A review of the pharmacotherapy of adults with attention-deficit/hyperactivity disorder.
OBJECTIVE
Despite the increasing recognition of attention deficit hyperactivity disorder (ADHD) in adults, the use of pharmacotherapeutics remains less established.


METHODS
A systematic review of the literature identified 15 studies (N = 435 subjects) of stimulants, and 22 studies of non-stimulant medications (N = 421 subjects) including antidepressants, antihypertensives, amino acids, and wake-promoting agents for the treatment of ADHD in adults.


RESULTS
Studies with stimulants and antidepressants demonstrated significant short-term improvement in ADHD symptoms compared to placebo in adults. Methylphenidate (MPH) and amphetamine had an immediate onset of action whereas the ADHD response to pemoline and antidepressants appeared delayed. The response to amphetamine and MPH appears to be dose-dependent. Controlled data on nicotonic and noradrenergic compounds appear promising. There was considerable variability in diagnostic criteria, dosing parameters, and response rates between the various studies.


CONCLUSIONS
Under controlled conditions, the aggregate literature shows that the stimulants and noradrenergic antidepressants had a clinically and statistically significant beneficial effect on treating ADHD in adults.
Wilens
Timothy E
TE
Massachusetts General Hospital, Boston, MA 02114, USA. wilens@helix.mgh.harvard.edu
Spencer
Thomas J
TJ
Biederman
Joseph
J
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D018678:Cholinergic Agents / Q000627:therapeutic use*; D006801:Humans
D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D000697:Central Nervous System Stimulants; D018678:Cholinergic Agents