Two-Year Outcome of Treatment With Central Stimulant Medication in Adult Attention-Deficit/Hyperactivity Disorder: A Prospective Study

Given that adults with ADHD continue to use stimulants for extended periods of time, studies on the long-term effectiveness and adverse events are warranted. The aims of this study were to investigate factors associated with persistence in treatment in an exploratory manner and to document side effe...

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Bibliographic Details
Published in:	The journal of clinical psychiatry Vol. 71; no. 12; pp. 1590 - 1597
Main Authors:	BEJEROT, Susanne, RYDEN, Eleonore M, ARLINDE, Christina M
Format:	Journal Article
Language:	English
Published:	Memphis, TN Physicians Postgraduate Press 01-12-2010
Subjects:	Adult Anxiety - diagnosis Anxiety - drug therapy Anxiety - epidemiology Anxiety - psychology Attention - drug effects Attention Deficit Disorder with Hyperactivity - diagnosis Attention Deficit Disorder with Hyperactivity - drug therapy Attention Deficit Disorder with Hyperactivity - epidemiology Attention Deficit Disorder with Hyperactivity - psychology Attention deficit disorders. Hyperactivity Biological and medical sciences Blood Pressure - drug effects Central Nervous System Stimulants - adverse effects Central Nervous System Stimulants - therapeutic use Child clinical studies Comorbidity Diagnostic and Statistical Manual of Mental Disorders Female Follow-Up Studies Heart Rate - drug effects Humans Impulsive Behavior - drug therapy Irritable Mood - drug effects Male Medical sciences Medicin och hälsovetenskap Neuropharmacology Outpatients Pharmacology. Drug treatments Prospective Studies Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychomotor Agitation - drug therapy Psychopathology. Psychiatry Psychopharmacology Surveys and Questionnaires Treatment Outcome Human Treatment CNS stimulant Psychotropic Follow up study Adult Attention disorder with hyperactivity
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Summary:	Given that adults with ADHD continue to use stimulants for extended periods of time, studies on the long-term effectiveness and adverse events are warranted. The aims of this study were to investigate factors associated with persistence in treatment in an exploratory manner and to document side effects and reasons for discontinuation. The current study describes the systematic follow-up of 133 psychiatric patients with DSM-IV-diagnosed ADHD treated with central stimulants at a specialized outpatient unit between January 1, 2001, and August 31, 2006. A standardized questionnaire, derived from the Targeted Attention-deficit Disorder Symptoms Rating Scale, was used in order to measure improvement of the following target symptoms: hyperactivity, impulsivity, irritability, distractibility, structure/organization problems, inattention, and restlessness. Eighty percent of the patients were successfully treated with stimulants at the 6- to 9-month follow-up. Fifty percent remained in treatment after 2 years or more. Forty-five percent were treated for comorbid anxiety and/or depression during the study period. Only 15% dropped out because of lack of efficacy. The amount of clinical response over the first 6 to 9 months (but not at 6 weeks) predicted adherence to treatment at 2 years. The patients' heart rate increased from a least squares mean ± SE of 70 ± 2.2 to 80 ± 2.1 bpm (P = .00003) while blood pressure remained unchanged at the ≥ 2-year follow-up. Severe side effects or drug abuse were not detected in this cohort. The long-term treatment outcome shows that stimulants are effective in adult ADHD and side effects tend to be mild.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0160-6689 1555-2101 1555-2101
DOI:	10.4088/JCP.09m05168pur