Psychiatry Online
neuro.psychiatryonline.org
Our present findings confirm the efficacy of MPH in the treatment of adult ADHD as demonstrated in other controlled studies. Efficacy (as defined by a reduction of at least 30% in the severity of ADHD symptoms) was 48% in our study, which is similar to the 57% efficacy reported by Wender et al.20 but lower than the 78% efficacy reported by Spencer et al.3 Our study also expands previous findings demonstrating significant improvement in behavioral domains such as irritability, aggression, anxiety, and depression—which, although not part of the ADHD cluster, are nonetheless frequently reported in adult ADHD. To our knowledge this is the first study to show the usefulness of lithium to treat adult ADHD. Although lithium had a somewhat lower overall efficacy than MPH (37% and 48% respectively), it produced similar improvements on scores of anxiety, depression, overt aggression, and anterograde verbal memory. Because our study did not include a placebo arm, whether the memory-related finding is a genuine effect of the medication or is due to a practice effect could not be ascertained. The prevalence and severity of side effects were similar for lithium and MPH.