Pubmed (TDAH) du 16/05/26
1. Baweja R, Waschbusch DA, Petrovic-Dovat L, Baweja R, Singh B, Singh MK, Waxmonsky JG. Treatment patterns and comparative clinical outcomes of ADHD medications in adolescents and young adults with comorbid major depressive disorder. J Affect Disord;2026 (May 16);410:121967.
OBJECTIVE: This study examined how comorbid major depressive disorder (MDD) influences ADHD treatment patterns and compared the associations between specific ADHD medication classes and clinical outcomes in adolescents and young adults aged 10-24 years. METHODS: This retrospective comparative cohort study analyzed electronic health records from the TriNetX US Collaborative Network (2010-2025). Among 1,026,253 patients with ADHD, 223,665 (21.8%) had comorbid MDD. Propensity score matching yielded balanced cohorts (ADHD-only and ADHD + MDD; 159,259 per cohort). ADHD treatment patterns were assessed prospectively over 12 months. Within the ADHD + MDD cohort, Cox proportional hazards regression examined whether CNS stimulants versus non-stimulants (including bupropion) differed in their associations with suicidality, antipsychotic initiation, mood stabilizer initiation, and intensive healthcare utilization. RESULTS: Compared with ADHD-only, ADHD + MDD was associated with higher overall ADHD medication prescribing, driven primarily by non-stimulants, particularly bupropion (RR 3.75, 95% CI 3.58-3.92), while racial and ethnic minority patients received fewer ADHD medications. New CNS stimulant prescriptions declined following MDD diagnosis (RR 0.92, 95% CI 0.91-0.93), especially in non-psychiatric settings. Among ADHD + MDD, CNS stimulants were associated with more favorable clinical outcomes compared with non-stimulants (aHRs 0.49-0.68). Bupropion demonstrated outcomes broadly comparable to CNS stimulants for suicidality and mood stabilizer initiation. CONCLUSIONS: Comorbid MDD is associated with substantial shifts in ADHD medication prescribing toward non-stimulants, yet CNS stimulants were associated with the most favorable clinical outcomes, with bupropion emerging as a clinically meaningful alternative when a non-stimulant is considered. These findings should be validated in future longitudinal prospective studies and randomized clinical trials.
Lien vers le texte intégral (Open Access ou abonnement)
2. Dayan H, Khoury M, Krivine E, Bloch Y. Neurodiversity-affirming SEA for ADHD: evaluation of an online program for parents and children in the ultra-orthodox Jewish community. Eur Child Adolesc Psychiatry;2026 (May 16)
In recent years, there has been growing recognition of the importance of affirmative interventions for neurodiverse individuals. However, empirical evidence regarding such interventions in ADHD remains limited, particularly within conservative-religious cultures. The present study examined the effectiveness of a culturally sensitive, online psychosocial intervention for parents and children. The intervention is grounded in a salutogenic existential approach (SEA), an integrative framework that conceptualizes ADHD as a tension between a tendency toward freedom and reality demands (necessity), and aims to enhance sense of coherence (SOC), autonomous motivation, and support for neurodivergent identity while integrating the medical model with the neurodiversity framework. The study included 427 participants from the Ultra-Orthodox Jewish (UOJ) community in Israel: 311 in the intervention group and 116 in the control group. The intervention group participated in a 12-session online program that combined weekly lectures and practice for parents, along with audio story episodes and a workbook for children. Assessments were conducted before and after the intervention or waiting period using parent-report questionnaires: ADHD symptoms and comorbid difficulties (VADPRS), child functioning (WFIRS-P), and parental self-efficacy (TOPSE). The intervention group demonstrated a significant reduction in ADHD symptoms, behavioral problems, and anxiety/depression, as well as significant improvements in child functioning and parental self-efficacy. In the control group, only a minimal reduction in ADHD symptoms was observed, with no changes in the other domains. Between-group differences remained significant after controlling for background variables. The findings indicate the potential of an SEA-based intervention to improve parent and child functioning among individuals with ADHD symptoms in the UOJ community, and highlight the contribution of SEA as an integrative model for addressing ADHD.
Lien vers le texte intégral (Open Access ou abonnement)
3. Hwang G, Yi H, Pinkhasov A. Strategies for Substituting ADHD Medications During Stimulant Shortages. J Pharm Pract;2026 (May 16):8971900261450836.
Stimulant shortages, driven by manufacturing delays, regulatory production quotas, and rising demand, have created significant challenges in the treatment of attention-deficit/hyperactivity disorder. This review provides a systematic framework for medication substitution during shortages, including dose equivalence table and conversion formulas. Critical considerations guiding substitutions include pharmacological distinctions between amphetamine (AMP) and methylphenidate (MPH), isomer composition, dose equivalence, and duration of action. Nonstimulant agents such as atomoxetine and α2-adrenergic agonists are reviewed with attention to their efficacy, tolerability, need for gradual titration, and delayed onset. Patient-specific factors, including age, psychiatric comorbidities, substance use history, and cardiovascular risks, remain essential when selecting alternatives. Systematic monitoring is emphasized to ensure effectiveness and treatment safety during transitions. By integrating pharmacological and patient-centered considerations, this review provides a practical approach for clinicians to maintain treatment continuity during stimulant shortages.
