The Effectiveness of Short- and Long-Acting Stimulant Medications for Adolescents With ADHD in a Naturalistic Secondary School Setting

J Atten Disord. 2017 Jan;21(1):40-45. doi: 10.1177/1087054712474688. Epub 2016 Jul 28.


Objective: Stimulant medication is an efficacious and first-line approach to treating ADHD in adolescence. However, less is known about the effectiveness of this approach as a treatment in real-world settings. The complicated nature of the secondary school environment and documented adolescent nonadherence with stimulant medication may undermine the exportability of this approach.

Method: This study investigates stimulant medication effectiveness and adherence in a sample of adolescents with ADHD who were observed in their natural secondary school environment.

Results: Results indicated that the effect of stimulant medication on adolescent functioning is smaller in naturalistic settings than in previous analogue studies. Long-acting pemoline produced greater adherence than the short-acting methylphenidate (MPH), but parents and adolescents preferred the short-acting MPH.

Conclusions: Overall, adolescents reported very low satisfaction with stimulant medication. Findings are discussed.

Keywords: ADHD; adolescence; pharmacotherapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Academic Failure
  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Central Nervous System Stimulants / administration & dosage*
  • Child
  • Cross-Over Studies
  • Delayed-Action Preparations
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Methylphenidate / administration & dosage*
  • Patient Satisfaction
  • Treatment Outcome


  • Central Nervous System Stimulants
  • Delayed-Action Preparations
  • Methylphenidate