title: Alternative pharmacological strategies for adult ADHD treatment: a systematic review.
abstract: Adult Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition associated with high disability and frequent comorbidity. Current standard pharmacotherapy (methylphenidate and atomoxetine) improves ADHD symptoms in the short-term, but poor data were published about long-term treatment. In addition a number of patients present partial or no response to methylphenidate and atomoxetine. Research into the main database sources has been conducted to obtain an overview of alternative pharmacological approaches in adult ADHD patients. Among alternative compounds, amphetamines (mixed amphetamine salts and lisdexamfetamine) have the most robust evidence of efficacy, but they may be associated with serious side effects (e.g. psychotic symptoms or hypertension). Antidepressants, particularly those acting as noradrenaline or dopamine enhancers, have evidence of efficacy, but they should be avoided in patients with comorbid bipolar disorder. Finally metadoxine and lithium may be particularly suitable in case of comorbid alcohol misuse or bipolar disorder.
authors.affiliation: a Department of Psychiatry, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico , University of Milan , Milan , Italy.|b Department of Psychiatry, Brain Center Rudolf Magnus , University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Buoli
authors.affiliation: a Department of Psychiatry, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico , University of Milan , Milan , Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Serati
authors.affiliation: b Department of Psychiatry, Brain Center Rudolf Magnus , University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Wiepke
authors.initials: W
authors.lastname: Cahn
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000328:Adult; D000662:Amphetamines / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D019086:Bridged Bicyclo Compounds, Heterocyclic / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003891:Desipramine / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use*; D015103:Droxidopa / Q000627:therapeutic use; D004338:Drug Combinations; D000068736:Duloxetine Hydrochloride / Q000627:therapeutic use; D016316:Guanfacine / Q000627:therapeutic use; D018494:Histamine Agents / Q000627:therapeutic use; D006801:Humans; D000069478:Lisdexamfetamine Dimesylate / Q000627:therapeutic use; D018020:Lithium Compounds / Q000627:therapeutic use; D008120:Lobeline / Q000627:therapeutic use; D008464:Mecamylamine / Q000627:therapeutic use; D008559:Memantine / Q000627:therapeutic use; D000077408:Modafinil; D009025:Morpholines / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D018733:Nicotinic Antagonists / Q000627:therapeutic use; D009627:Nomifensine / Q000627:therapeutic use; D017374:Paroxetine / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D011736:Pyridoxine / Q000627:therapeutic use; D011761:Pyrrolidonecarboxylic Acid / Q000627:therapeutic use; D052999:Quinazolinones / Q000627:therapeutic use; D000077593:Reboxetine; D000069470:Venlafaxine Hydrochloride / Q000627:therapeutic use; D064690:Wakefulness-Promoting Agents / Q000627:therapeutic use
chemical_list: C578484:3-(5-chloro-2-furoyl)-3,7-diazabicyclo(3.3.0)octane; C090411:Adderall; D000316:Adrenergic alpha-Agonists; D000662:Amphetamines; D000928:Antidepressive Agents; D001559:Benzhydryl Compounds; D019086:Bridged Bicyclo Compounds, Heterocyclic; D000697:Central Nervous System Stimulants; D015259:Dopamine Agents; D004338:Drug Combinations; D018494:Histamine Agents; D018020:Lithium Compounds; C574738:MK-0249; D009025:Morpholines; D018722:Nicotinic Agonists; D018733:Nicotinic Antagonists; D011725:Pyridines; D052999:Quinazolinones; D064690:Wakefulness-Promoting Agents; D016642:Bupropion; D009627:Nomifensine; D016316:Guanfacine; C490152:ispronicline; D017374:Paroxetine; D008464:Mecamylamine; D000069470:Venlafaxine Hydrochloride; D000068736:Duloxetine Hydrochloride; D000077593:Reboxetine; D008120:Lobeline; C037845:metadoxine; D015103:Droxidopa; D011736:Pyridoxine; D000077408:Modafinil; D000069478:Lisdexamfetamine Dimesylate; D011761:Pyrrolidonecarboxylic Acid; D003891:Desipramine; D008559:Memantine
keywords: Adults; Amphetamines; Antidepressants; Attention Deficit Hyperactivity Disorder (ADHD); Efficacy; Lithium; Metadoxine; Pharmacological Treatment