Efficacy of stimulants in adult ADHD.

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.