Efficacy and Tolerability of Pharmacotherapies for Attention-Deficit Hyperactivity Disorder in Adults

  title={Efficacy and Tolerability of Pharmacotherapies for Attention-Deficit Hyperactivity Disorder in Adults},
  author={Paramala J Santosh and Sanjida Sattar and Myooran Canagaratnam},
  journal={CNS Drugs},
This review examines the evidence regarding the efficacy and tolerability of long- and short-acting stimulant medications, as well as the non-stimulant medications atomoxetine and bupropion in the treatment of adult attention-deficit hyperactivity disorder (ADHD). Effect sizes in adults appear to be of almost the same magnitude as in school-age children when robust doses are used. There are adequate data demonstrating short-term efficacy and safety of medication in ADHD during adulthood but… 
Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder
The high attrition rate underscores the need for further research to identify possible modes to increase retention to treatment and indicates those diagnosed with ADHD and on long-term treatment with stimulants experience mild and tolerable adverse effects.
Pharmacological and clinical dilemmas of prescribing in co‐morbid adult attention‐deficit/hyperactivity disorder and addiction
The present article reviews whether available efficacy and safety data support the pharmacological treatment of adult attention‐deficit/hyperactivity disorder (ADHD) in patients with concurrent
Pharmacological treatment of adult ADHD
Effect sizes from the most recent studies are calculated and they are almost identical with prior estimates, and in terms of Cohen-d typically indicate medium-to-high effect sizes for the pharmacotherapy of adult ADHD.
The Effectiveness of Medicinal and Non-medicinal Treatments of Attention-Deficit/Hyperactivity Disorder
The effectiveness of multiple treatment methods commonly used for this disorder as well as issues concerning the effects and over-prescription of stimulant medications has become more prominent in recent years and should be further discussed.
Attention deficit hyperactivity disorder in adults
Examination of available literature regarding attention deficit hyperactivity disorder in adults found psychological therapy may be beneficial in adults who continue to experience clinically significant symptoms while receiving pharmacotherapy, and these therapies are generally well tolerated.
Risk of Serious Cardiovascular Problems with Medications for Attention-Deficit Hyperactivity Disorder
The risk for serious cardiovascular adverse events associated with stimulants, atomoxetine or α2-adrenergic agonists prescribed for ADHD is extremely low and the benefits of treating individual patients with ADHD, after an adequate assessment, outweigh the risks.
The female side of pharmacotherapy for ADHD—A systematic literature review
Several sex-differences are demonstrated in the prescription, usage and efficacy /effectiveness of both stimulant and non-stimulant ADHD pharmacotherapy, suggesting a single daily use of MPH may possibly not be optimal for girls with ADHD and ATX may be a promising medication for girls and women with ADHD.
Resveratrol adjunct to methylphenidate improves symptoms of attention-deficit/hyperactivity disorder: a randomized, double-blinded, placebo-controlled clinical trial
Resveratrol administration for a duration of 8 weeks improved characteristic symptoms in patients with ADHD according to their parents and further investigations containing larger sample sizes, longer supplementation periods, and dose–response evaluations are required to replicate these findings in ADHD children more confidently.


Safety of therapeutic methylphenidate in adults: a systematic review of the evidence
  • J. Godfrey
  • Psychology, Medicine
    Journal of psychopharmacology
  • 2009
There is little information on the long-term safety of methylphenidate in adults, although the number of serious adverse effects reported to regulatory authorities has, so far, been low.
A controlled trial of methylphenidate in adults with attention deficit/hyperactivity disorder and substance use disorders.
The effect of low-dose methylphenidate in adult ADHD patients with concomitant substance use disorders is limited, and ADHD symptoms in adults were susceptible to a distinct short-term placebo response.
A controlled clinical trial of bupropion for attention deficit hyperactivity disorder in adults.
The results suggest a therapeutic role for bupropion in the armamentarium of agents for ADHD in adults, while further validating the continuity of pharmacological responsivity of ADHD across the lifespan.
Non-stimulant treatments for ADHD
Several lines of evidence provide preliminary support for the potential benefits of cholinergic cognitive enhancing drugs in such as anticholinesterase inhibitors (tacrine, donepezil) as well as novel nicotinic analogues (ABT-418).
Six-week, double-blind, placebo-controlled study of desipramine for adult attention deficit hyperactivity disorder.
Results in adults with ADHD indicate that desipramine is effective in the treatment of ADHD in adults, similar to findings in children and adolescents with ADHD.
Effectiveness and tolerability of tomoxetine in adults with attention deficit hyperactivity disorder.
This preliminary study showed that tomoxetine was effective in treating adult ADHD and was well tolerated, and these promising results provide support for further studies of tomoxettine over an extended period of treatment.
A pilot clinical trial of oxcarbazepine in adults with attention deficit hyperactivity disorder
The results of this investigation indicate that oxcarbazepine may be a potentially useful agent for the treatment of ADHD in adults.
A comparison of the efficacy of medications for adult attention-deficit/hyperactivity disorder using meta-analysis of effect sizes.
Although both stimulant and nonstimulant medications are effective for treating ADHD in adults, stimulant medications show greater efficacy for the short durations of treatment characteristic of placebo-controlled studies.
Efficacy of a mixed amphetamine salts compound in adults with attention-deficit/hyperactivity disorder.
Adderall was effective and well tolerated in the short-term treatment of adults with ADHD and more work is needed to evaluate the long-term effects of Adderall, or other amphetamine compounds, in the treatment of adult attention-deficit/hyperactivity disorder.
Safety and tolerability of once versus twice daily atomoxetine in adults with ADHD.
  • L. AdlerA. Dietrich D. Kelsey
  • Medicine, Psychology
    Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
  • 2006
Data indicate both dosing strategies are safe, well tolerated, and efficacious in the treatment of adult ADHD, implying that there is room for prescribers to use discretion and to base dosed strategies on individual factors.