Low-Dose Amphetamine Salts and Adult Attention-Deficit/Hyperactivity Disorder
J Clin Psychiatry 2000;61(6):414-417
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Effective treatments for
attention-deficit/hyperactivity disorder (ADHD) in adults are
still being defined. Pediatric studies have suggested that a
mixed amphetamine salt product (Adderall) is safe and effective
in the treatment of childhood forms of ADHD. Presently, there are
no reports in the scientific literature concerning the safety and
efficacy of Adderall in adults with ADHD, which is the focus of
Method: Twenty-four outpatients (mean age = 33.3
years) with DSM-IV ADHD were administered Adderall in an
open-label fashion, starting at 5 mg p.o. b.i.d., with titration
according to clinical response, across a 16-week period.
Relatives or spouses of each patient completed serial checklists
(including the Copeland Symptom Checklist and the Brown
Attention-Deficit Disorder Scales). Prospectively collected data
were analyzed retrospectively.
Results: Thirteen patients (54%) responded in a
positive manner to Adderall, based on Clinical Global
Impressions-Improvement scale scores. The mean end dose for
responders was 10.77 mg/day (0.14 mg/kg/day). An intent-to-treat
analysis revealed a decrease in the mean Copeland score from
99.05 to 63.3 (p < .001), while the mean Brown score dropped
from 76.75 to 50.85 (p < .0001). Nine patients (38%) were poor
responders or nonresponders to Adderall. Acute anxiety symptoms
occurred in 4 of 7 patients with a comorbid anxiety diagnosis.
Conclusion: Adderall may be an effective agent
for the treatment of adult forms of ADHD, with positive responses
occurring at relatively low doses, at least for some individuals.
However, Adderall may precipitate anxiety in vulnerable
individuals. Further study is required.