Bupropion XL in adults with attention-deficit/hyperactivity disorder: A randomized, placebo-controlled study

• Published in: Biological psychiatry (1969) 2005-04, Vol.57 (7), p.793-801
• Main Authors: Wilens, Timothy E., Haight, Barbara R., Horrigan, Joseph P., Hudziak, James J., Rosenthal, Norman E., Connor, Daniel F., Hampton, Kenneth D., Richard, Nathalie E., Modell, Jack G.
• Format: Article
• Language: English
• Subjects: ADHD; Adult and adolescent clinical studies; adults; Analysis of Variance; antidepressant; Antidepressive Agents, Second-Generation - therapeutic use; Attention Deficit Disorder with Hyperactivity - drug therapy; Biological and medical sciences; bupropion; Bupropion - therapeutic use; Demography; Dose-Response Relationship, Drug; Double-Blind Method; Drug Evaluation; Humans; Medical sciences; Miscellaneous; pharmacotherapy; Placebos; Prospective Studies; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Time Factors; Treatment Outcome
• ISSN: 0006-3223; 1873-2402
• DOI: 10.1016/j.biopsych.2005.01.027

Data remain limited on treatment strategies for adults with attention-deficit/hyperactivity disorder (ADHD). This study evaluated the efficacy and safety of an extended-release, once-daily formulation of bupropion (XL) in the treatment of adults with ADHD. This multisite, placebo-controlled, 8-week prospective trial evaluated 162 adult patients diagnosed with ADHD (combined and inattentive types). Subjects were treated with up to 450 mg/day of bupropion XL. The primary efficacy endpoint was the proportion of ADHD responders (defined as at least a 30% reduction in the investigator-rated ADHD Rating Scale score) at week 8 (last observation carried forward [LOCF]). Bupropion XL responders (53%) exceeded placebo responders (31%) ( p =.004 at week 8) with a significantly greater proportion of bupropion XL responders as early as week 2 ( p = .01). Treatment effect size calculated for the ADHD Rating Scale total score was .6. Bupropion XL appeared to provide sustained benefit throughout the day compared with placebo (morning p =.033, afternoon p =.004, evening p = .024). Bupropion XL was safe and well tolerated, with no serious or unexpected adverse events and a low rate of drug-related study discontinuation (5%). The results from this multisite study indicate that bupropion XL is an effective and well-tolerated nonstimulant treatment for adult ADHD.