Adult ADHD. Controlled medication assessment.

Many adults with ADHD respond to stimulant therapy, but controlled medication assessments have not been reported. We administered an effortful working memory task in four half-day sessions, double blind, at methylphenidate levels of 0, 5, 10 and 20 mg. Dose-response curves were established individually. Fifteen of 17 patients displayed a favorable response to one or more levels of medication; that is, they achieved more correct responses and less variability than on placebo. Each dose level elicited optimal performance from some of the patients. Unlike monitoring by self-report, the objective medication assessment offers an expeditious approximation to the ultimate optimal dose, potentially saving the patient weeks on an ineffective and/or excessive dosage regime.