Long-Term Effects of Stimulant Treatment for ADHD: What Can We Tell Our Patients?

Abstract

Introduction: Stimulant medication is a well-researched treatment for attention deficit hyperactivity disorder (ADHD) and is among the most effective treatments in psychiatry. Parents often want to know more about the long-term risks and benefits of medication. Our objective was to review the seminal papers on long-term outcomes of stimulant treatment for ADHD for the purpose of providing clinicians with the background they need to interpret these findings for patients. Methods: We reviewed key articles on long-term outcome of symptoms, comorbidity, substance use, executive functioning, academics, side effects, neurobiology, functioning, and quality of life. Results: Stimulants are very effective medications in the short term when used optimally. Long-term randomized, placebo-controlled studies are not feasible. Long-term naturalistic studies are limited by absence of controls. Discussion: When administered properly with careful titration, follow-up, and dose adjustment, stimulants are a safe and effective treatment for ADHD with minimal long-term risk and possible long-term benefit.