A one year trial of methylphenidate in the treatment of ADHD.
OBJECTIVE
To determine the effects of long-term methylphenidate treatment on symptom severity and social adjustment in adult ADHD.


METHODS
Adults (n = 116) meeting operational diagnostic criteria for ADHD (the "Utah Criteria") entered a randomized double-blind crossover trial of methylphenidate and placebo. Participants who improved on immediate-release methylphenidate entered a 12-month, open-label trial. Outcomes were assessed using the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS), Clinical Global Impression-Improvement (CGI-I), global assessment of functioning (GAF), and the Weissman Social Adjustment Scale (WSAS).


RESULTS
In the double-blind trial more patients improved (50% reduction of symptoms) receiving methylphenidate (74%) than placebo (21%, p = .001). During the open-label trial, symptom severity decreased 80% from baseline, and the WSAS decreased >50% in all subscales. The average GAF improved significantly (p < .0001).


CONCLUSIONS
ADHD adults, who responded to methylphenidate in a short-tem, placebo-controlled trial, responded to long-term treatment with marked improvements in ADHD symptoms and psychosocial functioning.
Wender
Paul H
PH
Harvard Medical School, Boston, MA, USA.
Reimherr
Frederick W
FW
Marchant
Barrie K
BK
Sanford
Mary Eve
ME
Czajkowski
Laura A
LA
Tomb
David A
DA
D000328:Adult; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012917:Social Adjustment; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D008774:Methylphenidate