Long-term pharmacotherapy in adults may be efficacious and well tolerated, a recent literature review and clinical study has reported.
Researchers investigated the effect of prolonged drug treatment on long-term outcomes in adults with ADHD. Although a systematic literature review revealed few long-term (≥24 weeks) treatment studies in adults with ADHD, ADHD medication was found to be more efficacious versus placebo in all included randomised controlled trials (n=4). Furthermore, efficacy was maintained or improved during the follow-up period in short-term studies with extension phases of up to 1 year (n=9). Researchers judged medication to be well tolerated by most patients.
A prospective clinical study in medication-naïve outpatient adults with ADHD (n=250) was conducted to investigate the effectiveness of medication administered in accordance with current clinical guidelines (combined with usual psychosocial interventions) over a 1-year period. A follow-up evaluation at 12 months was completed by 93% of patients, of whom 70% remained on medication. Significant improvements in symptoms* and functioning† were observed in adults still medicated at 12 months, compared with those who were not (both p<0.001). Of 69 (28%) patients who had discontinued treatment before the 12 month follow-up, 31 (12%) terminated due to adverse events; no serious adverse events occurred.
Researchers concluded that these results were indicative of favourable effects associated with ADHD medication maintained over a prolonged period. More longitudinal studies would be useful in helping clinicians make informed decisions about long-term pharmacotherapy in adults with ADHD.
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*Adult ADHD Self-Report Scale version 1.1
†Global Assessment of Functioning (investigator-rated)
Fredriksen M, Peleikis DE. Long-term pharmacotherapy of adults with attention deficit hyperactivity disorder: a literature review and clinical study. Basic Clin Pharmacol Toxicol 2016; 118: 23-31.