Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults
Xavier Castells1, Josep Antoni Ramos-Quiroga, Rosa Bosch
1Unit of Clinical Pharmacology, Department of Medical Sciences, Faculty of Medicine, Universitat de Girona, Girona, Catalonia, Spain.
The Cochrane Database of Systematic Reviews
|June 17, 2011
Summary
Amphetamines effectively reduce Attention Deficit Hyperactivity Disorder (ADHD) symptoms in adults but are linked to increased adverse events and dropout. Mixed amphetamine salts (MAS) also improved treatment retention.
Area of Science:
- Pharmacology
- Clinical Psychology
- Neuroscience
Background:
- Attention Deficit Hyperactivity Disorder (ADHD) often persists into adulthood, with amphetamines being a common treatment.
- Uncertainties remain regarding the long-term efficacy and safety of amphetamines for adult ADHD.
Purpose of the Study:
- To evaluate the efficacy and safety of amphetamines in treating adult ADHD.
- To analyze the impact of dosage, drug type, and release formulation on treatment outcomes.
- To compare amphetamines with placebo and other active interventions.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases including PubMed, EMBASE, and clinicaltrials.gov up to February 2010.
- Extracted data on symptom severity, treatment retention, and adverse events; analyzed risk of bias and publication bias.
Main Results:
- Seven placebo-controlled RCTs with 1091 participants were included.
- Amphetamines significantly improved ADHD symptom severity (SMD = -0.72) but increased dropout due to adverse events (RR 3.03).
- Mixed amphetamine salts (MAS) improved treatment retention, while other derivatives showed efficacy in symptom reduction; no dose or formulation differences were found.
Conclusions:
- Amphetamines demonstrate short-term efficacy for adult ADHD symptom reduction.
- Higher attrition due to adverse events was observed with amphetamines.
- Study limitations include short follow-up, restrictive criteria, and high risk of bias, potentially overestimating efficacy.
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