SNAP 25 Gene Study
SNAP 25 Gene Study
To enhance our capacity to correctly choose the appropriate medication for ADHD patients on
 the first try based on the presence of a particular variant of a gene that could be
 identified on a laboratory test. It is hypothesized that patients with Attention Deficit
 Hyperactivity Disorder (ADHD) who have failed to respond to methylphenidate medication, but
 do respond to amphetamines, have a higher than expected incidence the allelic variants of the
 SNAP 25 gene associated with ADHD, and mutations of the dopamine system genes DRD1, 2, 4, 5
 and dopamine transporter and COMTand MAOA.
Previous research has demonstrated that while 75% of patients respond to any stimulant, of
 those who do not 33% will respond to a stimulant of the other class. Based on previous
 research correlating increased mutations in the dopamine system genes DRD1, 2, 4, 5, dopamine
 transporter, COMT, and MAOA with ADHD, we will also be investigating the relationship between
 mutations in these genes and patient response to MPH and amphetamines. This study is a pilot,
 but it was an obvious next step in the studies that are being done on the genetics of ADHD.
 The outcome of this research, whether an association is or is not found, will be of
 considerable interest to researchers internationally, and will demonstrate the value of HELP
 funding in promoting research that can alleviate mental illness in children The study will
 make a significant contribution to appropriate intervention for these children, and promote
 greater awareness that the deficits suffered by children with attention problems is neither
 willful nor a matter of intelligence, but rather a syndrome that can be explained and can be
 modified with appropriate medical care.

 A chi-square test will be conducted to determine whether there is differential representation
 of SNAP 25 among therapeutic methylphenidate responders versus non-responders. Statistical
 comparison will be performed using a two-tailed test at the .05 level of significance.
Inclusion Criteria:

 1. Patients will be male or female outpatients who are at least 6 years of age (there is
 no upper age limit)

 2. Patients must meet DSM-IV criteria for ADHD

 3. Patients and parents/guardians must have a degree of understanding sufficient to be
 able to communicate suitably with the investigator and study coordinator

 4. Patients must have tolerated the drug at therapeutic doses, but have shown a true lack
 of improvement in symptoms

 5. Must have shown clinically significant superiority in improvement in ADHD symptoms on
 amphetamine relative to MPH.

 Exclusion Criteria:

 1. Must not have a true allergy to methylphenidate or amphetamines

 2. Must not have a history of serious adverse reactions to methylphenidate