Can Viloxazine Help Children and Teens with ADHD Improve Their School Performance?

What you need to know

Viloxazine, a new non-stimulant ADHD medication, showed promise in improving learning and school problems in children and teens with ADHD
The medication led to significant improvements in parent-reported measures of school functioning and learning difficulties
Benefits were seen in both behavioral issues at school and academic performance, though changes in academic performance may take longer to appear
While the medication helped many children, individual responses varied - some children showed large improvements while others showed little change

Background on ADHD and School Difficulties

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition that affects many children’s ability to focus, control impulses, and regulate activity levels. These symptoms often create challenges for children with ADHD in school settings. Research has consistently shown that children with ADHD tend to struggle more academically compared to their peers without ADHD.

Some key school-related difficulties associated with ADHD include:

Lower academic achievement scores
Higher rates of grade retention (repeating a grade)
Increased likelihood of dropping out of high school
Greater need for special education services
Problems completing and turning in homework
Disruptive behaviors in the classroom

Given these challenges, finding effective treatments to help children with ADHD succeed in school is crucial. While stimulant medications like methylphenidate (Ritalin) and amphetamines (Adderall) are commonly prescribed, they don’t work for all children or may cause unwanted side effects. This has led researchers to explore new non-stimulant medication options for ADHD.

About the Study

This article examines data from clinical trials of viloxazine extended-release (viloxazine ER), a novel non-stimulant medication for ADHD. Viloxazine ER was recently approved by the FDA to treat ADHD in children and adolescents ages 6-17.

The researchers conducted a “post-hoc analysis,” meaning they took a fresh look at data that was originally collected for other purposes. They combined data from four separate clinical trials that tested viloxazine ER in over 1,000 children and teens with ADHD.

The goal was to evaluate if viloxazine ER could help improve learning and school problems (LSPs) in addition to core ADHD symptoms. To measure LSPs, they used two different rating scales completed by parents:

The School domain of the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P-S)
The Learning Problems content scale of the Conners 3rd Edition-Parent Short Form (C3PS-LP)

These scales assess things like academic performance, classroom behavior, and learning difficulties.

Key Findings

The analysis revealed several promising findings about viloxazine ER’s effects on learning and school problems:

Overall Improvements

Children taking viloxazine ER showed significantly greater improvements in both the WFIRS-P-S and C3PS-LP scores compared to those taking a placebo. This suggests the medication helped reduce learning and school-related difficulties beyond just improving core ADHD symptoms.

Academic and Behavioral Benefits

The WFIRS-P-S scale includes items related to both academic performance (e.g. “needs tutoring”) and behavioral issues at school (e.g. “causes problems for the teacher”). Viloxazine ER appeared to help in both of these areas. However, the improvements were more pronounced for the behavioral aspects. This makes sense, as changes in academic performance may take longer to appear than changes in behavior.

Response Rates

About 37% of children taking viloxazine ER were classified as “responders” on the WFIRS-P-S scale, compared to 27% of those on placebo. A responder was defined as someone whose score improved by at least 50%. This means for every 10 children treated with viloxazine ER, 1 additional child had a significant improvement in school functioning compared to placebo.

Individual Variation

While the medication helped many children, there was considerable variation in individual responses. Some children showed large improvements in both ADHD symptoms and learning/school problems. Others improved a lot in one area but not the other. And some showed little change in either domain. This highlights the importance of monitoring each child’s unique response to ADHD medications.

Understanding the Results

These findings are encouraging, as they suggest viloxazine ER may offer benefits for school functioning beyond just reducing core ADHD symptoms. However, it’s important to interpret the results cautiously and in context:

Short-Term Results

The clinical trials only lasted 6-8 weeks. Longer studies are needed to see if the benefits persist and if academic performance continues to improve over time.

Parent Reports

The measures relied on parents’ observations of their children’s school functioning. While valuable, parent reports don’t capture the full picture of a child’s school experience. Future studies using teacher reports or direct measures of academic achievement would be helpful.

Comparison to Other Medications

This study didn’t directly compare viloxazine ER to other ADHD medications. So we can’t say if it’s more or less effective than other options for improving school functioning. Head-to-head comparison studies would be needed for that.

Mechanism Unclear

The study doesn’t tell us exactly how viloxazine ER improves school functioning. Is it solely through reducing ADHD symptoms? Or does it have more direct effects on learning processes? More research is needed to understand the mechanism.

Practical Implications

For families and healthcare providers considering viloxazine ER as a treatment option for ADHD, these results offer some valuable insights:

Beyond core symptoms: Viloxazine ER may provide benefits for school functioning and learning problems in addition to improving standard ADHD symptoms. This could be especially relevant for children struggling academically.
Individual monitoring: Given the variation in responses, it’s crucial to monitor each child’s progress carefully. Look for changes in both ADHD symptoms and school functioning.
Behavioral vs. academic: Improvements in classroom behavior may be noticeable sooner than changes in academic performance. Be patient in assessing academic progress.
Comprehensive approach: While medication can help, it’s most effective as part of a comprehensive treatment plan. This may include behavioral therapy, academic accommodations, and family support.
Realistic expectations: Not all children will show dramatic improvements. For some, the benefits may be modest. Discuss realistic expectations with your healthcare provider.

Conclusions

Viloxazine ER shows promise in improving learning and school problems for many children and adolescents with ADHD
Benefits were seen in both behavioral issues at school and measures of learning difficulties
Individual responses varied considerably - close monitoring of each child’s progress is important
Longer-term studies are needed to assess the medication’s impact on academic achievement over time
Medication should be considered as part of a comprehensive treatment approach for ADHD

This study adds to our understanding of how ADHD medications can impact school functioning. For many children with ADHD, difficulties in school are a major concern. Having treatment options that can potentially improve both ADHD symptoms and school performance is valuable. However, it’s important to remember that medication is just one tool in managing ADHD. A comprehensive approach that includes behavioral strategies, school accommodations, and family support is often most effective in helping children with ADHD succeed academically and socially.