Ian D Maidment1. 1. Pharmacy Department, Kent and Canterbury Hospital, Ethelbert Rd., Canterbury, Kent CT1 3NG, England. ian.maidment@ekht.nhs.uk
Abstract
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.
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.
Authors: Danielle C Turner; Andrew D Blackwell; Jonathan H Dowson; Andrew McLean; Barbara J Sahakian Journal: Psychopharmacology (Berl) Date: 2004-08-27 Impact factor: 4.530