Efficacy of stimulants in adult ADHD.
OBJECTIVE
To review the literature regarding the efficacy of stimulants to treat attention-deficit-hyperactivity disorder (ADHD) in adults.


METHODS
The relevant pharmaceutical manufacturers were contacted, and searches of MEDLINE (1966-December 2002) and the reference sections of each article obtained were performed using the key search terms: adult ADHD, stimulants, methylphenidate, amphetamines, and pemoline.


METHODS
All English-language original studies identified from the data sources were evaluated and all information deemed relevant was included in the review.


RESULTS
Studies involving methylphenidate, amphetamines, and pemoline were identified. There was evidence for the efficacy of amphetamines from 5 studies (4 controlled, 1 open). Methylphenidate data from 6 controlled trials were conflicting. Three studies indicated efficacy; 2 studies failed to show efficacy, possibly due to methodologic reasons; and the results from 1 study were conflicting. The limited data from 1 controlled and 1 open study indicated that pemoline may be less effective than methylphenidate and amphetamines.


CONCLUSIONS
While the current limited data indicate that stimulants may be effective in adult ADHD, more data are required to confirm long-term efficacy.
Maidment
Ian D
ID
Pharmacy Department, Kent and Canterbury Hospital, Ethelbert Rd., Canterbury, Kent CT1 3NG, England. ian.maidment@ekht.nhs.uk
D000328:Adult; D000662:Amphetamines / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D006801:Humans; D010389:Pemoline / Q000627:therapeutic use
D000662:Amphetamines; D000697:Central Nervous System Stimulants; D010389:Pemoline