Acta Medica Iranica 2014. 52(9):675-680.

Bupropion in adults with Attention-Deficit/Hyperactivity Disorder: a randomized, double-blind study.
Mehdi Hamedi, Mohammadreza Mohammdi, Ali Ghaleiha, Zahra Keshavarzi, Morteza Jafarnia, Rasool Keramatfar, Rosa Alikhani, Abolfazl Ehyaii, Shahin Akhondzadeh

Abstract


Attention-Deficit/Hyperactivity Disorder is one of the most common mental disorders in childhood, and it continues to adulthood without proper treatment. Stimulants have been used in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) for many years, and the efficacy of methylphenidate in the treatment of adults with ADHD has been proven to be acceptable according to meta-analysis studies. However, there are some concerns about stimulants. Finding other effective medications for the treatment of adult ADHD seems necessary. We hypothesized bupropion could be effective in the treatment of adult ADHD because some theoretical and experimental evidence exists to support efficacy of this medication. Forty-two patients with a diagnosis of ADHD, according to the revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, were randomized to receive 150 mg/day bupropion or placebo for a 6-week double-blind, placebo-controlled clinical trial. Each patient filled the Conners' Adult ADHD Rating Scales-Self-Report-Screening version (CAARS) before starting to take medication and in weeks 3 and 6 of the study. The mean score of the two groups receiving bupropion or placebo decreased over the 6 weeks. There was a significant difference between the two groups in CAARS score after 6 weeks. Bupropion is more effective than placebo in the treatment of adults with ADHD. Bupropion can be an alternative medication for the treatment of Adults with ADHD as its clinical efficacy was proven by other studies.

Keywords


Adult; ADHD; Bupropion; Clinical Trial

Full Text:

PDF

References


Mohammadi MR, Hafezi P, Galeiha A, et al. Buspirone versus methylphenidate in the treatment of children with attention- deficit/hyperactivity disorder: randomized, double-blind study. Acta Med Iran 2012;50(11):723-8.

Mohammadi M, Akhondzadeh S. Advances and considerations in attention-deficit/hyperactivity disorder pharmacotherapy. Acta Med Iran 2011;49(8):487-98.

Haavik J, Halmøy A, Lundervold AJ, et al. Clinical assessment and diagnosis of adults with attentiondeficit/ hyperactivity disorder. Expert Rev Neurother 2010;10(10):1569-80.

Spencer TJ, Biederman J, Mick E. Attention- Deficit/Hyperactivity Disorder: Diagnosis, Lifespan, Comorbidities, and Neurobiology. J Pediatr Psychol 2007;32(6):631-42.

Pelham WE, Foster EM, Robb JA. The Economic Impact of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. J Pediatr Psychol 2007;32(6):711-27.

Abbasi SH, Heidari S, Mohammadi MR, et al. Acetyl-Lcarnitine as an adjunctive therapy in the treatment of attention-deficit/hyperactivity disorder in children and adolescents: a placebo-controlled trial. Child Psychiatry Hum Dev 2011;42(3):367-75.

Mohammadi MR, Kazemi MR, Zia E, et al. Amantadine versus methylphenidate in children and adolescents with attention deficit/hyperactivity disorder: a randomized, double-blind trial. Hum Psychopharmacol 2010;25(7-8):560-5.

Baron DA, Pato MT, Cyr RL. Treatment of Adults with Attention-Deficit/Hyperactivity Disorder. J Am Osteopath Assoc 2011;111(11):610-4.

Zarinara AR, Mohammadi MR, Hazrati N, et al. Venlafaxine versus methylphenidate in pediatric outpatients with attention deficit hyperactivity disorder: a randomized, double-blind comparisontrial. Hum Psychopharmacol 2010;25(7-8):530-5.

Salehi B, Imani R, Mohammadi MR, et al. Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 2010;34(1):76-80.

Lee SS, Humphreys KL, Flory K, et al. Prospective Association of Childhood Attention-deficit/hyperactivity Disorder (ADHD) and Substance Use and Abuse/Dependence: A Meta-Analytic Review. Clin Psychol Rev 2011;31(3):328-41.

Adamou M, Arif M, Asherson P, et al. Occupational issues of adults with ADHD. BMC Psychiatry 2013;13(1):59-65.

Ivanchak N, Fletcher K, Jicha GA. Attention- Deficit/Hyperactivity Disorder in Older Adults: Prevalence and Possible Connections to Mild Cognitive Impairment. Curr Psychiatry Rep 2012;14(5):552-60.

Shaw M, Hodgkins P, Caci H, et al. A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and nontreatment. BMC Medicine 2012;10(1):99-114.

Arns M, de Ridder S, Strehl U, et al. Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clin EEG Neurosci 2009;40(3):180-9.

Kooij SJ1, Bejerot S, Blackwell A, et al. European consensus statement on diagnosis and treatment of adult ADHD. The European Network Adult ADHD. BMC Psychiatry 2010;10(1):67-90.

Wilens TE, Spencer TJ, Biederman J, et al. A Controlled Clinical Trial of Bupropion for Attention Deficit Hyperactivity Disorder in Adults. Am J Psychiatry 2001;158(2):282-8.

Wilens TE, Haight BR, Horrigan JP, et al. Bupropion XL in Adults with Attention-Deficit/Hyperactivity Disorder. A Randomized, Placebo-Controlled Study. Biol Psychiatry 2005;57(7):793-801.

Wilens TE, Prince JB, Waxmonsky J, et al. An Open Trial of Sustained Release Bupropion for Attention- Deficit/Hyperactivity Disorder in Adults with ADHD plus Substance Use Disorders. J ADHD Relat Disord 2010;1(3):25-35.

Levin FR, Evans SM, Brooks DJ, et al. Treatment of methadone-maintained patients with adult ADHD:Doubleblind comparison of methylphenidate, bupropion and placebo. Drug and Alcohol Dependence 2006;81(2):137-48.

Reimherr FW, Hedges DW, Strong RE, et al. Bupropion SR in adults with ADHD: a shortterm,placebo-controlled trial. Neuropsychiatr Dis Treat 2005;1(3):245-51.

Maneeton N, Maneeton B, Srisurapanont M, et al. Bupropion for adults with attention-deficit hyperactivity disorder: Meta-analysis of randomized, placebo-controlled trials. Psychiatry Clin Neurosci 2011;65(7):611-17.

Conners CK, Erhardt D, Sparrow MA. Book Review. Conners' adult ADHD rating scales (CAARS). Arch Clin Neuropsychol 2003;18:431-7.

Wender PH, Reimherr FW. Bupropion Treatment of ADHD in Adult. Am J Psychiatr 1990;147(1):8.

Wilens TE, Prince JB, Spencer T, et al. An open trial of bupropion for the treatment of adults with attentiondeficit/ hyperactivity disorder and bipolar disorder. Biol Psychiatry 2003;54(1):9-16.

Wilens TE, Prince JB, Waxmonsky J, et al. An Open Trial of Sustained Release Bupropion for Attention- Deficit/Hyperactivity Disorder in Adults with ADHD plusnSubstance Use Disorders. J ADHD Relat Disord 2010;1(3):25-35.

Jafarinia M, Mohammadi MR, Modabbernia A, et al. Bupropion versus methylphenidate in the treatment of children with attention-deficit/hyperactivity disorder: randomized double-blind study. Hum Psychopharmacol 2012;27(4):411-8.

Lamba V, Lamba J, Yasuda K, et al. Hepatic CYP2B6 expression: gender and ethnic differences and relationship to CYP2B6 genotype and CAR (constitutive androstane receptor) expression. J Pharmacol Exp Ther 2003;307(3):906-22.

Ilic K, Hawke RL, Thirumaran RK, et al. The influence of sex, ethnicity, and CYP2B6 genotype on bupropion metabolism as an index of hepatic CYP2B6 activity in humans. Drug Metab Dispos 2013;41(3):575-81.

Zhu AZ, Cox LS, Nollen N, et al. CYP2B6 and bupropion's smoking-cessation pharmacology: the role of hydroxybupropion. Clin Pharmacol Ther 2012;92(6):771-7.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.