Pharmacotherapy of attention-deficit/
hyperactivity disorder in adults

Wender PH
Department of Psychiatry, University of Utah School
of Medicine, Salt Lake City 84132, USA.
J Clin Psychiatry 1998; 59 Suppl 7:76-9


A history of childhood attention-deficit/hyperactivity disorder (ADHD) is a mandatory prerequisite for the diagnosis of adult type ADHD, for which no DSM criteria exists. Since the diagnosis must be made retroactively, tentative criteria have been designed to establish the presence of the childhood disorder. In the 1970s, I advanced the hypothesis that "minimal brain dysfunction" (as ADHD was called) might be produced by decreased catecholaminergic function. A total of over 300 ADHD patients have been included in treatment studies, including 224 patients who received stimulants in four double-blind, placebo-controlled trials: three of methylphenidate (N = 176) and one of pemoline (N = 48). An additional 79 patients have been included in open-label trials of pargyline, selegiline, bupropion, levodopa, phenylalanine, and tyrosine. Altogether, these studies have demonstrated the efficacy of methylphenidate, pemoline, and monoamine oxidase-B (MAO-B) inhibitors when administered to adult ADHD patients; a robust response was produced in 60% of the patients. Bupropion and selegiline were effective in the open-label studies and should be systematically evaluated. A long-term study is being conducted with methylphenidate maintenance; patients have been followed for as long as 5 years, and little, if any, drug tolerance has been observed. Treatment of adult patients who have ADHD is symptomatic, not curative, but the combination of medication and psychotherapy may offer life-changing opportunities to individuals who suffer from the disorder.
ADHD and sport
Tomoxetine (Strattera) for ADHD
Ritalin, Adderall and Strattera for ADHD
Antidepressants to treat ADHD in adults
Bupropion for ADHD and bipolar disorder
ADHD, amphetamine and the dopamine transporter

and further reading

Future Opioids
BLTC Research
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family