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Meta-Analysis
. 2018 Aug 9;8(8):CD007813.
doi: 10.1002/14651858.CD007813.pub3.

Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults

Xavier Castells  1 , Lídia Blanco-Silvente, Ruth Cunill
Affiliations
Meta-Analysis

Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults

Xavier Castells et al. Cochrane Database Syst Rev. .

Abstract

Background: Attention deficit hyperactivity disorder (ADHD) is a childhood-onset disorder characterised by inattention, hyperactivity, and impulsivity. ADHD can persist into adulthood and can affects individuals' social and occupational functioning, as well as their quality of life and health. ADHD is frequently associated with other mental disorders such as substance use disorders and anxiety and affective disorders. Amphetamines are used to treat adults with ADHD, but uncertainties about their efficacy and safety remain.

Objectives: To examine the efficacy and safety of amphetamines for adults with ADHD.

Search methods: In August 2017, we searched CENTRAL, MEDLINE, Embase, PsycINFO, 10 other databases, and two trials registers, and we ran citation searches for included studies. We also contacted the corresponding authors of all included studies, other experts in the field, and the pharmaceutical company, Shire, and we searched the reference lists of retrieved studies and reviews for other published, unpublished, or ongoing studies. For each included study, we performed a citation search in Web of Science to identify any later studies that may have cited it.

Selection criteria: We searched for randomised controlled trials comparing the efficacy of amphetamines (at any dose) for ADHD in adults aged 18 years and over against placebo or an active intervention.

Data collection and analysis: Two review authors extracted data from each included study. We used the standardised mean difference (SMD) and the risk ratio (RR) to assess continuous and dichotomous outcomes, respectively. We conducted a stratified analysis to determine the influence of moderating variables. We assessed trials for risk of bias and drew a funnel plot to investigate the possibility of publication bias. We rated the quality of the evidence using the GRADE approach, which yielded high, moderate, low, or very low quality ratings based on evaluation of within-trial risk of bias, directness of evidence, heterogeneity of data; precision of effect estimates, and risk of publication bias.

Main results: We included 19 studies that investigated three types of amphetamines: dexamphetamine (10.2 mg/d to 21.8 mg/d), lisdexamfetamine (30 mg/d to 70 mg/d), and mixed amphetamine salts (MAS; 12.5 mg/d to 80 mg/d). These studies enrolled 2521 participants; most were middle-aged (35.3 years), Caucasian males (57.2%), with a combined type of ADHD (78.8%). Eighteen studies were conducted in the USA, and one study was conducted in both Canada and the USA. Ten were multi-site studies. All studies were placebo-controlled, and three also included an active comparator: guanfacine, modafinil, or paroxetine. Most studies had short-term follow-up and a mean study length of 5.3 weeks.We found no studies that had low risk of bias in all domains of the Cochrane 'Risk of bias' tool, mainly because amphetamines have powerful subjective effects that may reveal the assigned treatment, but also because we noted attrition bias, and because we could not rule out the possibility of a carry-over effect in studies that used a cross-over design.Sixteen studies were funded by the pharmaceutical industry, one study was publicly funded, and two studies did not report their funding sources.Amphetamines versus placeboSeverity of ADHD symptoms: we found low- to very low-quality evidence suggesting that amphetamines reduced the severity of ADHD symptoms as rated by clinicians (SMD -0.90, 95% confidence interval (CI) -1.04 to -0.75; 13 studies, 2028 participants) and patients (SMD -0.51, 95% CI -0.75 to -0.28; six studies, 120 participants).Retention: overall, we found low-quality evidence suggesting that amphetamines did not improve retention in treatment (risk ratio (RR) 1.06, 95% CI 0.99 to 1.13; 17 studies, 2323 participants).Adverse events: we found that amphetamines were associated with an increased proportion of patients who withdrew because of adverse events (RR 2.69, 95% CI 1.63 to 4.45; 17 studies, 2409 participants).Type of amphetamine: we found differences between amphetamines for the severity of ADHD symptoms as rated by clinicians. Both lisdexamfetamine (SMD -1.06, 95% CI -1.26 to -0.85; seven studies, 896 participants; low-quality evidence) and MAS (SMD -0.80, 95% CI -0.93 to -0.66; five studies, 1083 participants; low-quality evidence) reduced the severity of ADHD symptoms. In contrast, we found no evidence to suggest that dexamphetamine reduced the severity of ADHD symptoms (SMD -0.24, 95% CI -0.80 to 0.32; one study, 49 participants; very low-quality evidence). In addition, all amphetamines were efficacious in reducing the severity of ADHD symptoms as rated by patients (dexamphetamine: SMD -0.77, 95% CI -1.14 to -0.40; two studies, 35 participants; low-quality evidence; lisdexamfetamine: SMD -0.33, 95% CI -0.65 to -0.01; three studies, 67 participants; low-quality evidence; MAS: SMD -0.45, 95% CI -1.02 to 0.12; one study, 18 participants; very low-quality evidence).Dose at study completion: different doses of amphetamines did not appear to be associated with differences in efficacy.Type of drug-release formulation: we investigated immediate- and sustained-release formulations but found no differences between them for any outcome.Amphetamines versus other drugsWe found no evidence that amphetamines improved ADHD symptom severity compared to other drug interventions.

Authors' conclusions: Amphetamines improved the severity of ADHD symptoms, as assessed by clinicians or patients, in the short term but did not improve retention to treatment. Amphetamines were associated with higher attrition due to adverse events. The short duration of studies coupled with their restrictive inclusion criteria limits the external validity of these findings. Furthermore, none of the included studies had an overall low risk of bias. Overall, the evidence generated by this review is of low or very low quality.

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Conflict of interest statement

Xavier Castells received a research grant for 'Improving the scientific productivity' (MPCUdG2016/ref50) from the Universitat de Girona, Spain. Ruth Cunill ‐ none known. Lídia Blanco‐Silvente has a pre‐doctoral research contract (IFUdG2015/17) with the Universitat de Girona, Spain.

Figures

1
1
Flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study. Note: scores for blinding of participants, personnel, and outcome assessors refer to amphetamines vs placebo only comparisons; scores on all remaining domains refer to amphetamines vs placebo, guanfacine, modafinil, or paroxetine.
3
3
Forest plot of comparison: 1 Amphetamines vs placebo for ADHD in adults, outcome: 1.1 Severity of ADHD symptoms: clinician rated.
4
4
Funnel plot of comparison: 1 Amphetamines vs placebo for ADHD in adults, outcome: 1.1 Severity of ADHD symptoms: clinician rated.
5
5
Forest plot of comparison: 1 Amphetamines vs placebo for ADHD in adults, outcome: 1.11 Retention in treatment.
6
6
Forest plot of comparison: 1 Amphetamines vs placebo for ADHD in adults, outcome: 1.13 Proportion of participants withdrawn owing to any adverse event.
1.1
1.1. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 1 ADHD symptom severity: clinician‐rated.
1.2
1.2. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 2 ADHD symptom severity: patient‐rated.
1.3
1.3. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 3 Clinical impression of severity at study end.
1.4
1.4. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 4 Clinical impression of improvement at study end.
1.5
1.5. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 5 Proportion of participants achieving a reduction ≥ 30% in severity of ADHD symptoms.
1.6
1.6. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 6 Proportion of participants achieving a CGI‐Improvement score of 1 or 2.
1.7
1.7. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 7 Proportion of participants achieving a reduction ≥ 30% in severity of ADHD symptoms and a CGI‐Improvement score of 1 or 2.
1.8
1.8. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 8 Global functioning.
1.9
1.9. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 9 Depressive symptoms.
1.10
1.10. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 10 Anxiety symptoms.
1.11
1.11. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 11 Retention in treatment.
1.12
1.12. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 12 Proportion of participants withdrawn owing to any cardiovascular adverse event.
1.13
1.13. Analysis
Comparison 1 Amphetamines vs placebo for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 13 Proportion of participants withdrawn owing to any adverse event.
2.1
2.1. Analysis
Comparison 2 Subgroup analysis 1: comorbidity, Outcome 1 ADHD symptom severity: clinician‐rated.
2.2
2.2. Analysis
Comparison 2 Subgroup analysis 1: comorbidity, Outcome 2 ADHD symptom severity: patient‐rated.
2.3
2.3. Analysis
Comparison 2 Subgroup analysis 1: comorbidity, Outcome 3 Retention in treatment.
2.4
2.4. Analysis
Comparison 2 Subgroup analysis 1: comorbidity, Outcome 4 Proportion of patients withdrawn owing to any adverse event.
3.1
3.1. Analysis
Comparison 3 Subgroup analysis 2: type of amphetamine, Outcome 1 ADHD symptom severity: clinician‐rated.
3.2
3.2. Analysis
Comparison 3 Subgroup analysis 2: type of amphetamine, Outcome 2 ADHD symptom severity: patient‐rated.
3.3
3.3. Analysis
Comparison 3 Subgroup analysis 2: type of amphetamine, Outcome 3 Retention in treatment.
3.4
3.4. Analysis
Comparison 3 Subgroup analysis 2: type of amphetamine, Outcome 4 Proportion of participants withdrawn owing to any adverse event.
4.1
4.1. Analysis
Comparison 4 Subgroup analysis 3: dose of dexamphetamine, Outcome 1 ADHD symptom severity: patient rated.
5.1
5.1. Analysis
Comparison 5 Subgroup analysis 3: dose of lisdexamfetamine, Outcome 1 ADHD symptom severity: clinician rated.
5.2
5.2. Analysis
Comparison 5 Subgroup analysis 3: dose of lisdexamfetamine, Outcome 2 ADHD symptom severity: patient rated.
5.3
5.3. Analysis
Comparison 5 Subgroup analysis 3: dose of lisdexamfetamine, Outcome 3 Retention in treatment.
5.4
5.4. Analysis
Comparison 5 Subgroup analysis 3: dose of lisdexamfetamine, Outcome 4 Proportion of participants withdrawn owing to any adverse event.
6.1
6.1. Analysis
Comparison 6 Subgroup analysis 3: dose of mixed amphetamine salts, Outcome 1 ADHD symptom severity: clinician rated.
6.2
6.2. Analysis
Comparison 6 Subgroup analysis 3: dose of mixed amphetamine salts, Outcome 2 Retention in treatment.
6.3
6.3. Analysis
Comparison 6 Subgroup analysis 3: dose of mixed amphetamine salts, Outcome 3 Proportion of participants withdrawn owing to any adverse event.
7.1
7.1. Analysis
Comparison 7 Subgroup analysis 4: type of drug‐release formulation, Outcome 1 ADHD symptom severity: clinician rated.
7.2
7.2. Analysis
Comparison 7 Subgroup analysis 4: type of drug‐release formulation, Outcome 2 ADHD symptom severity: patient rated.
7.3
7.3. Analysis
Comparison 7 Subgroup analysis 4: type of drug‐release formulation, Outcome 3 Retention in treatment.
8.1
8.1. Analysis
Comparison 8 Sensitivity analysis: incomplete subjective outcome data, Outcome 1 ADHD symptom severity: clinician rated.
8.2
8.2. Analysis
Comparison 8 Sensitivity analysis: incomplete subjective outcome data, Outcome 2 ADHD symptom severity: patient rated.
9.1
9.1. Analysis
Comparison 9 Sensitivity analysis: other potential sources of bias, Outcome 1 ADHD symptom severity: clinician rated.
9.2
9.2. Analysis
Comparison 9 Sensitivity analysis: other potential sources of bias, Outcome 2 ADHD symptom severity: patient rated.
9.3
9.3. Analysis
Comparison 9 Sensitivity analysis: other potential sources of bias, Outcome 3 Retention in treatment.
10.1
10.1. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 1 ADHD symptom severity: clinician‐rated.
10.2
10.2. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 2 ADHD symptom severity: patient‐rated.
10.3
10.3. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 3 Clinical impression of severity at study end.
10.4
10.4. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 4 Clinical impression of improvement at study end.
10.5
10.5. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 5 Proportion of participants achieving a reduction ≥ 30% in severity of ADHD symptoms.
10.6
10.6. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 6 Proportion of participants achieving a CGI‐Improvement score of 1 or 2.
10.7
10.7. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 7 Proportion of participants achieving a reduction ≥ 30% in severity of ADHD symptoms and a CGI‐Improvement score of 1 or 2.
10.8
10.8. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 8 Global functioning.
10.9
10.9. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 9 Depressive symptoms.
10.10
10.10. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 10 Anxiety symptoms.
10.11
10.11. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 11 Retention in treatment.
10.12
10.12. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 12 Proportion of participants withdrawn owing to any cardiovascular adverse event.
10.13
10.13. Analysis
Comparison 10 Sensitivity analysis: fixed‐effect model, Outcome 13 Proportion of participants withdrawn owing to any adverse event.
11.1
11.1. Analysis
Comparison 11 Post hoc sensitivity analysis 1: calculation of effect sizes using correlation coefficient from Taylor 2000, Outcome 1 ADHD symptom severity: clinician rated.
11.2
11.2. Analysis
Comparison 11 Post hoc sensitivity analysis 1: calculation of effect sizes using correlation coefficient from Taylor 2000, Outcome 2 ADHD symptom severity: patient rated.
12.1
12.1. Analysis
Comparison 12 Post hoc sensitivity analysis 2: pooled risk difference for proportion of participants withdrawn owing to cardiovascular adverse events and any adverse event, Outcome 1 Proportion of participants withdrawn owing to any cardiovascular adverse event.
12.2
12.2. Analysis
Comparison 12 Post hoc sensitivity analysis 2: pooled risk difference for proportion of participants withdrawn owing to cardiovascular adverse events and any adverse event, Outcome 2 Proportion of participants withdrawn owing to any adverse event.
13.1
13.1. Analysis
Comparison 13 Post hoc sensitivity analysis 3: exclusion of cross‐over study, Outcome 1 ADHD symptom severity: clinician rated.
14.1
14.1. Analysis
Comparison 14 Amphetamines vs guanfacine for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 1 ADHD symptom severity: patient rated.
15.1
15.1. Analysis
Comparison 15 Amphetamines vs modafinil for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 1 ADHD symptom severity: patient rated.
16.1
16.1. Analysis
Comparison 16 Amphetamines vs paroxetine for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 1 ADHD symptom severity: clinician rated.
16.2
16.2. Analysis
Comparison 16 Amphetamines vs paroxetine for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 2 Proportion of participants achieving a CGI‐Improvement score of 1 or 2.
16.3
16.3. Analysis
Comparison 16 Amphetamines vs paroxetine for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 3 Global functioning.
16.4
16.4. Analysis
Comparison 16 Amphetamines vs paroxetine for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 4 Depressive symptoms.
16.5
16.5. Analysis
Comparison 16 Amphetamines vs paroxetine for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 5 Anxiety symptoms.
16.6
16.6. Analysis
Comparison 16 Amphetamines vs paroxetine for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 6 Retention in treatment.
16.7
16.7. Analysis
Comparison 16 Amphetamines vs paroxetine for adult attention deficit hyperactivity disorder (ADHD) in adults, Outcome 7 Proportion of participants withdrawn owing to any adverse event.
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Update of

References

References to studies included in this review

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Weisler 2006 {published data only}
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Weisler 2017 {published data only (unpublished sought but not used)}
    1. Weisler RH, Greenbaum M, Arnold V, Yu M, Yan M, Jaffee M, et al. Efficacy and safety of SHP465 mixed amphetamine salts in the treatment of attention‐deficit/hyperactivity disorder in adults: results of a randomized, double‐blind, placebo‐controlled, forced‐dose clinical study. CNS Drugs 2017;31(8):685–97. [DOI: 10.1007/s40263-017-0455-7; NCT02604407; PMC5533822; PUBMED: 28712074] - DOI - PMC - PubMed
Weiss 2006 {published and unpublished data}
    1. Weiss M, Hechtman L, Adult ADHD Research Group. A randomized double‐blind trial of paroxetine and/or dextroamphetamine and problem‐focused therapy for attention‐deficit/hyperactivity disorder in adults. Journal of Clinical Psychiatry 2006;67(4):611‐9. [PUBMED: 16669726] - PubMed
    1. Weiss M, Murray C, Wasdell M, Greenfield B, Giles L, Hechtman L. A randomized controlled trial of CBT therapy for adults with ADHD with and without medication. BMC Psychiatry 2012;12:30‐8. [DOI: 10.1186/1471-244X-12-30] - DOI - PMC - PubMed
Wigal 2010 {published data only (unpublished sought but not used)}
    1. Wigal T, Brams M, Gasior M, Gao J, Giblin J. Effect size of lisdexamfetamine dimesylate in adults with attention‐deficit/hyperactivity disorder. Postgraduate Medicine 2011;123(2):169‐76. [DOI: 10.3810/pgm.2011.03.2275; NCT00746733; PUBMED: 21474905] - DOI - PubMed
    1. Wigal T, Brams M, Gasior M, Gao J, Squires L, Giblin J. Randomized, double‐blind, placebo‐controlled, crossover study of the efficacy and safety of lisdexamfetamine dimesylate in adults with attention‐deficit/hyperactivity disorder: novel findings using a simulated adult workplace environment design. Behavioral and Brain Functions 2010;6:34‐48. [DOI: 10.1186/1744-9081-6-34; PMC2908054] - DOI - PMC - PubMed

References to studies excluded from this review

Adler 2011 {published data only}
    1. Adler LA, Lynch LR, Shaw DM, Wallace SP, Ciranni MA, Briggie AM, et al. Medication adherence and symptom reduction in adults treated with mixed amphetamine salts in a randomized crossover study. Postgraduate Medicine 2011;123(5):71‐9. [DOI: 10.3810/pgm.2011.09.2461; NCT00468143; PUBMED: 21904088] - DOI - PubMed
Adler 2014 {published data only}
    1. Adler LA, Alperin S, Leon T, Faraone S. Clinical effects of lisdexamfetamine and mixed amphetamine salts immediate release in adult ADHD: results of a crossover design clinical trial. Postgraduate Medicine 2014;126(5):17‐24. [DOI: 10.3810/pgm.2014.09.2796; NCT01070394; PUBMED: 25295646] - DOI - PubMed
    1. Adler LA, Alperin S, Leon T, Faraone, SV. Pharmacokinetic and pharmacodynamic properties of lisdexamfetamine in adults with attention‐deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology 2017;27(2):196‐9. [DOI: 10.1089/cap.2016.0121; PUBMED: 27935735] - DOI - PubMed
Arnold 1972 {published data only}
    1. Arnold LE, Strobl D, Weisenberg A. Hyperkinetic adult. Study of the "paradoxical" amphetamine response. JAMA 1972;222(6):693‐4. - PubMed
Castaneda 2000 {published data only}
    1. Castaneda R, Levy R, Hardy M, Trujillo M. Long‐acting stimulants for the treatment of attention‐deficit disorder in cocaine‐dependent adults. Psychiatric Services 2000;51(2):169‐71. [DOI: 10.1176/appi.ps.51.2.169; PUBMED: 10654994] - DOI - PubMed
Dodson 2005 {published data only}
    1. Dodson WW. Pharmacotherapy of adult ADHD. Journal of Clinical Psychology 2005;61(5):589‐606. [DOI: 10.1002/jclp.20122; PUBMED: 15723384] - DOI - PubMed
Faraone 2002 {published data only}
    1. Faraone SV, Short EJ, Biederman J, Findling RL, Roe C, Manos MJ. Efficacy of Adderall and methylphenidate in attention deficit hyperactivity disorder: a drug‐placebo and drug‐drug response curve analysis of a naturalistic study. International Journal of Neuropsychopharmacology 2002;5(2):121‐9. [DOI: 10.1017/S1461145702002845; PUBMED: 12135536] - DOI - PubMed
Goodman 2005 {published data only}
    1. Goodman DW, Ginsberg L, Weisler RH, Cutler AJ, Hodgkins P. An interim analysis of the Quality of Life, Effectiveness, Safety, and Tolerability (QU.E.S.T.) evaluation of mixed amphetamine salts extended release in adults with ADHD. CNS Spectrums 2005;10(12 Suppl 20):26‐34. [PUBMED: 16344838] - PubMed
Lasser 2010 {published data only}
    1. Lasser RA, Dirks B, Adeyi B, Babcock T. Comparative efficacy and safety of lisdexamfetamine dimesylate and mixed amphetamine salts extended release in adults with attention‐deficit/hyperactivity disorder. Primary Psychiatry 2010;17(9):44‐54.
Mattingly 2012 {published data only}
    1. Mattingly G, Weisler R, Dirks B, Babcock T, Adeyi B, Scheckner B, et al. Attention deficit hyperactivity disorder subtypes and symptom response in adults treated with lisdexamfetamine dimesylate. Innovations in Clinical Neuroscience 2012;9(5‐6):22‐30. [PMC3398683; PUBMED: 22808446] - PMC - PubMed
Paterson 1999 {published data only}
    1. Paterson R, Douglas C, Hallmayer J, Hagan M, Krupenia Z. A randomised, double‐blind, placebo‐controlled trial of dexamphetamine in adults with attention deficit hyperactivity disorder. Australian and New Zealand Journal of Psychiatry 1999;33(4):494‐502. [DOI: 10.1080/j.1440-1614.1999.00590.x; PUBMED: 10483843] - DOI - PubMed
Rostain 2009 {published data only}
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Spencer 2004 {published data only}
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Waxmonsky 2011 {published data only}
    1. Waxmonsky JG, Waschbusch DA, Glatt SJ, Faraone SV. Prediction of placebo response in 2 clinical trials of lisdexamfetamine dimesylate for the treatment of ADHD. Journal of Clinical Psychiatry 2011;72(10):1366‐75. [DOI: 10.4088/JCP.10m05979pur; NCT00334880; NCT00556296; PUBMED: 21367347] - DOI - PubMed
Weisler 2014 {published data only}
    1. Weisler RH, Adler LA, Kollins SH, Goodman DW, Hamdani M, Dirks B, et al. Analysis of individual items on the attention‐deficit/hyperactivity disorder symptom rating scale in children and adults: the effects of age and sex in pivotal trials of lisdexamfetamine dimesylate. Neuropsychiatric Disease and Treatment 2014;10:1‐12. [DOI: 10.2147/NDT.S47087; PUBMED: PMC3862743] - DOI - PMC - PubMed
Wiebe 2010 {published data only}
    1. Wiebe S, Gruber R, Charney El, Aryal S, Waldman I, Newcorn H, et al. Sleep and emotional reactivity to extended release dexmethylphenidate versus mixed amphetamine salts: a double‐blind, placebo controlled study. European Child & Adolescent Psychiatry 2010;19(Suppl 1):S82.
Wilens 2005 {published data only}
    1. Wilens TE, Hammerness PG, Biederman J, Kwon A, Spencer TJ, Clark S, et al. Blood pressure changes associated with medication treatment of adults with attention‐deficit/hyperactivity disorder. Journal of Clinical Psychiatry 2005;66(2):253‐9. [PUBMED: 15705013] - PubMed
Young 2015 {published data only}
    1. Young S, Khondoker M, Emilsson B, Sigurdsson JF, Philipp‐Wiegmann F, Baldursson G, et al. Cognitive‐behavioural therapy in medication‐treated adults with attention‐deficit/hyperactivity disorder and co‐morbid psychopathology: a randomized controlled trial using multi‐level analysis. Psychological Medicine 2015;45(13):2793‐804. [DOI: 10.1017/S0033291715000756; PMC4595859; PUBMED: 26022103] - DOI - PMC - PubMed

References to ongoing studies

NCT00202605 {published data only}
    1. NCT00202605. Safety and efficacy of SPD465 in adults with ADHD [A phase II, randomized, double‐blind, multi‐center, placebo‐controlled, crossover study of SPD465 in adults with attention‐deficit hyperactivity disorder (ADHD)]. clinicaltrials.gov/ct2/show/NCT00202605 (first received 20 September 2005).
NCT00514202 {published data only}
    1. NCT00514202. Pilot study examining effect for dextroamphetamine to treat cocaine dependence plus attention‐deficit hyperactivity disorder [Dextroamphetamine treatment for comorbid cocaine dependence and ADHD]. clinicaltrials.gov/ct2/show/NCT00514202 (first received 9 August 2007).
NCT00928148 {published data only}
    1. NCT00928148. The safety and efficacy of SPD465 in adults with attention deficit hyperactivity disorder (ADHD) [A phase 2, randomized, double‐blind, multi‐center, placebo‐ and active‐controlled, crossover study of SPD465 in adults with attention‐deficit hyperactivity disorder]. clinicaltrials.gov/ct2/show/NCT00928148 (first received 25 June 2009).
NCT01863459 {published data only}
    1. NCT01863459. Lisdexamfetamine dimesylate in the treatment of adult ADHD with anxiety disorder comorbidity. clinicaltrials.gov/ct2/show/NCT01863459 (first received 29 May 2013).
NCT02635035 {published data only}
    1. NCT02635035. Shire SCT: lisdexamfetamine treatment for ADHD and SCT [Efficacy of lisdexamfetamine in adults with attention deficit hyperactivity disorder (ADHD) and sluggish cognitive tempo (SCT)]. clinicaltrials.gov/ct2/show/NCT02635035 (first received 18 December 2015).
NCT02803229 {published data only}
    1. NCT02803229. Treatment of cannabis use disorder among adults with comorbid attention‐deficit/hyperactivity disorder (MJ‐ADHD). clinicaltrials.gov/ct2/show/NCT02803229 (first received 16 June 2016).
NCT03153488 {published data only}
    1. NCT03153488. Attention deficit hyperactivity disorder (ADHD) prediction of treatment response. Clinicaltrials.gov/ct2/show/NCT03153488 (first received 15 May 2007).

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