Skip to main content
SpringerLink
Log in

Pharmacologic Management of Cognitive Disengagement Syndrome (CDS) and Implications for Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment: Emerging Treatments and Recommendations for Future Research

  • Leading Article
  • Published:
CNS Drugs Aims and scope Submit manuscript

Abstract

Although the study of cognitive disengagement syndrome (CDS; previously called sluggish cognitive tempo) first emerged in the 1980s, very little is known about treating CDS or its impact on evidence-based interventions for attention-deficit/hyperactivity disorder (ADHD) with which it frequently co-occurs. The objective of this leading article was to investigate the existing evidence on medication treatment and CDS, including studies that have examined CDS response to medication and CDS as a moderator of ADHD treatment response. A total of seven studies were identified. At present, the limited existing literature suggests that psychostimulants such as methylphenidate and lisdexamfetamine, as well as atomoxetine, may improve CDS symptoms, although replication and research on related medications is needed. However, there are indications that CDS symptoms may predict a reduced response to methylphenidate in children with ADHD. Although untested, research on the neurobiological, neuropsychological, and behavioral correlates of CDS point to a possible benefit of other ADHD medications (e.g., guanfacine), medications that treat narcolepsy (e.g., modafinil), and medications traditionally used to treat depression and anxiety (e.g., viloxazine, bupropion, fluvoxamine), some of which have also recently been used in ADHD management. The article concludes with recommendations for future research on pharmacologic treatment and CDS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Becker SP, Willcutt EG, Leopold DR, et al. Report of a Work Group on Sluggish Cognitive Tempo: key research directions and a consensus change in terminology to cognitive disengagement syndrome. J Am Acad Child Adoles Psychiatry. 2022. https://doi.org/10.1016/j.jaac.2022.07.821.

    Article  Google Scholar 

  2. Becker SP, Leopold DR, Burns GL, et al. The internal, external, and diagnostic validity of sluggish cognitive tempo: a meta-analysis and critical review. J Am Acad Child Adoles Psychiatry. 2016;55(3):163–78. https://doi.org/10.1016/j.jaac.2015.12.006.

    Article  Google Scholar 

  3. Barkley RA. Sluggish cognitive tempo (concentration deficit disorder?): current status, future directions, and a plea to change the name. J Abnormal Child Psychol. 2014;42(1):117–25. https://doi.org/10.1007/s10802-013-9824-y.

    Article  Google Scholar 

  4. Neeper R, Lahey BB. The Children’s Behavior Rating Scale: a factor analytic developmental study. School Psychol Rev. 1986;15(2):277–88. https://doi.org/10.1080/02796015.1986.12085230.

    Article  Google Scholar 

  5. Lahey BB, Pelham WE, Schaughency EA, et al. Dimensions and types of attention deficit disorder. J Am Acad Child Adolesc Psychiatry. 1988;27(3):330–5. https://doi.org/10.1097/00004583-198805000-00011.

    Article  CAS  PubMed  Google Scholar 

  6. Barkley RA. Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. J Clin Child Adoles Psychol. 2013;42(2):161–73. https://doi.org/10.1080/15374416.2012.734259.

    Article  Google Scholar 

  7. Servera M, Sáez B, Burns GL, et al. Clinical differentiation of sluggish cognitive tempo and attention-deficit/hyperactivity disorder in children. J Abnormal Psychol. 2018;127(8):818. https://doi.org/10.1037/abn0000375.

    Article  Google Scholar 

  8. Burns GL, Becker SP. Sluggish cognitive tempo and ADHD symptoms in a nationally representative sample of US children: differentiation using categorical and dimensional approaches. J Clin Child Adolesc Psychol. 2021;50(2):267–80. https://doi.org/10.1080/15374416.2019.1678165.

    Article  PubMed  Google Scholar 

  9. Carlson CL, Mann M. Sluggish cognitive tempo predicts a different pattern of impairment in the attention deficit hyperactivity disorder, predominantly inattentive type. J Clin Child Adolesc Psychol. 2002;31(1):123–9.

    Article  PubMed  Google Scholar 

  10. Willcutt EG, Chhabildas N, Kinnear M, et al. The internal and external validity of sluggish cognitive tempo and its relation with DSM-IV ADHD. J Abnormal Child Psychol. 2014;42(1):21–35. https://doi.org/10.1007/s10802-013-9800-6.

    Article  Google Scholar 

  11. McBurnett K, Villodas M, Burns GL, et al. Structure and validity of sluggish cognitive tempo using an expanded item pool in children with attention-deficit/hyperactivity disorder. J Abnormal Child Psychol. 2014;42(1):37–48. https://doi.org/10.1007/s10802-013-9801-5.

    Article  Google Scholar 

  12. Barkley RA, Willcutt E, Jacobson LA. What is the cognitive deficit in sluggish cognitive tempo (SCT)? A review of neuropsychological research. ADHD Rep. 2022;30(2):1–10. https://doi.org/10.1521/adhd.2022.30.2.1.

    Article  Google Scholar 

  13. Kofler MJ, Irwin LN, Sarver DE, et al. What cognitive processes are “sluggish” in sluggish cognitive tempo? J Consult Clin Psychol. 2019;87(11):1030. https://doi.org/10.1037/ccp0000446.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Creque CA, Willcutt EG. Sluggish cognitive tempo and neuropsychological functioning. Res Child Adolesc Psychopathol. 2021;49(8):1001–13. https://doi.org/10.1007/s10802-021-00810-3.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Becker SP, Luebbe AM, Fite PJ, et al. Sluggish cognitive tempo in psychiatrically hospitalized children: factor structure and relations to internalizing symptoms, social problems, and observed behavioral dysregulation. J Abnormal Child Psychol. 2014;42(1):49–62. https://doi.org/10.1007/s10802-013-9719-y.

    Article  Google Scholar 

  16. Smith ZR, Eadeh H-M, Breaux RP, et al. Sleepy, sluggish, worried, or down? The distinction between self-reported sluggish cognitive tempo, daytime sleepiness, and internalizing symptoms in youth with attention-deficit/hyperactivity disorder. Psychol Assess. 2019;31(3):365. https://doi.org/10.1037/pas0000671.

    Article  PubMed  Google Scholar 

  17. Jung SH, Lee S, Burns GL, et al. Internal and external validity of self-report and parent-report measures of sluggish cognitive tempo in South Korean adolescents. J Psychopathol Behav Assess. 2021;43:355–66. https://doi.org/10.1007/s10862-020-09821-8.

    Article  Google Scholar 

  18. Fırat S, Gül H, Aysev A. Distinguishing SCT symptoms from ADHD in children: internal and external validity in Turkish culture. J Psychopath Behav Assess. 2019;41(2):716–29. https://doi.org/10.1007/s10862-019-09750-1.

    Article  Google Scholar 

  19. Sáez B, Servera M, Becker SP, et al. Optimal items for assessing sluggish cognitive tempo in children across mother, father, and teacher ratings. J Clin Child Adolesc Psychol. 2019;48(6):825–39. https://doi.org/10.1080/15374416.2017.1416619.

    Article  PubMed  Google Scholar 

  20. Sadeghi-Bahmani D, Mohammadian Y, Ghasemi M, et al. Sluggish cognitive tempo among Iranian children and adolescents: a validation study of the Farsi Child and Adolescent Behavior Inventory (CABI)-Parent Version. J Clin Med. 2022;11(21):6346. https://doi.org/10.3390/jcm11216346.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Becker SP. Systematic review: assessment of sluggish cognitive tempo over the past decade. J Am Acad Child Adolesc Psychiatry. 2021;60(6):690–709. https://doi.org/10.1016/j.jaac.2020.10.016.

    Article  PubMed  Google Scholar 

  22. Camprodon-Rosanas E, Pujol J, Martínez-Vilavella G, et al. Brain structure and function in school-aged children with sluggish cognitive tempo symptoms. J Am Acad Child Adolesc Psychiatry. 2019;58(2):256–66. https://doi.org/10.1016/j.jaac.2018.09.441.

    Article  PubMed  Google Scholar 

  23. Corbetta M, Patel G, Shulman GL. The reorienting system of the human brain: from environment to theory of mind. Neuron. 2008;58(3):306–24. https://doi.org/10.1016/j.neuron.2008.04.017.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Fassbender C, Krafft CE, Schweitzer JB. Differentiating SCT and inattentive symptoms in ADHD using fMRI measures of cognitive control. Neuroimage Clin. 2015;8:390–7. https://doi.org/10.1016/j.nicl.2015.05.007.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kardaş B, Baytunca B, Bolat GÜ, et al. An investigation of cranial functional magnetic resonance imaging results in children and adolescents with attention deficit and hyperactivity disorder and sluggish cognitive tempo (SCT). Int J Child Health Hum Dev. 2021;14(1):21–33.

    Google Scholar 

  26. Jarrett MA, Gable PA, Rondon AT, et al. An EEG study of children with and without ADHD symptoms: between-group differences and associations with sluggish cognitive tempo symptoms. J Atten Disord. 2020;24(7):1002–10. https://doi.org/10.1177/1087054717723.

    Article  PubMed  Google Scholar 

  27. Becker SP, Barkley RA. Field of daydreams? Integrating mind wandering in the study of sluggish cognitive tempo and ADHD. JCPP Adv. 2021;1(1):e12002. https://doi.org/10.1111/jcv2.12002.

    Article  Google Scholar 

  28. Ünsel-Bolat G, Baytunca MB, Kardaş B, et al. Diffusion tensor imaging findings in children with sluggish cognitive tempo comorbid attention deficit hyperactivity disorder. Nordic J Psychiatry. 2020;74(8):620–6. https://doi.org/10.1080/08039488.2020.1772364.

    Article  Google Scholar 

  29. Tamm L, Epstein JN, Orban SA, et al. Neurocognition in children with cognitive disengagement syndrome: accurate but slow. Child Neuropsychol. 2023. https://doi.org/10.1080/09297049.2023.2185215.

    Article  PubMed  Google Scholar 

  30. Becker SP, Dvorsky MR, Tamm L, et al. Preschool neuropsychological predictors of school-aged sluggish cognitive tempo and inattentive behaviors. Res Child Adolesc Psychopathol. 2021;49(2):197–210. https://doi.org/10.1007/s10802-020-00728-2.

    Article  PubMed  Google Scholar 

  31. Jacobson LA, Geist M, Mahone EM. Sluggish cognitive tempo, processing speed, and internalizing symptoms: the moderating effect of age. J Abnormal Child Psychol. 2018;46(1):127–35. https://doi.org/10.1007/s10802-017-0281-x.

    Article  Google Scholar 

  32. Becker SP, Marsh NP, Holdaway AS, et al. Sluggish cognitive tempo and processing speed in adolescents with ADHD: do findings vary based on informant and task? Eur Child Adolesc Psychiatry. 2020;29(10):1371–84. https://doi.org/10.1007/s00787-019-01446-x.

    Article  PubMed  Google Scholar 

  33. Tamm L, Brenner SB, Bamberger ME, et al. Are sluggish cognitive tempo symptoms associated with executive functioning in preschoolers? Child Neuropsychol. 2018;24(1):82–105. https://doi.org/10.1080/09297049.2016.1225707.

    Article  PubMed  Google Scholar 

  34. Lundervold AJ, Posserud M-B, Ullebø A-K, et al. Teacher reports of hypoactivity symptoms reflect slow cognitive processing speed in primary school children. Eur Child Adolesc Psychiatry. 2011;20(3):121–6. https://doi.org/10.1007/s00787-010-0153-1.

    Article  PubMed  Google Scholar 

  35. Mayes SD, Calhoun SL, Waschbusch DA. Relationship between sluggish cognitive tempo and sleep, psychological, somatic, and cognitive problems and impairment in children with autism and children with ADHD. Clin Child Psychol Psychiatry. 2021;26(2):518–30. https://doi.org/10.1177/1359104520978459.

    Article  PubMed  Google Scholar 

  36. Cook NE, Braaten EB, Vuijk PJ, et al. Slow processing speed and sluggish cognitive tempo in pediatric attention-deficit/hyperactivity disorder: evidence for differentiation of functional correlates. Child Psychiatry Hum Dev. 2019;50(6):1049–57. https://doi.org/10.1007/s10578-019-00904-6.

    Article  PubMed  Google Scholar 

  37. Reinvall O, Kujala T, Voutilainen A, et al. Sluggish cognitive tempo in children and adolescents with higher functioning autism spectrum disorders: social impairments and internalizing symptoms. Scand J Psychol. 2017;58(5):389–99. https://doi.org/10.1111/sjop.12379.

    Article  PubMed  Google Scholar 

  38. Wood WL, Potts HE, Lewandowski LJ, et al. Sluggish cognitive tempo and speed of performance. J Atten Disord. 2017;21(8):684–90. https://doi.org/10.1177/1087054716666322.

    Article  PubMed  Google Scholar 

  39. Baytunca MB, Inci SB, Ipci M, et al. The neurocognitive nature of children with ADHD comorbid sluggish cognitive tempo: might SCT be a disorder of vigilance? Psych Res. 2018;270:967–73. https://doi.org/10.1016/j.psychres.2018.03.038.

    Article  Google Scholar 

  40. Mahdavi S, Hasper E, Donders J. Sluggish cognitive tempo in children with traumatic brain injuries. Appl Neuropsychol Child. 2021;10(3):240–6. https://doi.org/10.1080/21622965.2019.1674653.

    Article  PubMed  Google Scholar 

  41. Barkley RA, editor. Concentration deficit disorder (sluggish cognitive tempo). In: Attention-deficit/hyperactivity disorder: a handbook for diagnosis and treatment. 4th ed. New York: Guilford; 2015. p. 435–52.

  42. Saxbe C, Barkley RA. The second attention disorder? Sluggish cognitive tempo vs. attention-deficit/hyperactivity disorder: update for clinicians. J Psychiatr Pract. 2014;20(1):38–49. https://doi.org/10.1097/01.pra.0000442718.82527.cd.

    Article  PubMed  Google Scholar 

  43. Kim K, Kim H-J. Normal executive attention but abnormal orienting attention in individuals with sluggish cognitive tempo. Int J Clin Health Psychol. 2021;21(1):100199. https://doi.org/10.1016/j.ijchp.2020.08.003.

    Article  PubMed  Google Scholar 

  44. Wåhlstedt C, Bohlin G. DSM-IV-defined inattention and sluggish cognitive tempo: independent and interactive relations to neuropsychological factors and comorbidity. Child Neuropsychol. 2010;16(4):350–65. https://doi.org/10.1080/09297041003671176.

    Article  PubMed  Google Scholar 

  45. Fredrick JW, Kofler MJ, Jarrett MA, et al. Sluggish cognitive tempo and ADHD symptoms in relation to task-unrelated thought: examining unique links with mind-wandering and rumination. J Psychiatr Res. 2020;123:95–101. https://doi.org/10.1016/j.jpsychires.2020.01.016.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Fredrick JW, Becker SP. Sluggish cognitive tempo symptoms, but not ADHD or internalizing symptoms, are uniquely related to self-reported mind-wandering in adolescents with ADHD. J Atten Disord. 2021;25(11):1605–11. https://doi.org/10.1177/1087054720923091.

    Article  PubMed  Google Scholar 

  47. Smallwood J, Schooler JW. The science of mind wandering: empirically navigating the stream of consciousness. Annu Rev Psychol. 2015;66:487–518. https://doi.org/10.1146/annurev-psych-010814-015331.

    Article  PubMed  Google Scholar 

  48. Kofler MJ, Rapport MD, Sarver DE, et al. Reaction time variability in ADHD: a meta-analytic review of 319 studies. Clin Psychol Rev. 2013;33(6):795–811. https://doi.org/10.1016/j.cpr.2013.06.001.

    Article  PubMed  Google Scholar 

  49. Ramos AA, Hamdan AC, Machado L. A meta-analysis on verbal working memory in children and adolescents with ADHD. Clin Neuropsychologist. 2020;34(5):873–98. https://doi.org/10.1080/13854046.2019.1604998.

    Article  Google Scholar 

  50. Barkley RA. Barkley sluggish cognitive tempo scale-children and adolescents (BSCTS-CA). New York: Guilford; 2018.

    Google Scholar 

  51. Fırat S, Gul H, Aysev A. An open-label trial of methylphenidate treating sluggish cognitive tempo, inattention, and hyperactivity/impulsivity symptoms among 6-to 12-year-old ADHD children: what are the predictors of treatment response at home and school? J Atten Disord. 2021;25(9):1321–30. https://doi.org/10.1177/1087054720902846.

    Article  PubMed  Google Scholar 

  52. Adler LA, Leon TL, Sardoff TM, et al. A placebo-controlled trial of lisdexamfetamine in the treatment of comorbid sluggish cognitive tempo and adult ADHD. J Clin Psychiatry. 2021;82(4):34965. https://doi.org/10.4088/JCP.20m13687.

    Article  Google Scholar 

  53. Wietecha L, Williams D, Shaywitz S, et al. Atomoxetine improved attention in children and adolescents with attention-deficit/hyperactivity disorder and dyslexia in a 16 week, acute, randomized, double-blind trial. J Child Adolesc Psychopharmacol. 2013;23(9):605–13. https://doi.org/10.1089/cap.2013.0054.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. McBurnett K, Clemow D, Williams D, et al. Atomoxetine-related change in sluggish cognitive tempo is partially independent of change in attention-deficit/hyperactivity disorder inattentive symptoms. J Child Adoless Psychopharmacol. 2017;27(1):38–42. https://doi.org/10.1089/cap.2016.0115.

    Article  CAS  Google Scholar 

  55. Weiss M, Tannock R, Kratochvil C, et al. A randomized, placebo-controlled study of once-daily atomoxetine in the school setting in children with ADHD. J Am Acad Child Adolesc Psychiatry. 2005;44(7):647–55. https://doi.org/10.1097/01.chi.0000163280.47221.c9.

    Article  PubMed  Google Scholar 

  56. Kelsey DK, Sumner CR, Casat CD, et al. Once-daily atomoxetine treatment for children with attention-deficit/hyperactivity disorder, including an assessment of evening and morning behavior: a double-blind, placebo-controlled trial. Pediatrics. 2004;114(1):e1-8. https://doi.org/10.1542/peds.114.1.e1.

    Article  PubMed  Google Scholar 

  57. Froehlich TE, Becker SP, Nick TG, et al. Sluggish cognitive tempo as a possible predictor of methylphenidate response in children with ADHD: a randomized controlled trial. J Clin Psychiatry. 2018;79(2):19052.

    Article  Google Scholar 

  58. Ludwig HT, Matte B, Katz B, et al. Do sluggish cognitive tempo symptoms predict response to methylphenidate in patients with attention-deficit/hyperactivity disorder-inattentive type? J Child Adolesc Psychopharmacol. 2009;19(4):461–5. https://doi.org/10.1089/cap.2008.0115.

    Article  PubMed  Google Scholar 

  59. Minzenberg MJ, Carter CS. Modafinil: a review of neurochemical actions and effects on cognition. Neuropsychopharmacology. 2008;33(7):1477–502. https://doi.org/10.1038/sj.npp.1301534.

    Article  CAS  PubMed  Google Scholar 

  60. Esposito R, Cilli F, Pieramico V, et al. Acute effects of modafinil on brain resting state networks in young healthy subjects. PLoS ONE. 2013;8(7):e69224. https://doi.org/10.1371/journal.pone.0069224.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Chappell PB, Riddle MA, Scahill L, et al. Guanfacine treatment of comorbid attention-deficit hyperactivity disorder and Tourette’s syndrome: preliminary clinical experience. J Am Acad Child Adolesc Psychiatry. 1995;34(9):1140–6. https://doi.org/10.1097/00004583-199509000-00010.

    Article  CAS  PubMed  Google Scholar 

  62. Scahill L, Chappell PB, Kim YS, et al. A placebo-controlled study of guanfacine in the treatment of children with tic disorders and attention deficit hyperactivity disorder. Am J Psychiatry. 2001;158(7):1067–74. https://doi.org/10.1176/appi.ajp.158.7.1067.

    Article  CAS  PubMed  Google Scholar 

  63. Fernando AB, Economidou D, Theobald DE, et al. Modulation of high impulsivity and attentional performance in rats by selective direct and indirect dopaminergic and noradrenergic receptor agonists. Psychopharmacology. 2012;219:341–52. https://doi.org/10.1007/s00213-011-2408-z.

    Article  CAS  PubMed  Google Scholar 

  64. Intuniv (guanfacine) [package insert]. Federal Drug Administration. Shire, US Inc. 2016. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/022037s018lbl.pdf. Accessed 30 Oct 2022.

  65. Scahill L. Alpha-2 adrenergic agonists in children with inattention, hyperactivity and impulsiveness. CNS Drugs. 2009;23(1):43–9. https://doi.org/10.2165/00023210-200923000-00006.

    Article  CAS  PubMed  Google Scholar 

  66. Coull J, Nobre A, Frith C. The noradrenergic α2 agonist clonidine modulates behavioural and neuroanatomical correlates of human attentional orienting and alerting. Cereb Cortex. 2001;11(1):73–84. https://doi.org/10.1093/cercor/11.1.73.

    Article  CAS  PubMed  Google Scholar 

  67. Becker SP, Willcutt EG. Advancing the study of sluggish cognitive tempo via DSM, RDoC, and hierarchical models of psychopathology. Eur Child Adolesc Psychiatry. 2019;28(5):603–13. https://doi.org/10.1007/s00787-018-1136-x.

    Article  PubMed  Google Scholar 

  68. Becker SP, Burns GL, Smith ZR, et al. Sluggish cognitive tempo in adolescents with and without ADHD: differentiation from adolescent-reported ADHD inattention and unique associations with internalizing domains. J Abnormal Child Psychol. 2020;48(3):391–406. https://doi.org/10.1007/s10802-019-00603-9.

    Article  Google Scholar 

  69. Sáez B, Servera M, Burns GL, et al. Advancing the multi-informant assessment of sluggish cognitive tempo: child self-report in relation to parent and teacher ratings of SCT and impairment. J Abnormal Child Psychol. 2019;47(1):35–46. https://doi.org/10.1007/s10802-018-0436-4.

    Article  Google Scholar 

  70. Wilens TE, Spencer TJ, Biederman J, et al. A controlled clinical trial of bupropion for attention deficit hyperactivity disorder in adults. Am J Psychiatry. 2001;158(2):282–8. https://doi.org/10.1176/appi.ajp.158.2.282.

    Article  CAS  PubMed  Google Scholar 

  71. Barrickman LL, Perry PJ, Allen A, et al. Bupropion versus methylphenidate in the treatment of attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1995;34(5):649–57. https://doi.org/10.1097/00004583-199505000-00017.

    Article  CAS  PubMed  Google Scholar 

  72. Wellbutrin (buproprion hydrochloride) [package insert ]. Federal Drug Administration. DSM Pharmaceuticals, Inc. 2017. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/018644s039s040.pdf. Accessed 30 Oct 2022.

  73. Yu C, Garcia-Olivares J, Candler S, et al. New insights into the mechanism of action of viloxazine: serotonin and norepinephrine modulating properties. J Exp Pharmacol. 2020;12:285.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Findling RL, Candler SA, Nasser AF, et al. Viloxazine in the management of CNS disorders: a historical overview and current status. CNS Drugs. 2021;35(6):643–53. https://doi.org/10.1007/s40263-021-00825-w.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Lamb YN. Viloxazine: pediatric first approval. Pediatr Drugs. 2021;23(4):403–9. https://doi.org/10.1007/s40272-021-00453-3.

    Article  Google Scholar 

  76. Johnson JK, Liranso T, Saylor K, et al. A phase II double-blind, placebo-controlled, efficacy and safety study of SPN-812 (extended-release viloxazine) in children with ADHD. J Atten Disord. 2020;24(2):348–58. https://doi.org/10.1177/1087054719836159.

    Article  PubMed  Google Scholar 

  77. Achenbach TM, Edelbrock C. Child behavior checklist. Burlington (Vt). 1991;7:371–92.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45206, USA

    Kelsey K. Wiggs & Stephen P. Becker

  2. Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Tanya E. Froehlich

  3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Tanya E. Froehlich & Stephen P. Becker

Authors
  1. Kelsey K. Wiggs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tanya E. Froehlich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephen P. Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephen P. Becker.

Ethics declarations

Funding

Kelsey K. Wiggs’ effort while preparing this manuscript was supported by the National Research Service Award in Primary Medical Care, T32HP10027, through the Health Resources and Services Administration. Stephen P. Becker’s effort while preparing this manuscript was supported in part by grants from the National Institute of Mental Health (R01MH122415) and the Institute of Education Sciences, US Department of Education (R305A200028).

Conflicts of Interest/Competing Interests

Kelsey K. Wiggs has no disclosures to report. Tanya E. Froehlich has received grant funding from the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the Jack H. Rubinstein Foundation. Stephen P. Becker has received grant funding from the Institute of Education Sciences (US Department of Education; R305A200028), the National Institute of Mental Health (R01MH122415), and the Cincinnati Children’s Research Foundation, and has received book honoraria from Guilford Press, editorial honoraria as a Joint Editor of JCPP Advances, grant review panel honoraria from the Institute of Education Sciences, speaking honoraria from the Society of Pediatric Psychology and the Journal of Clinical Child and Adolescent Psychology Future Directions Forum, and educational seminar speaking fees and continuing education course royalties from J&K Seminars and from PESI, Inc.

Ethics Approval

Not applicable.

Consent to Participate

Not applicable.

Consent for Publication

Not applicable.

Availability of Data and Material

Data sharing not applicable to this article as no datasets were generated or analyzed.

Code Availability

Not applicable.

Authors’ Contributions

Kelsey K. Wiggs searched for and read the literature and wrote and revised the current article. Tanya E. Froehlich searched for and read the literature and assisted in writing and revising the current article. Stephen P. Becker read the literature and assisted in writing and revising the current article. All authors have read and approved the final submitted manuscript, and agree to be accountable for the work.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wiggs, K.K., Froehlich, T.E. & Becker, S.P. Pharmacologic Management of Cognitive Disengagement Syndrome (CDS) and Implications for Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment: Emerging Treatments and Recommendations for Future Research. CNS Drugs 37, 293–304 (2023). https://doi.org/10.1007/s40263-023-00999-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40263-023-00999-5

Search

Navigation