Pharmacotherapy of Attention-Deficit Hyperactivity Disorder across the Life Cycle
Abstract
Objective To evaluate the scope of the available therapeutic armamentarium in attention-deficit hyperactivity disorder (ADHD).Method The literature of medication trials in ADHD was systematically reviewed, with attention to issues of psychiatric comorbidity, age, gender, and ethnic background.Results One hundred fifty-five controlled studies of 5,768 children, adolescents, and adults have documented the efficacy of stimulants in an estimated 70% of subjects. The literature clearly documents that stimulants not only improve abnormal behaviors of ADHD, but also self-esteem, cognition, and social and family function. However, response varied in different age groups and with certain comorbid conditions. In addition, there is an impressive body of literature documenting the efficacy of tricyclic antidepressants on ADHD in more than 1,000 subjects. Studies of alternative antidepressants, antipsychotics, antihypertensives, and other compounds were also reviewed.Conclusions The available literature indicates the important role of psychopharmacological agents in the reduction of the core symptoms of ADHD and associated impairments. More research is needed on alternative pharmacological treatments and to further evaluate established therapeutics beyond school-age Caucasian boys. In addition, more research is needed on the efficacy of treatment for comorbid ADHD, use of combined medications, and the combination of medication and psychosocial treatment.
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Treatment responses from different patients are widely different in terms of the types of pharmacological treatments, dosage requirements, tolerability, response rates, and adverse-event profiles.
“evidence from a large body of studies showed that treatment responses from different patients are widely different in terms of the types of pharmacological treatments, dosage requirements, tolerability, response rates, and adverse-event profiles (Spencer et al., 1996; Efron et al., 1997; Pliszka, 2007; Newcorn et al., 2008; Victor et al., 2009; Wilens et al., 2011; Hodgkins et al., 2012).”
From A Review of Heterogeneity in Attention Deficit/Hyperactivity Disorder (ADHD) (2019) · cites this paper as Spencer et al., 1996
About 30% of children with ADHD do not respond to methylphenidate, and its side effects have forced patients to give up their therapy period.
“In addition, *30% of children with ADHD do not respond to methylphenidate, and its side effects has forced patients to give up their therapy period (Spencer et al. 1996).”
From <i>Crocus sativus</i> L. Versus Methylphenidate in Treatment of Children with Attention-Deficit/Hyperactivity Disorder: A Randomized, Double-Blind Pilot Study (2019) · cites this paper as Spencer et al. 1996
Stimulant medication improves core symptoms, compliance, aggression, and academic productivity.
“Stimulant medication has been shown to improve functioning in children with ADHD, with studies demonstrating improvements in core symptoms of ADHD, compliance, aggression, and academic productivity (Conners, 2002; Greenhill et al., 1999; Spencer et al., 1996).”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Spencer et al., 1996
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- Authors
- SPENCER, T., BIEDERMAN, J., WILENS, T., HARDING, M., O'DONNELL, D., & GRIFFIN, S.
- Affiliations
- Harvard University (US)
- Corresponding author
- SPENCER, THOMAS
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 1996-04
- Volume
- 35
- Issue
- 4
- Pages
- 409-432
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2006058627
- Cited by
- 830
- References
- 18
- Citations by year
- 2025: 4 · 2024: 9 · 2023: 13 · 2022: 8 · 2021: 10 · 2020: 11 · 2019: 12 · 2018: 8 · 2017: 20 · 2016: 17 · 2015: 18 · 2014: 19 · 2013: 28 · 2012: 24
- FWCI
- 7.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- attention deficit hyperactivity disorder, pharmacotherapy, stimulants, tricyclic antidepressants, psychiatric comorbidity, age differences in treatment response, gender differences, ethnic differences, adult ADHD
- MeSH terms
- Adolescent, Adult, Age Factors, Central Nervous System Stimulants, Antidepressive Agents, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Ethnicity, Female, Humans, Male, Sex Factors, Antipsychotic Agents
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