title: Pozanicline for the treatment of attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder occurring in childhood and often continues into adolescence and adulthood. The pathophysiology of ADHD is complex and likely involves multiple neurotransmitter systems. Medications currently used for the treatment of ADHD enhance dopaminergic and/or noradrenergic transmission. However, none of these drugs target the cholinergic system, which is also thought to play a significant role in cognitive disturbances such as those found in ADHD.
  
  
  METHODS
  In this review, the authors briefly discuss the cholinergic system, including multiple neuronal nicotinic receptor (NNR) subtypes that mediate the positive and negative effects of nicotine, in the context of animal models of ADHD. They also discuss the pharmacology of the NNR pozanicline , a partial agonist with high in vitro binding affinity and selectivity for the α4β2 NNR subtype. Finally, the authors examine pozanicline's clinical developments.
  
  
  CONCLUSIONS
  Pozanicline was shown to be effective in a pilot study in humans with ADHD, but larger trials were negative. Developing an efficacious therapy is difficult. ADHD is a complex disorder with an unknown cause, and it is unclear, at this time, which qualities from NNR agonists are needed to treat it. It is therefore necessary to develop a more enhanced understanding of the nicotinic cholinergic system and its role in ADHD. Furthermore, new research paradigms may need to be employed to find drugs that are effective in patients with ADHD.
authors.affiliation: Center for Psychiatry and Behavioral Medicine, Inc. , 7351 Prairie Falcon Road, Suite 160, Las Vegas, NV 89128 , USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Childress
authors.forename: Floyd R
authors.initials: FR
authors.lastname: Sallee
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology; D015195:Drug Design; D054333:Drug Partial Agonism; D006801:Humans; D018722:Nicotinic Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D011725:Pyridines / Q000494:pharmacology / Q000627:therapeutic use*; D011759:Pyrrolidines / Q000494:pharmacology / Q000627:therapeutic use*; D011978:Receptors, Nicotinic / Q000187:drug effects / Q000378:metabolism
chemical_list: D018722:Nicotinic Agonists; D011725:Pyridines; D011759:Pyrrolidines; D011978:Receptors, Nicotinic; C403531:nicotinic receptor alpha4beta2; C108326:pozanicline
keywords: attention-deficit/hyperactivity disorder; neuronal nicotinic receptor; pozanicline