Attention-deficit hyperactivity disorder medical therapy: Difference between revisions

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__NOTOC__
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{{ADHD}}
{{CMG}}; {{AE}} {{CP}}, {{HW}}
{{CMG}}; {{AE}} {{CP}}, {{HW}}


{{ADHD}}
==Overview==
==Overview==
The mainstay of therapy for ADHD is the administration of such [[stimulants]] as [[Ritalin]] and [[Adderall]]. While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Other treatment options include [[psychotherapy]], education and training, or a combination of therapies.<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref>  
The mainstay of therapy for ADHD is the administration of such [[stimulants]] as [[Ritalin]] and [[Adderall]]. While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Other treatment options include [[psychotherapy]], education and training, or a combination of therapies.<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref>
 
Measurement-based care may help<ref name="pmid22193788">{{cite journal| author=Bickman L, Kelley SD, Breda C, de Andrade AR, Riemer M| title=Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial. | journal=Psychiatr Serv | year= 2011 | volume= 62 | issue= 12 | pages= 1423-9 | pmid=22193788 | doi=10.1176/appi.ps.002052011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22193788  }} </ref><ref name="pmid37099379">{{cite journal| author=Lawrence-Sidebottom D, Huffman LG, Huberty J, Beatty C, Roots M, Roots K | display-authors=etal| title=Using Digital Measurement-Based Care to Address Symptoms of Inattention, Hyperactivity, and Opposition in Youth: Retrospective Analysis of Bend Health. | journal=JMIR Form Res | year= 2023 | volume= 7 | issue=  | pages= e46578 | pmid=37099379 | doi=10.2196/46578 | pmc=10173032 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=37099379  }} </ref>.
 
Practice guidelines are available<ref name="pmid30453134">{{cite journal| author=Kooij JJS, Bijlenga D, Salerno L, Jaeschke R, Bitter I, Balázs J | display-authors=etal| title=Updated European Consensus Statement on diagnosis and treatment of adult ADHD. | journal=Eur Psychiatry | year= 2019 | volume= 56 | issue=  | pages= 14-34 | pmid=30453134 | doi=10.1016/j.eurpsy.2018.11.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30453134  }} </ref><<ref name="pmid37878798">{{cite journal| author=Baughman DJ, Watson CM, Beich JW, Herboso MNJ, Cuttie LK, Marlyne AC| title=Recommendation for Long-term Management of Adult Attention-Deficit/Hyperactivity Disorder in Military Populations, Veterans, and Dependents: A Narrative Review. | journal=Mil Med | year= 2023 | volume=  | issue=  | pages=  | pmid=37878798 | doi=10.1093/milmed/usad403 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=37878798  }} </ref>


==Medical Therapy==
==Medical Therapy==
{{main|Attention-deficit hyperactivity disorder treatments}}
Several different types of medications may be prescribed to mitigate the symptoms associated with ADHD. Approximately 3% of adults are treated with persistent medication<ref name="pmid35476068">{{cite journal| author=Li L, Chang Z, Sun J, Jangmo A, Zhang L, Andersson LM | display-authors=etal| title=Association Between Pharmacological Treatment of Attention-Deficit/Hyperactivity Disorder and Long-term Unemployment Among Working-Age Individuals in Sweden. | journal=JAMA Netw Open | year= 2022 | volume= 5 | issue= 4 | pages= e226815 | pmid=35476068 | doi=10.1001/jamanetworkopen.2022.6815 | pmc=9047436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35476068  }} </ref>.
Several different types of medications may be prescribed to mitigate the symptoms associated with ADHD.
 
The research on treatment is summarized within reviews by the [https://research-information.bris.ac.uk/en/projects/cochrane-developmental-psychosocial-learning-problems-group Cochrane Developmental, Psychosocial & Learning Problems Group].
'
*[[Stimulants]], such as [[Methylphenidate]] (Ritalin) and amphetamine salts (dextroamphetamine and amphetamine; [[Adderall]]), are used to increase the patient’s supply of the brain chemicals [[dopamine]] and [[norepinephrine]], which play essential roles in thinking and [[attention]].<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref> Ritalin is safe and effective in preschool-aged children suffering from ADHD so long as they are closely monitored while taking the drug.<ref name="pmid23452683">{{cite journal| author=Riddle MA, Yershova K, Lazzaretto D, Paykina N, Yenokyan G, Greenhill L et al.| title=The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-year follow-up. | journal=J Am Acad Child Adolesc Psychiatry | year= 2013 | volume= 52 | issue= 3 | pages= 264-278.e2 | pmid=23452683 | doi=10.1016/j.jaac.2012.12.007 | pmc=3660093 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23452683  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23696095 Review in: Evid Based Ment Health. 2013 Aug;16(3):63] </ref>
*[[Stimulants]], such as [[Methylphenidate]] (Ritalin) and amphetamine salts (dextroamphetamine and amphetamine; [[Adderall]]), are used to increase the patient’s supply of the brain chemicals [[dopamine]] and [[norepinephrine]], which play essential roles in thinking and [[attention]].<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref> Ritalin is safe and effective in preschool-aged children suffering from ADHD so long as they are closely monitored while taking the drug.<ref name="pmid23452683">{{cite journal| author=Riddle MA, Yershova K, Lazzaretto D, Paykina N, Yenokyan G, Greenhill L et al.| title=The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-year follow-up. | journal=J Am Acad Child Adolesc Psychiatry | year= 2013 | volume= 52 | issue= 3 | pages= 264-278.e2 | pmid=23452683 | doi=10.1016/j.jaac.2012.12.007 | pmc=3660093 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23452683  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23696095 Review in: Evid Based Ment Health. 2013 Aug;16(3):63] </ref>
* [[Lisdexamfetamine]] is a prodrug of dextroamphetamine. It may be dosed once a day and is less likely to be abused.
* [[Lisdexamfetamine]] is a prodrug of dextroamphetamine. It may be dosed once a day and is less likely to be abused.
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*Other drugs, including [[anti-depressants]], may also be prescribed in cases of ADHD depending on the patient’s co-morbidities.<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref>
*Other drugs, including [[anti-depressants]], may also be prescribed in cases of ADHD depending on the patient’s co-morbidities.<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref>


===Education and training===
{| class="wikitable"
*Educating the patient and his or her family members can prove useful in combating the negative effects of ADHD. For the parents or guardians of young patients, parenting skills training can help teach them the skills they need to encourage and reward positive behaviors in their children. Such training helps parents learn how to use a system of rewards and consequences to change a child’s behavior. In this intervention, parents are taught to give immediate and positive feedback for behaviors they want to encourage, and ignore or redirect behaviors that they want to discourage.
|+  Pharmacotherapy of adult ADHD
*Parents may also find it helpful to learn stress management techniques, which could increase their ability to productively deal with their [[frustration]] and enable them to interact with their child in a calm manner.
|-
*[[Support groups]] can assist the parents and families of ADHD patients by connecting them with others who have similar problems and concerns. Groups often meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies, and to talk with experts.<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref>
!
 
! Standard mean difference (SMD)* for<br/>patient-reported symptoms
==Monitoring response to treatment==
! Discontinuation ratio
 
|-
Methods of monitoring treatment for ADHD have been reviewed.<ref name="pmid28184164">{{cite journal| author=Ramsay JR| title=Assessment and monitoring of treatment response in adult ADHD patients: current perspectives. | journal=Neuropsychiatr Dis Treat | year= 2017 | volume= 13 | issue=  | pages= 221-232 | pmid=28184164 | doi=10.2147/NDT.S104706 | pmc=5291336 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28184164 }} </ref>
| Amphetamines (dexamphetamine, lisdexamfetamine, mixed amphetamine salts)<ref name="pmid30091808">{{cite journal| author=Castells X, Blanco-Silvente L, Cunill R| title=Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults. | journal=Cochrane Database Syst Rev | year= 2018 | volume= 8 | issue=  | pages= CD007813 | pmid=30091808 | doi=10.1002/14651858.CD007813.pub3 | pmc=6513464 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30091808 }} </ref>
 
| -0.51 (95% CI -0.75 to -0.28)<br/> &bull; dexamphetamine: SMD -0.77, 95% CI -1.14 to -0.40; two studies, 35 participants<br/>&bull; lisdexamfetamine: SMD -0.33, 95% CI -0.65 to -0.01; three studies, 67 participants
One method is the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS). The WRAADDS has been validated in a clinician administered format<ref name="pmid23647041">{{cite journal| author=Marchant BK, Reimherr FW, Robison D, Robison RJ, Wender PH| title=Psychometric properties of the Wender-Reimherr Adult Attention Deficit Disorder Scale. | journal=Psychol Assess | year= 2013 | volume= 25 | issue= 3 | pages= 942-50 | pmid=23647041 | doi=10.1037/a0032797 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23647041 }} </ref> and a self-administered format<ref name="pmid26554368">{{cite journal| author=Marchant BK, Reimherr FW, Wender PH, Gift TE| title=Psychometric properties of the Self-Report Wender-Reimherr Adult Attention Deficit Disorder Scale. | journal=Ann Clin Psychiatry | year= 2015 | volume= 27 | issue= 4 | pages= 267-77; quiz 278-82 | pmid=26554368 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26554368 }} </ref>. The self-administered version typically reports about 2 points higher than the clinician adminsitered version. The WRAADDS asks 30 questions in 7 domains, each with Cronbach alpha > 0.7:
| 2.69
# Attention Difficulties
|-
# Hyperactivity/Restlessness
| Bupropion<ref name="pmid28965364">{{cite journal| author=Verbeeck W, Bekkering GE, Van den Noortgate W, Kramers C| title=Bupropion for attention deficit hyperactivity disorder (ADHD) in adults. | journal=Cochrane Database Syst Rev | year= 2017 | volume= 10 | issue= | pages= CD009504 | pmid=28965364 | doi=10.1002/14651858.CD009504.pub2 | pmc=6485546 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28965364 }} </ref>
# Temper
| -0.50 (95% CI -0.86 to -0.15)
# Affective Lability
| 1.20
# Emotional Over-Reactivity
|-
# Disorganization
| Methylphenidate, immediate-release<ref name="pmid33460048">{{cite journal| author=Cândido RCF, Menezes de Padua CA, Golder S, Junqueira DR| title=Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. | journal=Cochrane Database Syst Rev | year= 2021 | volume= 1 | issue= 1 | pages= CD013011 | pmid=33460048 | doi=10.1002/14651858.CD013011.pub2 | pmc=8092481 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33460048 }} </ref>
# Impulsivity
| -0.59, 95% CI -1.25 to 0.06; I<sup>2</sup> = 69%; 2 trials
 
|
Benchmarks for the self-reported version (SR-WRAADDS) are<ref name="pmid26554368" />:
|-
* Subjects ''without'' ADHD: 8.5  ± 4.6
| Methylphenidate, extended-release<ref name="pmid35201607">{{cite journal| author=Boesen K, Paludan-Müller AS, Gøtzsche PC, Jørgensen KJ| title=Extended-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. | journal=Cochrane Database Syst Rev | year= 2022 | volume= 2 | issue= 2 | pages= CD012857 | pmid=35201607 | doi=10.1002/14651858.CD012857.pub2 | pmc=8869321 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35201607 }} </ref>
* Subjects ''with'' ADHD: 23.4 ± 4.3
| −0.37, 95% CI −0.43 to −0.30; I<sup>2</sup> = 0%; 16 trials
** After treatment, score typically drops by 5 points or effect size (different / standard deviation) of 0.7
|
 
|-
Definitions of treatment response or 'normalization' include<ref name="pmid28184164">{{cite journal| author=Ramsay JR| title=Assessment and monitoring of treatment response in adult ADHD patients: current perspectives. | journal=Neuropsychiatr Dis Treat | year= 2017 | volume= 13 | issue= | pages= 221-232 | pmid=28184164 | doi=10.2147/NDT.S104706 | pmc=5291336 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28184164 }} </ref>:
| colspan="3" | * Interpretation of standard mean difference (SMD):<br/>0.2 represents a small effect<br/>0.5 a moderate effect<br/>0.8 a large effect
* "Follow-up scores falling within 1.0 standard deviation of the normal mean". For example, SR-WRAADD of less than 13.1
|}
* "30% reduction in symptoms" or score


==References==
==References==

Latest revision as of 20:39, 3 January 2024

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2], Haleigh Williams, B.S.

Overview

The mainstay of therapy for ADHD is the administration of such stimulants as Ritalin and Adderall. While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Other treatment options include psychotherapy, education and training, or a combination of therapies.[1]

Measurement-based care may help[2][3].

Practice guidelines are available[4]<[5]

Medical Therapy

Several different types of medications may be prescribed to mitigate the symptoms associated with ADHD. Approximately 3% of adults are treated with persistent medication[6].

The research on treatment is summarized within reviews by the Cochrane Developmental, Psychosocial & Learning Problems Group. '

  • Stimulants, such as Methylphenidate (Ritalin) and amphetamine salts (dextroamphetamine and amphetamine; Adderall), are used to increase the patient’s supply of the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention.[1] Ritalin is safe and effective in preschool-aged children suffering from ADHD so long as they are closely monitored while taking the drug.[7]
  • Lisdexamfetamine is a prodrug of dextroamphetamine. It may be dosed once a day and is less likely to be abused.
  • Atomoxetine (Strattera) is a selective norepinepherine reuptake inhibitor (SNRI) approved for the management of ADHD. It is effective in adult ADHD and is often favored due to lack of abuse potential[8]. Atomoxetine carries a black box warning as there is an increase risk of suicidal ideation in adolescents[9]. While it is non-inferior to methylphenidate in children, its adverse effects in children and adolescents render it a less favorable treatment option.[10]
  • Non-stimulants such as extended release Guanfacine and Clonidine (both alpha-2 adrenergic agonists) are also used to treat ADHD[11].
  • Other drugs, including anti-depressants, may also be prescribed in cases of ADHD depending on the patient’s co-morbidities.[1]
Pharmacotherapy of adult ADHD
Standard mean difference (SMD)* for
patient-reported symptoms 		Discontinuation ratio
Amphetamines (dexamphetamine, lisdexamfetamine, mixed amphetamine salts)[12] -0.51 (95% CI -0.75 to -0.28)
• dexamphetamine: SMD -0.77, 95% CI -1.14 to -0.40; two studies, 35 participants
• lisdexamfetamine: SMD -0.33, 95% CI -0.65 to -0.01; three studies, 67 participants 		2.69
Bupropion[13] -0.50 (95% CI -0.86 to -0.15) 1.20
Methylphenidate, immediate-release[14] -0.59, 95% CI -1.25 to 0.06; I2 = 69%; 2 trials
Methylphenidate, extended-release[15] −0.37, 95% CI −0.43 to −0.30; I2 = 0%; 16 trials
* Interpretation of standard mean difference (SMD):
0.2 represents a small effect
0.5 a moderate effect
0.8 a large effect

References

  1. ↑ 1.0 1.1 1.2 National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."
  2. ↑ Bickman L, Kelley SD, Breda C, de Andrade AR, Riemer M (2011). "Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial". Psychiatr Serv. 62 (12): 1423–9. doi:10.1176/appi.ps.002052011. PMID 22193788.
  3. ↑ Lawrence-Sidebottom D, Huffman LG, Huberty J, Beatty C, Roots M, Roots K; et al. (2023). "Using Digital Measurement-Based Care to Address Symptoms of Inattention, Hyperactivity, and Opposition in Youth: Retrospective Analysis of Bend Health". JMIR Form Res. 7: e46578. doi:10.2196/46578. PMC 10173032 Check |pmc= value (help). PMID 37099379 Check |pmid= value (help).
  4. ↑ Kooij JJS, Bijlenga D, Salerno L, Jaeschke R, Bitter I, Balázs J; et al. (2019). "Updated European Consensus Statement on diagnosis and treatment of adult ADHD". Eur Psychiatry. 56: 14–34. doi:10.1016/j.eurpsy.2018.11.001. PMID 30453134.
  5. ↑ Baughman DJ, Watson CM, Beich JW, Herboso MNJ, Cuttie LK, Marlyne AC (2023). "Recommendation for Long-term Management of Adult Attention-Deficit/Hyperactivity Disorder in Military Populations, Veterans, and Dependents: A Narrative Review". Mil Med. doi:10.1093/milmed/usad403. PMID 37878798 Check |pmid= value (help).
  6. ↑ Li L, Chang Z, Sun J, Jangmo A, Zhang L, Andersson LM; et al. (2022). "Association Between Pharmacological Treatment of Attention-Deficit/Hyperactivity Disorder and Long-term Unemployment Among Working-Age Individuals in Sweden". JAMA Netw Open. 5 (4): e226815. doi:10.1001/jamanetworkopen.2022.6815. PMC 9047436 Check |pmc= value (help). PMID 35476068 Check |pmid= value (help).
  7. ↑ Riddle MA, Yershova K, Lazzaretto D, Paykina N, Yenokyan G, Greenhill L; et al. (2013). "The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-year follow-up". J Am Acad Child Adolesc Psychiatry. 52 (3): 264–278.e2. doi:10.1016/j.jaac.2012.12.007. PMC 3660093. PMID 23452683. Review in: Evid Based Ment Health. 2013 Aug;16(3):63
  8. ↑ Garnock-Jones KP, Keating GM (2009). "Atomoxetine: a review of its use in attention-deficit hyperactivity disorder in children and adolescents". Paediatr Drugs. 11 (3): 203–26. doi:10.2165/00148581-200911030-00005. PMID 19445548.
  9. ↑ Barry, Colleen (01/21/2014). [www.ncbi.nlm.nih.gov/pmc/articles/PMC3896970/ "ADHD Medication Use Following FDA Risk Warnings"] Check |url= value (help). NIH. Retrieved 06/12/2018. Check date values in: |access-date=, |date= (help)
  10. ↑ Michelson D, Adler L, Spencer T, Reimherr FW, West SA, Allen AJ, Kelsey D, Wernicke J, Dietrich A, Milton D (2003). "Atomoxetine in adults with ADHD: two randomized, placebo-controlled studies". Biol. Psychiatry. 53 (2): 112–20. PMID 12547466.
  11. ↑ Southammakosane, Cathy (August 2015). [www.pediatrics.aappublications.org/content/136/2/351 "Pediatric Psychopharmacology for Treatment of ADHD, Depression, and Anxiety"] Check |url= value (help). AAP. Retrieved 06/12/18. Check date values in: |access-date= (help)
  12. ↑ Castells X, Blanco-Silvente L, Cunill R (2018). "Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults". Cochrane Database Syst Rev. 8: CD007813. doi:10.1002/14651858.CD007813.pub3. PMC 6513464 Check |pmc= value (help). PMID 30091808.
  13. ↑ Verbeeck W, Bekkering GE, Van den Noortgate W, Kramers C (2017). "Bupropion for attention deficit hyperactivity disorder (ADHD) in adults". Cochrane Database Syst Rev. 10: CD009504. doi:10.1002/14651858.CD009504.pub2. PMC 6485546. PMID 28965364.
  14. ↑ Cândido RCF, Menezes de Padua CA, Golder S, Junqueira DR (2021). "Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults". Cochrane Database Syst Rev. 1 (1): CD013011. doi:10.1002/14651858.CD013011.pub2. PMC 8092481 Check |pmc= value (help). PMID 33460048 Check |pmid= value (help).
  15. ↑ Boesen K, Paludan-Müller AS, Gøtzsche PC, Jørgensen KJ (2022). "Extended-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults". Cochrane Database Syst Rev. 2 (2): CD012857. doi:10.1002/14651858.CD012857.pub2. PMC 8869321 Check |pmc= value (help). PMID 35201607 Check |pmid= value (help).


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