence of adult ADHD.13 These findings suggest that treatment of this disabling condition in adults may have a substantial economic benefit to employers as well as to the patients themselves. Furthermore, an analysis of pharmacy and medical claims data obtained from a large managed care plan revealed that annual total costs for adults with ADHD were $3,020 per person, slightly more than the total annual cost for adults with seasonal allergies and less than those incurred by adults with depression or diabetes.14

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.