Efficacy of stimulants in adult ADHD

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.