Akili presents new real-world data from therapeutic ADHD video game

Akili has new data from its childhood hyperactivity therapeutic video game EndeavorRx, as the company builds a case for the technology with longer-term trial data.

The company announced several new data readouts, including outcomes data from the STARS-Adjunct trial, a multi-site open-label study testing EndeavorRx on impairments in daily life in children with attention-deficit/hyperactivity disorder (ADHD).

EndeavorRx is a therapeutic video game approved in the US and Europe in June and has been developed by one of a group of companies founded by PureTech, which retains a 34% stake in the venture.

The game is used with other treatments such as clinician-directed therapy, medication and education to treat the common disorder.

The game is designed to target and activate neural systems, by presenting sensory stimuli and motor challenges to improve cognitive functioning.

Data was presented at the American Academy of Child and Adolescent Psychiatry annual meeting, which has gone virtual because of the COVID-19 pandemic.

Figures revealed two-thirds of parents reported real-world improvements in a child’s ADHD-related impairments following two months of treatment, both when used alone or alongside stimulants.

Improvements in the ADHD Impairment Rating Scale (IRS) were statistically significant compared to baseline and were similar in magnitude regardless of whether or not children were taking stimulant medication.

More than a third of children no longer showed attention impairment on at least one measure of objective attention following treatment.

Analyses across four studies in paediatric ADHD showed that overall 34.5% of children moved into the normative range on at least one measure of attention following four weeks of EndeavorRx treatment.

Early exploratory evidence showed children who improved in attention functioning following treatment also improved their maths and reading skills.

The STARS-ADHD Adjunct study was a three-month open-label, multi-site study of EndeavorRx in 206 paediatric participants aged 8-14 years with a diagnosis of ADHD, across two cohorts: 130 children who were taking ADHD stimulant medications and 76 children who were not taking ADHD medications for the duration of the study.

Children completed one month of treatment with EndeavorRx, formerly known as AKL-T01, followed by a one-month pause and then another month on treatment.

The primary outcome measure of the study was the change from baseline after one month in the Impairment Rating Scale (IRS) for each cohort.

Secondary outcome measures included the ADHD Rating Scale (ADHD-RS), Test of Variables of Attention (TOVA), Clinical Global Impression – Improvement Scale (CGI-I), as well as exploratory outcomes of academic performance measures (TOSREC, MFaCTS).

 

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Retired NFL Linebacker Overcomes ADHD, Invests in Mental Health Platform Done

October is ADHD Awareness Month, and retired NFL linebacker J.T. Thomas wants people to know that it is okay to get help for the treatment of attention deficit hyperactivity disorder (ADHD). As a person with ADHD, J.T. Thomas knows how important getting help is, and why overcoming obstacles such as stigma, access to care and improper diagnosis are so important.
“Whether competing in the NFL, or in life, many of us feel that we can’t show weakness,” says Thomas. “Unfortunately, this way of thinking has kept millions of adults and children from getting the treatment they need. When I finally sought treatment in 2013, I learned how to turn my ADHD into a strength by better managing it. Getting help was the best thing I ever did.”
J.T. Thomas is advocating for greater awareness regarding diagnosis and treatment options for ADHD because he believes that “knowing and treating” can be life changing. This is what led him and others including David Sacks’ Craft Ventures, Dave Morin’s Offline Ventures and NFL Hall of Famer Joe Montana to invest in ADHD treatment platform Done. Done is the first telehealth platform created specifically for people looking to get help with ADHD.
“I travel a lot, and this makes it very difficult to maintain adherence to traditional, in-person treatment,” added Thomas. “A friend told me about telehealth, and that’s when I found Done. They were focused on ADHD 100%, so I reached out to them and started getting help. I enjoyed the service so much, I asked if I could invest in it.”
Done was founded in 2019 and is led by a 13 person team of former Facebook, Stanford University and Kaiser Permanente professionals. Done, which is making its public debut during ADHD Awareness Month, currently has a team of 25 clinicians available in *11 states.
Done is focused specifically on ADHD because many on the team either have ADHD, or have family and friends with ADHD. As such, Done’s staff fully understands the potential obstacles associated with ADHD.
The primary function for physicians is to enhance health and alleviate suffering. Sadly, in the real world, there are many barriers to the realization of these goals. Medical knowledge alone cannot remove the obstacles, for they are social, political, economic and organizational. This is especially true when it comes to the treatment of ADHD.
“In my career as a psychiatrist, I have been particularly affected by the barriers to care created by the stigma attached to the medical disorders artificially categorized as mental,” states Done Clinical President Dr. David Brody. “The care of all psychiatric disorders is severely affected by this stigma, which takes different forms depending on the specific disorder, but is always destructive. In the case of ADHD, the stigma includes the ideas that it is not real, not severe or serious, and that people seeking treatment for it are drug seeking or looking for an easy way. These stereotypes could not be further from the truth, and that’s why in addition to treatment, at Done we are focused on awareness.”
Done is here to combat these stereotypes, and is working to remove barriers to treatment such as requirements and expectations about frequency of visits, documentation, medication choice and choice of provider. Regulations regarding treatment vary tremendously state-to-state, which is primarily due to the regulatory climate surrounding the medications used for first-line treatment of the disorder. This often forces patients to end treatment, especially if they live far from their provider’s office or have multiple career and family responsibilities.
As a flexible and more affordable platform, Done is well on the way to achieving a more effective and patient-friendly system for ADHD treatment. However, much remains to be “done.”
Priorities for Done include recruitment of additional clinicians for its rapidly expanding organization, improved integration with pharmacies and pharmaceutical manufacturers, improvement of regulations affecting patient care, education of both the general public and the medical community on the reality of ADHD and the falseness of stigmatizing ideas, and streamlining the platform to deal with the roadblocks and inefficiencies that stem from that stigma.
*Done offers services to residents of California, Florida, Hawaii, Indiana, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Texas and Washington.

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Retired NFL Linebacker Overcomes ADHD, Invests in Mental Health Platform Done

October is ADHD Awareness Month, and retired NFL linebacker J.T. Thomas wants people to know that it is okay to get help for the treatment of attention deficit hyperactivity disorder (ADHD). As a person with ADHD, J.T. Thomas knows how important getting help is, and why overcoming obstacles such as stigma, access to care and improper diagnosis are so important.
“Whether competing in the NFL, or in life, many of us feel that we can’t show weakness,” says Thomas. “Unfortunately, this way of thinking has kept millions of adults and children from getting the treatment they need. When I finally sought treatment in 2013, I learned how to turn my ADHD into a strength by better managing it. Getting help was the best thing I ever did.”
J.T. Thomas is advocating for greater awareness regarding diagnosis and treatment options for ADHD because he believes that “knowing and treating” can be life changing. This is what led him and others including David Sacks’ Craft Ventures, Dave Morin’s Offline Ventures and NFL Hall of Famer Joe Montana to invest in ADHD treatment platform Done. Done is the first telehealth platform created specifically for people looking to get help with ADHD.
“I travel a lot, and this makes it very difficult to maintain adherence to traditional, in-person treatment,” added Thomas. “A friend told me about telehealth, and that’s when I found Done. They were focused on ADHD 100%, so I reached out to them and started getting help. I enjoyed the service so much, I asked if I could invest in it.”
Done was founded in 2019 and is led by a 13 person team of former Facebook, Stanford University and Kaiser Permanente professionals. Done, which is making its public debut during ADHD Awareness Month, currently has a team of 25 clinicians available in *11 states.
Done is focused specifically on ADHD because many on the team either have ADHD, or have family and friends with ADHD. As such, Done’s staff fully understands the potential obstacles associated with ADHD.
The primary function for physicians is to enhance health and alleviate suffering. Sadly, in the real world, there are many barriers to the realization of these goals. Medical knowledge alone cannot remove the obstacles, for they are social, political, economic and organizational. This is especially true when it comes to the treatment of ADHD.
“In my career as a psychiatrist, I have been particularly affected by the barriers to care created by the stigma attached to the medical disorders artificially categorized as mental,” states Done Clinical President Dr. David Brody. “The care of all psychiatric disorders is severely affected by this stigma, which takes different forms depending on the specific disorder, but is always destructive. In the case of ADHD, the stigma includes the ideas that it is not real, not severe or serious, and that people seeking treatment for it are drug seeking or looking for an easy way. These stereotypes could not be further from the truth, and that’s why in addition to treatment, at Done we are focused on awareness.”
Done is here to combat these stereotypes, and is working to remove barriers to treatment such as requirements and expectations about frequency of visits, documentation, medication choice and choice of provider. Regulations regarding treatment vary tremendously state-to-state, which is primarily due to the regulatory climate surrounding the medications used for first-line treatment of the disorder. This often forces patients to end treatment, especially if they live far from their provider’s office or have multiple career and family responsibilities.
As a flexible and more affordable platform, Done is well on the way to achieving a more effective and patient-friendly system for ADHD treatment. However, much remains to be “done.”
Priorities for Done include recruitment of additional clinicians for its rapidly expanding organization, improved integration with pharmacies and pharmaceutical manufacturers, improvement of regulations affecting patient care, education of both the general public and the medical community on the reality of ADHD and the falseness of stigmatizing ideas, and streamlining the platform to deal with the roadblocks and inefficiencies that stem from that stigma.
*Done offers services to residents of California, Florida, Hawaii, Indiana, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Texas and Washington.

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Eating to Block Lead Absorption

Intake of certain nutrients has been associated with lower lead levels in the body. For example, women with higher intake of thiamine, also called vitamin B1, tended to have lower blood lead levels, and the same was found for lead-exposed steel workers—and not just with thiamine, as “content of dietary fiber, iron, or thiamine intake each correlated inversely with blood lead concentrations in workers…” The thinking is that the fiber might glom onto the lead and flush it out of the body, the iron would inhibit the lead absorption, and the thiamine may accelerate lead removal through the bile. So, researchers suggest that eating lots of iron, fiber and especially thiamine-rich foods “may induce rapid removal and excretion of the lead from the tissues.” But thiamine’s never been put to the test by giving it to people to see if their lead levels drop. The closest I could find is a thiamine intervention for lead-intoxicated goats.
 

And much of the fiber data are just from test tube studies. In one, for example, researchers used simulated intestinal conditions, complete with “flasks” of feces, and both soluble and insoluble dietary fiber were able to bind up large amounts of mercury, cadmium, and lead to such an extent that they may have been able to block absorption in the small intestine. But, when our good gut flora then eat the fiber, some of the heavy metals may be re-released down in the colon, so it’s not completely fail safe. And, as with thiamine, there haven’t been controlled human studies.

But where is thiamine found? At 1:47 in my video How to Lower Lead Levels with Diet: Thiamine, Fiber, Iron, Fat, Fasting?, I feature a list of some of the healthiest sources of thiamine-rich foods that also contain fiber, which include highly concentrated, super healthy foods like beans and greens—foods we should all be eating anyway. So, even if thiamine- and fiber-rich foods don’t actually lower lead levels, we’ll still end up healthier.

What happened when iron was put to the test? It failed to improve the cognitive performance of lead-exposed children and failed to improve behavior or ADH symptoms, which is no surprise, because it also failed to bring down lead levels, as did zinc supplementation. It turns out that while iron may limit the absorption of lead, “it may also inhibit excretion of previously absorbed lead” that’s already in your body. What’s more, iron may not even inhibit lead absorption in the first place. That was based on rodent studies, and it turns out we’re not rodents.

We get the same story with zinc. It may have helped to protect rat testicles, but didn’t seem to help human children. “Nevertheless, iron is routinely prescribed in children with lead poisoning.” But, “given the lack of scientific evidence supporting the use of iron [supplementation] in…children with lead poisoning, its routine use should be re-examined.” Though, obviously, supplementation may help if you have an iron deficiency.

High fat intake has been identified as a nutritional condition that makes things worse for lead-exposed children. In fact, dietary fat has been associated with higher lead levels in cross-sectional, snapshot-in-time type studies, and there is a plausible biological mechanism: Dietary fat may boost lead absorption by stimulating extra bile, which in turn may contribute to lead absorption, but you really don’t know until you put it to the test.

In addition to testing iron, researchers also tested fat. They gave a group of intrepid volunteers a cocktail of radioactive lead and then, with a Geiger counter, measured how much radiation the subjects retained in their bodies. Drinking the lead with iron or zinc didn’t change anything, but adding about two teaspoons of vegetable oil boosted lead absorption into the body from about 60 percent up to around 75 percent, as you can see at 4:17 in my video.

The only thing that seemed to help, dropping lead absorption down to about 40 percent, was eating a light meal with the lead drink. What was the meal? Coffee and a donut. I think this is the first donut intervention I’ve ever seen with a positive outcome! Could it have been the coffee? Unlikely, because if anything, coffee drinking has been associated with a tiny increase in blood lead levels. If fat makes things worse, and the one sugar they tried didn’t help, the researchers figured that what made the difference was just eating food—any food—and not taking in lead on an empty stomach. And, indeed, if you repeat the study with a whole meal, lead absorption doesn’t just drop from 60 percent to 40 percent—it drops all the way down to just 4 percent! That’s extraordinary. That means it’s 15 times worse to ingest lead on an empty stomach.

Lead given 12 hours before a meal was absorbed at about 60 percent, so most of it was absorbed. When the same amount of lead was given three hours after a meal and also seven hours after a meal, most of it was absorbed at those times, too. But, if you get some food in your stomach within a few hours of lead exposure, you can suppress the absorption of some or nearly all of the lead you ingested, which you can see at 0:11 in my video How to Lower Lead Levels with Diet: Breakfast, Whole Grains, Milk, Tofu?.

This is why it’s critical to get the lead out of our tap water. Although it’s estimated that most of our lead exposure comes from food, rather than water, it’s not what we eat that matters, but what we absorb. If 90 percent of the lead in food is blocked from absorption by the very fact that it’s in food, 10 to 20 times more lead could be absorbed into your bloodstream simply by consuming the same amount of lead in water drank on an empty stomach.

And, since children empty their stomachs faster than adults because kids “have more rapid gastric emptying times,” the timing of meals may be even more important. With little tummies emptying in as few as two hours after a meal, offering midmorning and midafternoon snacks in addition to breakfast and regular meals may cut down on lead absorption in a contaminated environment. And, of course, we should ensure that children wash their hands prior to eating.

So, do preschoolers who eat breakfast have lower levels of lead in their blood? In the first study of its kind, researchers found that, indeed, children who ate breakfast regularly did appear to have lower lead levels, supporting recommendations to provide regular meals and snacks to young children at risk for lead exposure.

Is there anything in food that’s particularly protective? Researchers tested all sorts of foods to find out, and it turns out the “effect of a meal was probably largely due to its content of calcium and phosphate salts but lead uptake was probably further reduced by phytate which is plentiful in whole cereals,” but if calcium and phosphates are protective, you’d think dairy would work wonders. And, indeed, they started giving milk “to workers to prevent lead exposure” ever since calcium was shown to inhibit lead absorption in rats. But, in humans, there’s something in milk that appeared to increase lead uptake, and it wasn’t the fat because they found the same problem with skim milk.

“For over a century milk was recommended unreservedly to counteract lead poisoning in industry,” but this practice was abandoned in the middle of the last century once we learned that milk’s “overall effect is to promote the absorption of lead from the intestinal tract.” What’s the agent in milk that promotes the absorption of lead from the gut? It may be the milk sugar, lactose, though the “mechanism by which lactose enhances lead absorption is not clear.”

The bottom line? “In the past…milk was used as a prophylactic agent to protect workers in the lead industry. Recent studies, however, suggest that this practice is unjustified and may even be harmful.” So, giving people whole grains may offer greater protection against lead uptake.

However, the most potently calcium and phytate-rich food would be tofu. Isolated soy phytonutrients may have a neuroprotective effect, at least this was the case in petri dish-type studies. As you can see at 3:45 in my video, if you add a little lead to nerve cells, you can kill off about 40 percent of them, but if you then give more and more soy phytonutrients, you can ameliorate some of the damage. This is thought to be an antioxidant effect. If you add lead to nerve cells, you can get a big burst of free radicals, but less and less as you drip on more soy compounds.

Nevertheless, even if this worked outside of a lab, cutting down on the toxic effects of lead is nice, but cutting down on the levels of lead in your body is even better. “Because tofu has high content of both calcium and phytic acid phytate…it is biologically plausible that tofu may inhibit lead absorption and retention, thus reducing blood lead levels.” But you don’t know, until you put it to the test.

Tofu consumption and blood lead levels were determined for about a thousand men and women in China. For every nine or so ounces of tofu consumed a week, there appeared to be about four percent less lead in their bloodstream. Those who ate up to two and a half ounces a day had only half the odds of having elevated lead levels, compared to those eating less than about nine ounces a week. Those consuming nearly four ounces a day appeared to cut their odds by more than 80 percent. This was just a cross-sectional study, or snapshot in time, so it can’t prove cause and effect. What you need is an interventional study where you randomize people into two groups, giving half of them some food to see if it drives down lead levels. I cover this in my video Best Food for Lead Poisoning: Chlorella, Cilantro, Tomatoes, Moringa?.


Where does all this lead exposure come from anyway? Check out the first five videos on this series:

For more about blocking lead absorption, as well as what to eat to help rid yourself of the lead you’ve already built up, see:

Or, even better, don’t get exposed in the first place. Find out more in these videos:

Some of my other videos on lead include:

And what about lead levels in women? See:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Adult Exposure to Lead

“Children in approximately 4 million households in the United States are being exposed to high levels of lead.” As I discuss in my video The Effects of Low-Level Lead Exposure in Adults, “Despite the dramatic decline in children’s blood-lead concentrations over the decades, lead toxicity remains a major public health problem”—and not just for children. Yes, lead is “a devastating neurotoxin,” with learning disabilities and attention deficits in children beginning around blood lead levels of 10 mg/dL, which is when you start seeing high blood pressure and nerve damage in adults, as you can see at 0:41 in my video. But, the blood levels in American adults these days are down around 1 mg/dL, not 10 mg/dL, unless you work or play in an indoor firing range, where the lead levels in the air are so high that more than half of recreational target shooters have levels over 10 mg/dL or even 25 mg/dL.

In fact, even open-air outdoor ranges can be a problem. Spending just two days a month at such a range may quadruple blood lead levels and push them up into the danger zone. What if you don’t use firearms yourself but live in a house with someone who does? The lead levels can be so high that the Centers for Disease Control and Prevention advises those who go to shooting ranges to take “measures to prevent take-home exposure including showering and changing into clean clothes after shooting…, storing clean clothes in a separate bin from contaminated clothing, laundering of non disposable outer protective clothing…and leaving at the range shoes worn inside the firing range,” among other actions. Even if none of that applies and your blood levels are under 10 mg/dL, there is still some evidence of increased risk of hand tremors, high blood pressure, kidney damage, and other issues, as you can see at 1:44 in my video. But what if you’re down around a blood lead level of 1 mg/dL, like most people?

“Blood lead levels in the range currently considered acceptable are associated with increased prevalence of gout,” a painful arthritis. In fact, researchers found that blood levels as low as approximately 1.2 mg/dL, which is close to the current American average, can be associated with increased prevalence of gout. So, this means that “very low levels of lead may still be associated with health risks,” suggesting “there is no such thing as a ‘safe’ level of exposure to lead.”

Where is the lead even coming from? Lead only circulates in the body for about a month, so if you have lead in your bloodstream, it’s from some ongoing exposure. Most adults don’t eat peeling paint chips, though, and autos aren’t fueled by leaded gas anymore. There are specific foods, supplements, and cosmetics that are contaminated with lead (and I have videos on all those topics), but for most adults, the source of ongoing lead exposure is from our own skeleton. I just mentioned that lead only circulates in the body for about a month. Well, where does it go after that? It can get deposited in our bones. “More than 90% of the total body lead content resides in the bone, where the half-life is decades long,” not just a month. So, half or more of the lead in our blood represents lead from past exposures just now leaching out of our bones back into our bloodstream, and this “gradual release of lead from the bone serves as a persistent source of toxicity long after cessation of external exposure,” that is, long after leaded gasoline was removed from the pumps for those of us that who were around back before the 1980s.

So, the answer to where the lead comes from is like Pogo’s We’ve met the enemy and he is us or that classic horror movie scene where the call is coming from inside the house.

The amount of lead in our bones can actually be measured, and research shows higher levels are associated with some of our leading causes of death and disability, from tooth decay and miscarriages to cognitive decline and cataracts. “Much of the lead found in adults today was deposited decades ago. Thus, regulations enacted in the 1970s were too late” for many of us, but at least things are going in the right direction now. The “dramatic societal decreases” in blood lead in the United States since the 1970s have been associated with a four- to five-point increase in the average IQs of American adults. Given that, a “particularly provocative question is whether the whole country suffered brain damage prior to the 1980 decreases in blood lead. Was ‘the best generation’ really the brain damaged generation?”

I’m such a sucker for science documentaries, and my favorite episode of Cosmos: A Spacetime Odyssey was The Clean Room, which dealt with this very issue. Trivia: Carl Sagan was my next-door neighbor when I was at Cornell!

If you want to find out How the Leaded Gas Industry Got Away with It, check out that video. How the Lead Paint Industry Got Away with It is similarly scandalous. Lead in Drinking Water offers the modern-day tale of what happened in Flint, Michigan, and “Normal” Blood Lead Levels Can Be Toxic explores the impacts on childhood development.


I close out this extended video series on lead with information on what we can do about it:

Interested in learning more about lead being absorbed and released in our bones, and how calcium supplements may affect that process? See The Rise in Blood Lead Levels at Pregnancy and Menopause and Should Pregnant Women Take Calcium Supplements to Lower Lead Levels?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Recognising The Warning Signs Of ADHD

The Attention deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that affects children and teens. ADHD is mostly recognised during the early school years and can also continue into adulthood. ADHD includes symptoms such as inattentiveness, hyperactivity, and impulsiveness. Often referred to as attention deficit disorder (ADD), ADHD is one of the most commonly diagnosed mental disorders, it is neither preventable nor cured. 

It is observed that boys are most affected with ADHD as compared to girls. As per the NCBI, ADHD affects up to 1 in 20 children in the USA. Among the seven major markets (the United States, EU5 (France, Germany, Italy, Spain, the UK) and Japan), the US accounted for about 28% of the total ADHD prevalent cases in 2017. 

The process of identifying ADHD in children includes several steps. During the growing up, children often face difficulties in listening, following routine, paying attention, etc. but in the case of ADHD it is much harder for kids to maintain normal functioning. If goes undiagnosed, it affects their learning skills, social relationships and overall development process. Most of the cases are diagnosed during the age of 6-12 years due to the visible signs and symptoms such as behaviour and activity at different settings such as school, home or at other concerned places. However, the symptoms of ADHD overlap with other many medical conditions such as Depression, Conduct disorder, Anxiety disorders, Bipolar disorder and others; and these physiological and emotional behaviors are generally treated along with ADHD.

The signs and symptoms of ADHD are categorised into two subtypes namely Inattentive symptoms and Hyperactive (impulsive) symptoms. However a third subtype which is a combination of both ADHD might also occur. 

Inattentive symptoms of ADHD includes:

  • The kids affected with Inattentive symptoms find it difficult to keep their attention and concentration on tasks or play. 
  • The kids didn’t pay attention to details, which results in careless mistakes at work, school homework or any other related activity.
  • Forget or lose necessary things to perform essential tasks and activities.
  • The affected kids often find it difficult to properly organise an activity and track of time.
  • Difficulty in following instructions (misinterpreting of instructions), which make the completion of tasks difficult or take more time than required. 
  • Easy distraction by noise, unrelated thoughts or any other such stimuli.
  • Lose track of daily activities, appointments, and schedules.

Hyperactivity and impulsivity symptoms of ADHD includes

  • Fidgeting and squirming is one of the major signs of ADHD, the affected kids find it difficult to sit still or remain restless.
  • Interrupts or intrudes others on their work. 
  • Constant physical movement, touching and grabbing objects. 
  • Running, jumping, and climbing even in the situation when it is not expected to.
  • Interrupt in between conservations or activity.
  • Hard to wait for their turn.
  • Talking excessively during an event, activity or game.
  • Impulsive decision making without thinking. 

Usually the symptoms of ADHD improve with age. However, some of the symptoms that were present during teenage might persist during adulthood. As per the NHS, UK, ‘by the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of ADHD symptoms, and 65% still have some symptoms that affect their daily lives”. Forgetfulness, mood swings, irritability, carelessness, lack in time management and organisational skills, trouble in multitasking, impulsivity, hyperfocus and emotional sensitivity are some of the key symptoms of ADHD in adults. At the latter age it becomes harder for the individual with ADHD to handle the personal, professional and family matters. 

As of now it is not clear what exactly causes ADHD. Genetics, environmental toxins (such as exposure to lead), premature birth, brain function and structure are considered as possible risk factors for ADHD. Moreover, the treatment option for ADHD includes behavior therapy, education (training), parent coaching and intake of certain medicine that slows down the ADHD symptoms. For the children below age 6,  behavior therapy is considered as the first step for managing symptoms of ADHD prior medication use. The behavior therapy for ADHD focuses on learning and adopting positive behaviors. Along with medications that include Stimulants, non-stimulants and antidepressants, behavioral therapy, a healthy diet, proper sleep, regular exercise, limited use of gadgets (such as mobiles, TVs, computers) and parental support can be helpful in managing ADHD symptoms. 

However, the medication available in the market does not provide a permanent cure for ADHD. Medications can only help in managing the symptoms of ADHD. Research is ongoing to find a cure for the disorder. Although several pharma players at the global level such as AEVI Genomic Medicine, Amarantus Bioscience, NLS Pharma, Sumitomo Dainippon Pharma, Supernus Pharmaceuticals, Genentech, Otsuka pharmaceuticals, and RespireRx pharmaceuticals are involved in the therapeutic development of ADHD, the ADHD market needs a standard therapy. 

Conclusively, the launch of therapies in the pipeline, ongoing R&D, and heightened awareness about the disorder shall change the ADHD treatment landscape in the coming years.

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