A large, double-blind, randomized clinical trial of methylphenidate in the treatment of adults with attention-deficit/hyperactivity disorder.
BACKGROUND
The few controlled studies of methylphenidate (MPH) in adults with attention deficit/hyperactivity disorder (ADHD) have reported equivocal results. A previous, pilot study by our group suggested that these results were due to inadequate dosing.


METHODS
We conducted a randomized, 6-week, placebo-controlled, parallel study of MPH in 146 adult patients with DSM-IV ADHD using standardized instruments for diagnosis, separate assessments of ADHD, depressive and anxiety symptoms, and a robust average oral daily dose of 1.1 mg/kg/day.


RESULTS
We found a marked therapeutic response for the MPH treatment of ADHD symptoms that exceeded the placebo response (76% vs. 19%). Treatment was safe and well tolerated. Response to MPH was independent of socioeconomic status, gender, and lifetime history of psychiatric comorbidity.


CONCLUSIONS
These results confirm that robust doses of MPH are effective in the treatment of adult ADHD.
Spencer
Thomas
T
Pediatric Psychopharmacology Unit, Psychiatry Service Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. tspencer@partners.org.
Biederman
Joseph
J
Wilens
Timothy
T
Doyle
Robert
R
Surman
Craig
C
Prince
Jefferson
J
Mick
Eric
E
Aleardi
Megan
M
Herzig
Kathleen
K
Faraone
Stephen
S
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003710:Demography; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D010919:Placebos; D008774:Methylphenidate