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Attention-Deficit/Hyperactivity Disorder

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Effective agents for ADHD include psychostimulants, catecholaminergic antidepressants (e.g., bupropion, desipramine, venlafaxine), and noradrenergic agents (e.g., atomoxetine, clonidine). Other potentially effective agents include adrenergic blockers and modafinil. However, there are not enough data to definitely guide the optimal treatment for adolescents or adults with ADHD and comorbid SUDs. Despite fears that treating such patients with stimulants (especially those with a history of stimulant use disorders) will exacerbate their SUDs, the evidence suggests that these drugs are safe and effective in reducing core ADHD symptoms as well as possibly decreasing substance abuse (Levin et al. 1998; Wilson and Levin 2005). Furthermore, the agents may serve as a protective factor to decrease the longitudinal risk of developing an SUD in patients with ADHD (Wilens et al. 2003).

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