ADHD is a neurodevelopmental disorder characterized by inappropriate levels of inattention and/or hyperactivity-impulsivity and occurs in approximately 3% to 10% of children and adolescents and 2.5% of adults.1 Research indicates that increasing numbers of high school students with ADHD are going to college. Treatment options include both non-pharmacological (eg, behavioral support therapies, coaching, cognitive-behavior therapy, neurofeedback) and pharmacological approaches.
A plethora of studies attest to the effectiveness of prescription stimulants for ADHD symptoms in children and adults with the disorder, and more recent studies report that stimulants often lead to improvements in self-regulation, planning, and organizational skills (ie, executive functions).2 Commonly prescribed stimulants for ADHD include methylphenidate, mixed amphetamine salts, and the prostimulant lisdexamfetamine (see Table 1). Double-blind placebo-controlled studies support the efficacy and safety of these medications in children, adolescents, and adults when taken as prescribed and appropriately monitored.
The use of prescription stimulants to treat ADHD symptoms first began in 1937 when psychiatrist Charles Bradley administered benzedrine sulfate to children with behavior problems at the Emma Pendelton Bradley Home in Providence, Rhode Island. The practice of prescribing stimulants (methylphenidate) for the treatment of hyperactive and inattentive behavior became more commonplace in the 1950s and widely accepted in the 1980s, corresponding with the specification of attention deficit disorder in DSM-III.
Although prescription stimulants are often highly effective in reducing ADHD symptoms in children, adolescents, and adults, the misuse (ie, non-medical) of prescription stimulants among adolescents, college students, and adults has become problematic in recent years. Estimates of prescription stimulant misuse vary among studies but meta-analyses report between 5% to 35% of college students in the US report misusing prescription stimulants and varying rates have been reported among military personnel, lawyers, medical, dental, and nursing students.3,4
A recent population study conducted by the US National Association of Drug Abuse reported 16.0 million used prescription stimulants in the past year, 5.0 million misused prescription stimulants, and 0.4 million had prescription stimulant use disorders.5 International studies have found similar prevalence, underscoring that prescription stimulant misuse is present across cultures (eg, Germany, Iceland, Switzerland, UK).
Dr Weyandt is Professor, Department of Psychology, University of Rhode Island, George and Anne Ryan Institute for Neuroscience; Ms Bjorn is an undergraduate, Department of Psychology, University of Rhode Island, Kingston, RI.
The authors report no conflicts of interest concerning the subject matter of this article.
1. Centers for Disease Control and Prevention. Attention-Deficit/Hyperactivity Disorder: Data and Statistics. 2018. https://www.cdc.gov/ncbddd/adhd/data.html. Accessed August 13, 2018.
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