Low-dose amphetamine salts and adult attention-deficit/hyperactivity disorder.
BACKGROUND
Effective treatments for attention-deficit/hyperactivity disorder (ADHD) in adults are still being defined. Pediatric studies have suggested that a mixed amphetamine salt product (Adderall) is safe and effective in the treatment of childhood forms of ADHD. Presently, there are no reports in the scientific literature concerning the safety and efficacy of Adderall in adults with ADHD, which is the focus of this study.


METHODS
Twenty-four outpatients (mean age = 33.3 years) with DSM-IV ADHD were administered Adderall in an open-label fashion, starting at 5 mg p.o. b.i.d., with titration according to clinical response, across a 16-week period. Relatives or spouses of each patient completed serial checklists (including the Copeland Symptom Checklist and the Brown Attention-Deficit Disorder Scales). Prospectively collected data were analyzed retrospectively.


RESULTS
Thirteen patients (54%) responded in a positive manner to Adderall, based on Clinical Global Impressions-Improvement scale scores. The mean end dose for responders was 10.77 mg/day (0.14 mg/kg/day). An intent-to-treat analysis revealed a decrease in the mean Copeland score from 99.05 to 63.3 (p < .001), while the mean Brown score dropped from 76.75 to 50.85 (p < .0001). Nine patients (38%) were poor responders or nonresponders to Adderall. Acute anxiety symptoms occurred in 4 of 7 patients with a comorbid anxiety diagnosis.


CONCLUSIONS
Adderall may be an effective agent for the treatment of adult forms of ADHD, with positive responses occurring at relatively low doses, at least for some individuals. However, Adderall may precipitate anxiety in vulnerable individuals. Further study is required.
Horrigan
J P
JP
Department of Psychiatry, University of North Carolina at Chapel Hill, 27599-7160, USA. jhorrigan@css.unc.edu
Barnhill
L J
LJ
D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care; D000662:Amphetamines / Q000008:administration & dosage / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
C090411:Adderall; D000662:Amphetamines; D000697:Central Nervous System Stimulants