R. Paterson et al., A randomised, double-blind, placebo-controlled trial of dexamphetamine in adults with attention deficit hyperactivity disorder, AUST NZ J P, 33(4), 1999, pp. 494-502
Objective: The aim of this paper is to determine the efficacy of dexampheta
mine in adult attention deficit hyperactivity disorder (ADHD) in a naturali
stic setting.
Method: A randomised, double-blind, placebo-controlled study of dexamphetam
ine was conducted by two psychiatrists in private practice who saw a total
of 68 consecutive referrals of patients thought to have ADHD by their refer
ring general practitioners. Patients were admitted to the study if their cu
rrent level of ADHD symptoms satisfied DSM-IV criteria (modified for use in
adults), and were not currently comorbid for major mood disturbance or sub
stance abuse. Response to medication was assessed by repeated administratio
n of these modified DSM-IV criteria, self- and relatives' rating, as well a
s clinician rating using the Clinical Global Impressions Scale. More genera
l outcome measures included the Brief Symptom Inventory and a patient satis
faction questionnaire. Medication side effects were recorded, including mon
itoring blood pressure and weight change. Urinalysis monitored concurrent s
ubstance usage and compliance.
Results: Dexamphetamine had a significant therapeutic response exceeding th
e placebo response (p = 0.045). The response was similar in both genders an
d across the age range. it was detected by patients, their relatives and th
e two clinicians. The only significant side effect was weight loss. One pat
ient on dexamphetamine discontinued the trial because of an event possibly
related to the medication.
Conclusions: In the short term, dexamphetamine appears to be efficacious in
treating adult ADHD. As this is the first study in the literature, the res
ult requires replication. Given that stimulant medication use in adult ADHD
appears to be long-term, studies of long-term efficacy need to be carried
out.