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Thomas Spencer, MD; Timothy Wilens, MD; Joseph Biederman, MD; Stephen V. Faraone, PhD; J. Stuart Ablon; Kathleen Lapey

Arch Gen Psychiatry. 1995;52(6):434-443.

Abstract
Background
There are few controlled studies of methylphenidate hydrochloride in adults with attentiondeficit hyperactivity disorder (ADHD), and their results have been equivocal. The discrepancies among these studies may be related to low doses, diagnostic uncertainties, and lack of attention to comorbid disorders.

Methods
We conducted a randomized, 7-week, placebo-controlled, crossover study of methylphenidate in 23 adult patients with DSM-III-R ADHD using standardized instruments for diagnosis, separate assessments of ADHD and depressive and anxiety symptoms, and a robust daily dose of methylphenidate hydrochloride, 1.0 mg/kg per day.

Results
We found a marked therapeutic response for methylphenidate treatment of ADHD symptoms that exceeded the placebo response (78% vs 4%, P<.0001). Response to methylphenidate was independent of gender, psychiatric comorbidity with anxiety or moderate depression, or family history of psychiatric disorders.

Conclusion
Robust doses of methylphenidate are effective in the treatment of adult ADHD.

Author Affiliations
From the Pediatric Psychopharmacology Unit of the Massachusetts General Hospital (Drs Spencer, Wilens, Biederman, and Faraone) and the Harvard Medical School (Mr Ablon and Ms Lapey), Boston, Mass.

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