Bupropion XL in adults with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled study.
BACKGROUND
Data remain limited on treatment strategies for adults with attention-deficit/hyperactivity disorder (ADHD). This study evaluated the efficacy and safety of an extended-release, once-daily formulation of bupropion (XL) in the treatment of adults with ADHD.


METHODS
This multisite, placebo-controlled, 8-week prospective trial evaluated 162 adult patients diagnosed with ADHD (combined and inattentive types). Subjects were treated with up to 450 mg/day of bupropion XL. The primary efficacy endpoint was the proportion of ADHD responders (defined as at least a 30% reduction in the investigator-rated ADHD Rating Scale score) at week 8 (last observation carried forward [LOCF]).


RESULTS
Bupropion XL responders (53%) exceeded placebo responders (31%) (p =.004 at week 8) with a significantly greater proportion of bupropion XL responders as early as week 2 (p = .01). Treatment effect size calculated for the ADHD Rating Scale total score was .6. Bupropion XL appeared to provide sustained benefit throughout the day compared with placebo (morning p =.033, afternoon p =.004, evening p = .024). Bupropion XL was safe and well tolerated, with no serious or unexpected adverse events and a low rate of drug-related study discontinuation (5%).


CONCLUSIONS
The results from this multisite study indicate that bupropion XL is an effective and well-tolerated nonstimulant treatment for adult ADHD.
Wilens
Timothy E
TE
Pediatric Psychopharmacology Research, Yawkey Center for Outpatient Care, Massachusetts General Hospital, Boston, Massachusetts 021143-3117, USA. twilens@partners.org
Haight
Barbara R
BR
Horrigan
Joseph P
JP
Hudziak
James J
JJ
Rosenthal
Norman E
NE
Connor
Daniel F
DF
Hampton
Kenneth D
KD
Richard
Nathalie E
NE
Modell
Jack G
JG
D000704:Analysis of Variance; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D016642:Bupropion / Q000627:therapeutic use*; D003710:Demography; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004341:Drug Evaluation; D006801:Humans; D010919:Placebos; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D010919:Placebos; D016642:Bupropion