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Efficacy of stimulants in adult ADHD
1Pharmacy Department, Kent and Canterbury Hospital, Ethelbert Rd., Canterbury, Kent CT1 3NG, England. ian.maidment@ekht.nhs.uk
Objective:
To review the literature regarding the efficacy of stimulants to treat attention-deficit-hyperactivity disorder (ADHD) in adults.
Data Sources:
The relevant pharmaceutical manufacturers were contacted, and searches of MEDLINE (1966-December 2002) and the reference sections of each article obtained were performed using the key search terms: adult ADHD, stimulants, methylphenidate, amphetamines, and pemoline.
Study Selection And Data Extraction:
All English-language original studies identified from the data sources were evaluated and all information deemed relevant was included in the review.
Data Synthesis:
Studies involving methylphenidate, amphetamines, and pemoline were identified. There was evidence for the efficacy of amphetamines from 5 studies (4 controlled, 1 open). Methylphenidate data from 6 controlled trials were conflicting. Three studies indicated efficacy; 2 studies failed to show efficacy, possibly due to methodologic reasons; and the results from 1 study were conflicting. The limited data from 1 controlled and 1 open study indicated that pemoline may be less effective than methylphenidate and amphetamines.
Conclusions:
While the current limited data indicate that stimulants may be effective in adult ADHD, more data are required to confirm long-term efficacy.
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Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.