Journal of ADHD & related disorders最新文献

{"title":"An Open Trial of Sustained Release Bupropion for Attention-Deficit/Hyperactivity Disorder in Adults with ADHD plus Substance Use Disorders.","authors":"Timothy E Wilens, Jefferson B Prince, James Waxmonsky, Robert Doyle, Thomas Spencer, Marykate Martelon, Maggie Evans","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>OBJECTIVE: To evaluate the effectiveness and tolerability of bupropion in adults with Attention-Deficit/Hyperactivity Disorder (ADHD) and comorbid active Substance Use Disorders (SUD). METHODS: This was a six-week open trial of sustained-release (SR) bupropion in adults aged 18 to 55 years diagnosed with both ADHD and SUD. Bupropion-SR was initiated at 100 mg SR and increased weekly to a target dose of 200 mg SR twice daily. Subjects were assessed on multiple outcomes including ADHD, SUD, and adverse effects. All analyses were intent to treat, with last observation carried forward. RESULTS: Thirty-two subjects were treated with bupropion, with nineteen subjects completing the entire protocol (59%). At end point there were clinically significant reductions in the ADHD RS (34.1±8.2 to 19.4±11.4, -43%, t=6.49, p<0.0001) and the Clinical Global Impression (CGI) of ADHD severity (baseline=5.0, endpoint=3.8, -24%, t=6.16, p<0.0001). In contrast, there were clinically negligible effects on the self-report of substance use (p's >0.05) and on the overall CGI of SUD severity (-23%, t=4.95, p<0.0001). CONCLUSIONS: Results from this open trial suggest that in adults with ADHD and SUD, treatment with bupropion-SR is associated with clinically significant reductions in ADHD, but not SUD.</p>","PeriodicalId":89578,"journal":{"name":"Journal of ADHD & related disorders","volume":"1 3","pages":"25-35"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322541/pdf/nihms322989.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30572274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention-Deficit/Hyperactivity Disorder Symptom Profiles in Medication-Treated Adults Entering a Psychosocial Treatment Program.","authors":"Laura E Knouse,&nbsp;Susan Sprich,&nbsp;Christine Cooper-Vince,&nbsp;Steven A Safren","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Although medications are the most widely studied effective treatments for adults with attention-deficit/hyperactivity disorder (ADHD), patients treated with medications often have significant residual symptoms that may be amenable to psychosocial intervention. Few studies, however, report on the structure and severity of specific residual ADHD symptoms in adult patients who have been treated with medications. This information may be important in identifying the most important psychosocial treatment targets for medicated adults with ADHD with residual symptoms.</p><p><strong>Objectives: </strong>Identify which symptoms of ADHD are most frequent and severe for medication-treated adults. Identify meaningful factors underlying self-report and clinician ratings in this group.</p><p><strong>Methods: </strong>Self-reported and clinician-rated ADHD symptom data from 105 adults in the community already receiving medication treatment who were entering cognitive behavioral therapy studies were examined. First, we examined the frequency and severity of each of the 18 ADHD symptoms that were present in the sample. Second, we conducted exploratory factor analyses of self-reported and clinician-rated ADHD symptoms to best describe the structure of residual symptoms in medication-treated adults, Lastly, we examined the association of the resulting factor scores with clinician-rated global ADHD severity (Clinical Global Impressions) and functional impairment (Global Assessment of Functioning) scales to determine which factors relate to overall severity.</p><p><strong>Results: </strong>The 2 most frequent (self-reported and clinician-rated) residual symptoms were disorganization (85%-88%) and distractibility (74%-83%). Exploratory factor analyses for both self-reported and clinician-rated data yielded a 3-factor model: (1) Hyperactivity/Restlessness, (2) Impulsivity/Poor Prospective Memory, and (3) Inattention. Using multiple regression, the Inattention factor from self-reported and clinician-rated data was most strongly, consistently, and uniquely related to clinician ratings of both illness severity and functioning.</p><p><strong>Conclusions: </strong>In this sample, disorganization and distractibility were the most frequent and clinically significant residual symptoms; therefore, these should be important targets in psychosocial treatments for this population. Scoring symptom rating scales in medication-treated adults with ADHD using Hyperactivity. Restlessness, Impulsivity/Poor Prospective Memory, and Inattention factors may be more informative with respect to evaluating psychosocial treatment outcome than overall scale scores alone.</p>","PeriodicalId":89578,"journal":{"name":"Journal of ADHD & related disorders","volume":"1 1","pages":"34-48"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607083/pdf/nihms-686378.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34097555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}