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PSYCHIATRY

Efficacy of Stimulants in Adult ADHD

Pharmacy Services Manager (Mental Health), Pharmacy Department, Kent and Canterbury Hospital, Ethelbert Rd., Canterbury, Kent CT1 3NG, England, FAX 44 1227 864094, ian.maidment{at}ekht.nhs.uk

Reprints: Ian D Maidment BPharm MRPharmS

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.

Key Words: adult ADHD, amphetamines, methylphenidate, pemoline, stimulants

Published Online, October 29, 2003. www.theannals.com, DOI 10.1345/aph.1D028

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-03-042-H01

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