Pharmacy World & Science

, Volume 31, Issue 5, pp 509–516 | Cite as

Current issues around the pharmacotherapy of ADHD in children and adults

  • Willemijn M. MeijerEmail author
  • Adrianne Faber
  • Els van den Ban
  • Hilde Tobi


Background New drugs and new formulations enter the growing market for ADHD medication. The growing awareness of possible persistence of ADHD impairment beyond childhood and adolescence resulting in increased pharmacotherapy of ADHD in adults, is also a good reason for making an inventory of the what is generally known about pharmacotherapy in ADHD. Aim To discuss current issues in the possible pharmacotherapy treatment of ADHD in children, adolescents and adults with respect to the position of pharmacotherapy in ADHD treatment guidelines, the pharmacoepidemiological trends, and current concerns about the drugs used. Methods A search of the literature with an emphasis on the position of pharmacotherapy in ADHD treatment guidelines, the pharmacoepidemiological trends, and current concerns about the drugs used in pharmacotherapy. Results According to the guidelines, the treatment of ADHD in children consists of psychosocial interventions in combination with pharmacotherapy when needed. Stimulants are the first-choice drugs in the pharmacological treatment of ADHD in children despite a number of well known and frequently reported side effects like sleep disorders and loss of appetite. With regard to the treatment of adults, stimulant treatment was recommended as the first-choice pharmacotherapy in the single guideline available. Both in children and adults, there appears to be an additional though limited role for the nonadrenergic drug atomoxetine. The increase of ADHD medication use, in children, adolescents and in adults, can not only be interpreted as a sign of overdiagnosis of ADHD. Despite the frequent use of stimulants, there is still a lack of clarity on the effects of long-term use on growth and nutritional status of children. Cardiovascular effects of both stimulants and atomoxetine are rare but can be severe. The literature suggests that atomoxetine may be associated with suicidal ideation in children. Conclusion Although pharmacotherapy is increasing common in the treatment of ADHD in both children and adults, there are still a lot of questions about side effects and how best to counter them. This suggests an important role for close monitoring of children and adults treated with stimulants or atomoxetine.


Adults Attention deficit hyperactivity disorder Children and adolescents Pharmacotherapy 


Conflicts of interest statement

Willemijn Meijer is an employee of PHARMO Institute. This research institute performs financially supported studies for several pharmaceutical companies. For this publication no relations apply.

In the past Adrianne Faber received a limited research grant from Janssen-Cilag. For this publication no relations apply.

Els van den Ban received following financial supports: from Janssen-Cilag for lecture, reimbursed travel to convention; from Ely-Lilly for scientific research (no personal grant), lecture, advisory board, reimbursed travel to convention; from UCB Pharma for advisory board, reimbursed travel to convention: from Eurosept for lecture (no personal grant), reimbursed travel to convention. For this publication no relations apply.

Hilde Tobi received financial support from Janssen-Cilag for other research projects. For this publication no relations apply.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.


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Copyright information

© The Author(s) 2009

Authors and Affiliations

  • Willemijn M. Meijer
    • 1
    Email author
  • Adrianne Faber
    • 2
  • Els van den Ban
    • 3
  • Hilde Tobi
    • 4
  1. 1.PHARMO InstituteUtrechtThe Netherlands
  2. 2.SIR Institute for Pharmacy Practice and PolicyLeidenThe Netherlands
  3. 3.Altrecht, Division Child, Youth and FamilyUtrechtThe Netherlands
  4. 4.Research MethodologyWageningen University and Research CentreWageningenThe Netherlands

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