SNAPPER: an ADHD and Psychosis/Bipolar disorder trial

The clinical and cost-effectiveness of Stimulant compared with Non-stimulant medication for adults with Attention-deficit/hyperactivity disorder and a history of Psychosis or biPolar disordER

This study aims to investigate how effective a stimulant medication (Lisdexamfetamine) is compared to a non-stimulant medication (Atomoxetine) in reducing symptoms of attention deficit hyperactivity disorder (ADHD) in people who also have bipolar disorder or psychosis.

Summary of the project and objectives

This trial aims to find out how effective a stimulant medication is compared to a non-stimulant medication in patients who have been diagnosed with attention deficit hyperactivity disorder (ADHD) and also have a history of either psychosis or bipolar.

Why the project is important

Doctors are not sure how effective or safe ADHD medications are in people who also have psychosis and bipolar disorder. This is because these medications can sometimes make the symptoms of bipolar disorder and psychosis become worse rather than reduce them.

How we plan to achieve this

Interventions

ADHD stimulant medication (Lisdexamfetamine) initiated at 30mg once daily, increasing to 70mg (maximum) once daily for 6 months

ADHD non-stimulant medication (Atomoxetine) initiated at 40mg daily increasing to 100mg (maximum) daily for 6 months

Primary outcome is to evaluate ADHD symptom severity at 6 months.

Funding source

The research costs of the trial are funded by a National Institute for Health Research (NIHR) Health Technology Assessment (HTA) grant, reference NIHR129817, awarded to Professor Steven Marwaha at University of Birmingham.

Who is supporting the project

Medics in EIP, Mental Health Nurses and a Cognitive Behavioural Therapist, alongside members of the Research Delivery Team. Dr Zia Katshu is the Principal investigator for this trial.