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Pharmacotherapy for adult attention deficit hyperactivity disorder

Oscar Bukstein, MD
Section Editor
David Brent, MD
Deputy Editor
Richard Hermann, MD


Attention deficit hyperactivity disorder (ADHD), one of the most common neuropsychiatric disorders of childhood and adolescence, often persists in adults [1]. Studies have found that a majority of people diagnosed with ADHD in childhood continue to meet criteria for the disorder as adults [2]. ADHD in adulthood is associated with significant impairment in occupational, academic, and social functioning.

Findings from clinical trials of medications for ADHD in adults echo many of the findings on effective medications in child/adolescent ADHD; however, these data are less extensive in adults compared with children, show greater variability in outcomes, and have generated less definitive information on medication efficacy and dosing [1,2].

This topic discusses pharmacotherapy for ADHD in adults. The epidemiology, pathogenesis, clinical manifestations, assessment, diagnosis, and psychotherapy of adult ADHD are reviewed separately. ADHD in children and adolescents is reviewed separately. (See "Attention deficit hyperactivity disorder in adults: Epidemiology, pathogenesis, clinical features, course, assessment, and diagnosis" and "Psychotherapy for adult ADHD" and "Attention deficit hyperactivity disorder in children and adolescents: Overview of treatment and prognosis" and "Attention deficit hyperactivity disorder in children and adolescents: Epidemiology and pathogenesis" and "Attention deficit hyperactivity disorder in children and adolescents: Clinical features and diagnosis" and "Attention deficit hyperactivity disorder in children and adolescents: Treatment with medications" and "Pharmacology of drugs used to treat attention deficit hyperactivity disorder in children and adolescents".)


Research on the safety and efficacy of medication for ADHD in adults has grown since the early 2000s with increased recognition that ADHD often continues into adulthood and adversely affects functional outcomes. Short-term clinical trials of pharmacotherapy in adults with ADHD has shown efficacy in reducing ADHD symptoms and improving daily functioning [3]. Evidence of long-term symptom reduction is largely from observational studies, which also suggest some benefit in functioning, including work performance, and in self-esteem.


Stimulants are the most extensively tested and commonly prescribed medications for ADHD across the lifespan. The mechanism of action of stimulants in ADHD is not known, but most likely involves increased intrasynaptic concentrations of dopamine and norepinephrine [4]. Types of stimulants used to treat adult ADHD include methylphenidate and amphetamines:


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Literature review current through: Jan 2017. | This topic last updated: Wed Feb 22 00:00:00 GMT+00:00 2017.
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