A comparative analysis of antidepressants and stimulants for the treatment of adults with attention-deficit hyperactivity disorder.

BACKGROUND

Adults who identify themselves as having problems with attention and concentration will often make an office visit to request treatment with a stimulant medication, rather than an antidepressant. The uncertainty of the diagnosis and the prospect of a long-term prescription with a stimulant medication can create a dilemma for physicians.

METHODS

We searched MEDLINE for any English-language studies of antidepressant or stimulant treatment of adults with attention deficits. References from relevant articles were reviewed to supplement the MEDLINE search.

RESULTS

Antidepressants and stimulants seem to be equally effective for adults with attention-deficit hyperactivity disorder (ADHD). Recent controlled studies suggest that desipramine (an antidepressant) may be as effective as methylphenidate (a stimulant) for improving symptoms of adult ADHD.

CONCLUSIONS

Although few good controlled studies exist, the available research suggests that certain antidepressants and stimulants are equally effective for adults with ADHD. Antidepressants may offer a safe first-line treatment for adults with ADHD.