![]() In children with ADHD the prevalence of after-school stimulant use has increased. ![]() 13ĭespite the well-documented efficacy of stimulant drugs in the treatment of ADHD, their short duration of action commonly requires a 3-times-daily dosing schedule to obtain a daylong clinical effect. In an open, 6-week trial of dextroamphetamine in 18 adults with ADHD, dramatic changes were reported in behavior, but not on cognitive measures. For example, in a placebo-controlled, single-dose crossover study of dextroamphetamine in normal men (N = 31), Rapoport et al 10 reported improved cognitive performance. 9 In addition, there is a controlled study in normal men 10 as well as several case studies 11, 12 and open series 13, 14 in adults with ADHD. 8 To our knowledge, the only previous controlled trial of amphetamines in adults with ADHD was a recent short-term study of dextroamphetamine in adults with broadly defined ADHD indicating efficacy. In adults with ADHD, controlled studies have reported an average response of 54% of subjects both to methylphenidate (6 studies, 139 subjects) and pemoline (2 studies, 93 subjects). 2 - 7 However, these differences in response may be because of either efficacy or adverse effects. Of responders, 52% responded equally well to both, 25% preferentially to amphetamine, and 23% to methylphenidate. 1 However, crossover studies of dextroamphetamine and methylphenidate (6 studies, 274 subjects) reveal differences in response on the individual level. IN CHILDREN with attention-deficit/hyperactivity disorder (ADHD), the literature suggests that the percentage of responders is comparable between the stimulants. More work is needed to evaluate the long-term effects of Adderall, or other amphetamine compounds, in the treatment of adults with ADHD. 001).Ĭonclusions Adderall was effective and well tolerated in the short-term treatment of adults with ADHD. The percentage of subjects who improved (reduction in the ADHD rating scale of ≥30%) was significantly higher with Adderall treatment than with a placebo (70% vs 7% P =. Drug-specific improvement in ADHD symptoms was highly significant overall (42% decrease on the ADHD Rating Scale, P<.001), and sufficiently robust to be detectable in a parallel groups comparison restricted to the first 3 weeks of the protocol ( P<.001). Results Treatment with Adderall at an average oral dose of 54 mg (administered in 2 daily doses) was effective and well tolerated. Comorbid psychiatric disorders were assessed to test for potential effects on treatment outcome. Outcome measures included the ADHD Rating Scale and the Clinical Global Impression Score. Medication was titrated up to 30 mg twice a day. Methods This was a 7-week, randomized, double-blind, placebo-controlled, crossover study of Adderall in 27 well-characterized adults satisfying full DSM-IV criteria for ADHD of childhood onset and persistent symptoms into adulthood.
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