ADHD treatment in adults: Evaluating the efficacy of stimulant medication combined with cognitive behavioral therapy

Moultrie, GA

Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental disorder that presents with features of hyperactivity, inattention, and impulsivity which impair concentration and normal neurocognitive function. Stimulant medications, namely Methylphenidate, are the first line treatment for ADHD, however, it carries potential side effects including but not limited to: headaches, anxiety, mood changes, hypertension, and tachycardia (Weibel et al., 2021). In addition to stimulants, Cognitive Behavioral Therapy (CBT) has shown promising results when treating adults with ADHD. The article “A comparison of efficacy between cognitive behavioral therapy (CBT) and CBT combined with medication in adults with ADHD” revealed that CBT with or without adjuvant stimulants resulted in significant improvement compared to baseline symptoms, including anxiety and depression (Pan et al., 2019). Understanding the effectiveness of a combined treatment approach is critical for optimizing long-term outcomes in adults with ADHD.

This literature review aims to evaluate whether the combination of stimulant medication and CBT results in greater symptom improvement compared to stimulant treatment alone in adults with ADHD. A thorough search was done through the Philadelphia College of Osteopathic Medicine (PCOM) Online Library, following PICO criteria to identify relevant studies that provided data on both CBT and stimulants for ADHD. Preliminary findings suggest that psychological interventions such as CBT showed significant improvement in symptoms when combined with methylphenidate compared to placebo groups (Lam et al., 2024). Overall, the integration of CBT with stimulant medication appears to yield superior outcomes compared to medication alone, particularly in improving executive functioning and long-term adherence. These findings have important implications for primary care and psychiatric management, suggesting that a multimodal treatment approach should be prioritized for adults with ADHD.