Drug of choice for Adult ADHD?

Ans. C. Methylphenidate. (Ref. Kaplan and Sadock's Concise Textbook of Clinical Psychiatry 3rd edition: pg. 492; http:// ps.psychiatryonline.org/ article.aspx? articleid- 83195) ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)General comments# Male to female ratio--10:1# Overtreatment is common; differentiate from child who is simply " overactive"Clinical signs# Difficulty sustaining attention: difficulty with organization, easily distracted, often does not listen when spoken to, doesn't complete tasks# Hyperactivity: fidgets, often leaves seat in classroom, difficulty playing quietly, talks excessively# Impulsivity: interrupts others, blurts out answers, difficulty waiting turnTreatment# Behavior therapy# Drug therapy: methylphenidate, dextroamphetamine, atomoxetine# Because pharmacologic treatments have been shown to be the most effective approaches for childhood ADHD, they have been the most extensively studied treatment for adult ADHD. Among the nonstimulant medications used to treat adult ADHD, the most promising are desipramine, tomoxetine, and bupropion, and possibly venlafaxine (a atypical antidepressant referred to as SNRI).# Whereas bupropion and venlafaxine have been evaluated and found promising only in open trials, desipramine and tomoxetine have been studied under double-blind conditions and found to reduce ADHD symptoms significantly better than placebo.# Among stimulant medications for adults with ADHD, methylphenidate has been the most widely studied. Six studies have evaluated the efficacy of methylphenidate, and three studies have evaluated the efficacy of pemoline. The majority of studies have reported improvement in ADHD symptoms.# It has not been compared with proved ADHD medications, such as methylphenidate or atomoxetine, for childhood and adult ADHD. Bupropion is an appropriate choice for persons with comorbid ADHD and depression