Treatment of Adults with Attention-Deficit/Hyperactivity Disorder: A Systematic Literature Review

Objective: To compare treatment with stimulant medications to nonstimulant medications and/or nonpharmacologic interventions on professional and interpersonal functioning in adults with attention-deficit/hyperactivity disorder (ADHD). Method: Systematic literature review of five databases; 22 articles containing 323 studies (N=21,370) were included in this review. Results: Psychostimulants remain the most studied treatment for adults with ADHD and boast larger effect sizes than nonstimulant and nonpharmacologic therapy. Among nonpharmacologic therapy, cognitive behavior therapy (CBT) has proven most successful in randomized controlled trials. Effects of CBT are enhanced when combined with pharmacotherapy. Conclusions: Psychostimulants continue to be the most frequently prescribed treatment for adults with ADHD. Nonstimulant medications and nonpharmacotherapy remain used as an adjunct or alternative to psychostimulant therapy, but show promise in producing long-term improvements in professional and interpersonal functioning in adults with ADHD