Attention deficit hyperactivity disorder in adults.
OBJECTIVE
To examine available literature regarding attention deficit hyperactivity disorder (ADHD) in adults.


METHODS
An electronic literature search of peer-reviewed English language articles using MEDLINE (without time limits) was undertaken.


RESULTS
Symptoms of ADHD in adults exert a substantial negative impact on daily life, including work, social life and relationships. Co-morbidities are common, further impairing quality of life. Diagnosis of adult ADHD can be difficult, as current criteria require evidence of symptom onset before the age of 7 years and impact on activities typically undertaken by children. Drug therapy is the first-line treatment for adult ADHD, particularly stimulant medication. However, methylphenidate (MPH) immediate-release tablets require three or more times daily dosing, which can impact on compliance, while demonstrating a loss of symptomatic benefit later in the day. Extended-release preparations of MPH, mixed amphetamine salts and dexamphetamine can provide symptom control for 6-12 h and the non-stimulant atomoxetine has demonstrated benefit in reducing ADHD symptoms. These therapies are generally well tolerated, but may be associated with adverse effects on the cardiovascular system, which need to be further assessed in controlled clinical trials. Psychological therapy may be beneficial in adults who continue to experience clinically significant symptoms while receiving pharmacotherapy.


CONCLUSIONS
Further research in all areas of adult ADHD is urgently needed.
Neurozentrum, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. Michael.Roesler@uniklinikum-saarland.de
Michael
M
Rösler
Miguel
M
Casas
Eric
E
Konofal
Jan
J
Buitelaar
D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000662:Amphetamines / Q000009:adverse effects / Q000627:therapeutic use; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D006801:Humans; D055118:Medication Adherence / Q000523:psychology; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use; D011437:Propylamines / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D018759:Adrenergic Uptake Inhibitors; D000662:Amphetamines; D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D011437:Propylamines; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride