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

@article{Santosh2011EfficacyAT,
  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},
  year={2011},
  volume={25},
  pages={737-763}
}
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… 
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References

SHOWING 1-10 OF 107 REFERENCES
Safety of therapeutic methylphenidate in adults: a systematic review of the evidence
  • J. Godfrey
  • Psychology, Medicine
    Journal of psychopharmacology
  • 2009
TLDR
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.
TLDR
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.
TLDR
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
TLDR
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.
TLDR
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.
TLDR
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
TLDR
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.
TLDR
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.
TLDR
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
TLDR
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.
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