Treatment of Attention-Deficit/Hyperactivity Disorder

To the Editor: The AMA Council on Scientific Affairs¹ reasoned that review of the treatment and diagnosis of ADHD is of timely importance, as the authors rightly note that there is a public "climate of fear among physicians, parents, and educators" about treatment with psychostimulants, despite the clear efficacy these medications offer. It is, for this reason, surprising to find that the authors failed to mention that methamphetamine is also a US Food and Drug Administration–approved treatment for ADHD. No data exist that prescribed methamphetamine is more likely to be abused than methylphenidate or d-amphetamine. Methamphetamine is also regarded as having more potent centrally acting properties and less potent peripherally acting properties than d-amphetamine.² With the longest duration of action of any of the stimulants (8-12 hours), methamphetamine has the advantage of offering true once-a-day dosing. In addition, methamphetamine still has a limited role in the treatment of obesity, has antidepressant properties,³ and is an effective treatment for narcolepsy.⁴