Alternative pharmacological strategies for adult ADHD treatment: A systematic review

Massimiliano Buoli, Marta Serati, Wiepke Cahn

Research output: Contribution to journalArticlepeer-review


Adult Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition associated with high disability and frequent comorbidity. Current standard pharmacotherapy (methylphenidate and atomoxetine) improves ADHD symptoms in the short-term, but poor data were published about long-term treatment. In addition a number of patients present partial or no response to methylphenidate and atomoxetine. Research into the main database sources has been conducted to obtain an overview of alternative pharmacological approaches in adult ADHD patients. Among alternative compounds, amphetamines (mixed amphetamine salts and lisdexamfetamine) have the most robust evidence of efficacy, but they may be associated with serious side effects (e.g. psychotic symptoms or hypertension). Antidepressants, particularly those acting as noradrenaline or dopamine enhancers, have evidence of efficacy, but they should be avoided in patients with comorbid bipolar disorder. Finally metadoxine and lithium may be particularly suitable in case of comorbid alcohol misuse or bipolar disorder.

Original languageEnglish
Pages (from-to)131-144
Number of pages14
JournalExpert Review of Neurotherapeutics
Issue number2
Publication statusPublished - Feb 1 2016


  • Adults
  • Amphetamines
  • Antidepressants
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Efficacy
  • Lithium
  • Metadoxine
  • Pharmacological Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Pharmacology (medical)


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