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Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus
Online ISSN 1827-1731
CONTROVERSIES IN PSYCHIATRY
Center for Psychiatry and Behavioral Medicine Inc., Las Vegas, NV, USA
Attention-deficit/hyperactivity disorder (ADHD) consists of developmentally excessive levels of inattention and hyperactivity and is the most frequently occurring neurobehavioral disorder in children with a worldwide prevalence estimated to be 5.29%. Since the first publication of Bradley’s data in 1937 on the effectiveness of amphetamine (AMPH) in the treatment of hyperactivity in boys, stimulants have been used to control symptoms of ADHD. They are the most commonly prescribed medications used to treat ADHD in the USA and include AMPH and methylphenidate (MPH). MPH was first marketed in the US in 1955. Since these medications have been on the market for several decades, a vast amount of data regarding efficacy and side effects exists. Early use of stimulants was limited to short-acting formulations which had to be taken more than once daily to maintain effect, but with the development of new technology, longer-acting versions of both AMPH and MPH have made once-daily dosing standard in the US. The adverse effects of newer stimulant formulations are comparable to those of the original stimulant formulations. MPH and AMPH are available in multiple countries outside of the US, but AMPH use is more limited in Europe despite abundant efficacy and safety data. This review will focus on data supporting the use of stimulants as first line treatment of ADHD in children and adolescents. Differences between the European clinical guidelines for the treatment of hyperkinetic disorder and the guidelines published by the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry will be discussed.