Viloxazine in the Treatment of Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children. Over the past twenty years, research on the disease and its characteristics and treatment options has grown exponentially. The first-line pharmacologic treatment of ADHD is stimulants, which have a response rate of ~70%. With the support of four phase 3 studies involving more than 1,000 pediatric patients 6–17 years old, the FDA has approved the non-stimulant, serotonin-norepinephrine modulating agent (SNMA) viloxazine in an extended-release capsule (viloxazine ER) for treatment of ADHD in children aged 6–17. Viloxazine modulates serotonergic activity as a selective 5-HT22B receptor antagonist and 5-HT2C receptor agonist and moderately inhibits norepinephrine transporter (NET), thus blocking the reuptake of norepinephrine. A phase 2 study by Johnson et al. found that once-daily dosing of viloxazine ER in 200, 300, or 400 mg dosages in children with ADHD for eight weeks resulted in a statistically significant reduction of ADHD-RS-IV total score. A post hoc analysis of data from four phase 3, randomized, placebo-controlled, double-blind, three-arm, clinical trials by Faraone et al. found that early response to viloxazine treatment, defined as a change in ADHD-RS-5 total score at week 2, best predicted the treatment response at week 6 [75% positive predictive power (PPP), 75% sensitivity]. Proper treatment of the symptoms and comorbidities associated with ADHD is crucial in improving a patient\u27s quality of life, cognitive function, and overall therapeutic outcomes. Viloxazine\u27s mechanism of action, clinical effects, and limited side effect profile point toward the drug\u27s relevance in the treatment of ADHD

Viloxazine in the Treatment of Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children. Over the past twenty years, research on the disease and its characteristics and treatment options has grown exponentially. The first-line pharmacologic treatment of ADHD is stimulants, which have a response rate of ~70%. With the support of four phase 3 studies involving more than 1,000 pediatric patients 6–17 years old, the FDA has approved the non-stimulant, serotonin-norepinephrine modulating agent (SNMA) viloxazine in an extended-release capsule (viloxazine ER) for treatment of ADHD in children aged 6–17. Viloxazine modulates serotonergic activity as a selective 5-HT22B receptor antagonist and 5-HT2C receptor agonist and moderately inhibits norepinephrine transporter (NET), thus blocking the reuptake of norepinephrine. A phase 2 study by Johnson et al. found that once-daily dosing of viloxazine ER in 200, 300, or 400 mg dosages in children with ADHD for eight weeks resulted in a statistically significant reduction of ADHD-RS-IV total score. A post hoc analysis of data from four phase 3, randomized, placebo-controlled, double-blind, three-arm, clinical trials by Faraone et al. found that early response to viloxazine treatment, defined as a change in ADHD-RS-5 total score at week 2, best predicted the treatment response at week 6 [75% positive predictive power (PPP), 75% sensitivity]. Proper treatment of the symptoms and comorbidities associated with ADHD is crucial in improving a patient\u27s quality of life, cognitive function, and overall therapeutic outcomes. Viloxazine\u27s mechanism of action, clinical effects, and limited side effect profile point toward the drug\u27s relevance in the treatment of ADHD

Eagle Syndrome: Pathophysiology, Differential Diagnosis and Treatment Options

The present investigation summarizes relevant symptoms, differential diagnosis, imaging, and treatment options of Eagle Syndrome. A comprehensive literature review of peer-reviewed literature was employed utilizing most relevant databases. The diagnoses of Eagle Syndrome have recently increased because of increased awareness of physicians of Eagle Syndrome and the earlier identification of the cardinal symptoms of the disease. The most important symptoms are dysphagia in the setting of cervical neck pain, but there is a wide variety of symptomatology that make Eagle Syndrome a challenge to recognize and diagnose clinically. CT scan continues to be the standard of care for diagnosing Eagle Syndrome and CT Angiography has an important role in aiding diagnosis as well. Medical treatment options include steroids, antidepressants, and anticonvulsants however not all cases of Eagle Syndrome can be managed medically. Surgical approaches are varied but typically are either extraoral or transoral. This report aims to update providers on the important diagnostic criteria of Eagle Syndrome and how physicians can develop a treatment plan that addresses all the symptoms of patients with Eagle Syndrome because it can be treated safely and appropriately