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

Biol Psychiatry. 2005 Apr 1;57(7):793-801. doi: 10.1016/j.biopsych.2005.01.027.


Background: 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.

Methods: 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]).

Results: 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%).

Conclusions: The results from this multisite study indicate that bupropion XL is an effective and well-tolerated nonstimulant treatment for adult ADHD.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Analysis of Variance
  • Antidepressive Agents, Second-Generation / therapeutic use*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Bupropion / therapeutic use*
  • Demography
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Evaluation
  • Humans
  • Placebos
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Time Factors
  • Treatment Outcome


  • Antidepressive Agents, Second-Generation
  • Placebos
  • Bupropion