A double-blind, crossover comparison of methylphenidate and placebo in adults with childhood-onset attention-deficit hyperactivity disorder.
BACKGROUND
There are few controlled studies of methylphenidate hydrochloride in adults with attention-deficit hyperactivity disorder (ADHD), and their results have been equivocal. The discrepancies among these studies may be related to low doses, diagnostic uncertainties, and lack of attention to comorbid disorders.


METHODS
We conducted a randomized, 7-week, placebo-controlled, crossover study of methylphenidate in 23 adult patients with DSM-III-R ADHD using standardized instruments for diagnosis, separate assessments of ADHD and depressive and anxiety symptoms, and a robust daily dose of methylphenidate hydrochloride, 1.0 mg/kg per day.


RESULTS
We found a marked therapeutic response for methylphenidate treatment of ADHD symptoms that exceeded the placebo response (78% vs 4%, P < .0001). Response to methylphenidate was independent of gender, psychiatric comorbidity with anxiety or moderate depression, or family history of psychiatric disorders.


CONCLUSIONS
Robust doses of methylphenidate are effective in the treatment of adult ADHD.
Spencer
T
T
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, USA.
Wilens
T
T
Biederman
J
J
Faraone
S V
SV
Ablon
J S
JS
Lapey
K
K
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care; D001008:Anxiety Disorders / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D018592:Cross-Over Studies; D003866:Depressive Disorder / Q000453:epidemiology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010919:Placebos; D016896:Treatment Outcome
D010919:Placebos; D008774:Methylphenidate