In this video, we present a brief history of stimulants and their use as a first-line pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD). Check your understanding of the use of stimulants to improve attention, organization, focus, and hyperactivity. Review the published efficacy and potential side effects observed with stimulant treatment.
This module was medically reviewed by Julie Carbray, PhD, APRN, Clinical Professor of Psychiatry and Nursing, University of Illinois, Chicago.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hy
peractivity, and impulsivity that results in functional impairment.
Although most often first diagnosed in childhood, ADHD is diagnosed and managed across the lifespan.
Stimulants are a first-line pharmacotherapy for ADHD.
Stimulants can be categorized into amphetamines or methylphenidates.
Both of these categories function in the same manner. They block the reuptake of dopamine and norepinephrine at the presynaptic and postsynaptic membranes.
In this way, they impact patients’ executive and attentional function, and improve hyperactivity.
Stimulants are available in several different formulations that offer different features. For example, immediate-release formulations offer more flexibility with dosing frequency and titration. However, long-acting formulations tend to yield better medication adherence and a lower risk of rebound effects such as moodiness or more extreme ADHD symptoms.
Stimulants can also be taken through several delivery systems, such as liquid formulations, chewable tablets, and transdermal patches.
Hundreds of studies have been conducted to evaluate the efficacy of individual stimulant medications for the treatment of ADHD.
One recent meta-analysis compared 6 stimulants against each other as well as placebo in terms of efficacy and tolerability in children, adolescents, and adults.
For reducing core ADHD symptoms in children and adolescents, teachers and clinicians indicated that all active medications were more effective than placebo.
For adult core symptom improvement, clinicians rated amphetamines, methylphenidate, bupropion, and atomoxetine as more effective than placebo.
The results of this meta-analysis provide evidence to support the therapeutic use of these stimulant medications in children, adolescents, and adults as treatment options for ADHD.
Stimulants can cause some undesired side effects or adverse events that patients should be aware of and clinicians should monitor.
Unfortunately, methamphetamine has become the second most abused illicit drug in the United States.
While prescription stimulants improve attention, organization, and focus, clinicians must be vigilant that stimulants should be used for managing ADHD symptoms rather than misused for performance enhancement or adverse effects.
Overall, stimulants are an effective first-line pharmacotherapy for the treatment of ADHD. These medications are available in various formulations and delivery systems to help patients better address common symptoms of ADHD.