Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Trials

Background:

• Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder impacting children and adults, often co-occurring with other mental health conditions.
• Amphetamines are prescribed for adult ADHD, yet their effectiveness and safety profiles require further investigation.

Purpose of the Study:

• To systematically review the efficacy and safety of amphetamines in treating adult ADHD.

Main Methods:

• Conducted a comprehensive search of multiple databases and trial registers for randomized controlled trials (RCTs) comparing amphetamines against placebo or active interventions.
• Extracted data on symptom severity, treatment retention, and adverse events, assessing risk of bias and evidence quality using the GRADE approach.

Main Results:

• Amphetamines demonstrated a low to very low-quality evidence of reducing ADHD symptom severity in the short term, as rated by clinicians and patients.
• No significant improvement in treatment retention was observed, with a notable increase in withdrawals due to adverse events.
• Lisdexamfetamine and mixed amphetamine salts showed efficacy in reducing clinician-rated ADHD symptoms, unlike dexamphetamine.

Conclusions:

• While amphetamines may offer short-term symptom relief for adult ADHD, concerns regarding adverse events and limited evidence quality persist.
• The short duration and restrictive criteria of included studies limit the generalizability of findings, highlighting the need for further high-quality research.