Understanding the impact of adhd familiality and genetics on adhd medication response and optimization

To adopt a precision medicine approach to ADHD medication selection, there is a need for prospective studies to identify and then validate clinical, genetic, and other biomarkers that index interindividual variability (Buitelaar et al, 2022). We have conducted several studies of treating parents and children with ADHD, and previously reported decreased response to stimulant dose for the homozygous 9/9 allele of DAT1 (Stein et al, 2014). This genotype has also been linked with shorter life expectancy and twice smoking rate (Barkley et al, 2019). Because most individuals respond positively to ADHD medications, clinical and genetic predictors of poor tolerability and nonresponse to stimulants (eg, DAT1, CES1) could guide selection and dosing strategies.