Possible Medication-Resistant Deficits in Adult ADHD

J Atten Disord. 2017 Dec;21(14):1169-1179. doi: 10.1177/1087054714538659. Epub 2014 Jun 26.


Objective: The nature of ADHD, especially in adulthood, is not well-understood. Therefore, we explored subcomponents of attention in adult ADHD.

Method: Twenty-three adults with ADHD were tested on neurocognitive and visual tracking performance both while on their regular prescription stimulant medication and while abstaining from the medication for 1 day. Pairwise comparisons to 46 two-for-one matched normal controls were made to detect medication-resistant effects of ADHD, and within-participant comparisons were made to detect medication-sensitive effects in patients.

Results: Even when on medication, patients performed more poorly than controls on a spatial working memory task, and on visual tracking and simple reaction time tasks immediately following other attention-demanding tasks. Patients' visual tracking performance degraded while off-medication in a manner consistent with reduced vigilance.

Conclusion: There may be persistent cognitive impairments in adult ADHD despite medication. In addition, the benefit of stimulants seems reduced under cognitive fatigue.

Keywords: assessment; case–control; eye movement; fatigue; ocular pursuit.

MeSH terms

  • Adult
  • Attention / drug effects*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Central Nervous System Stimulants / therapeutic use
  • Female
  • Humans
  • Male
  • Memory, Short-Term / drug effects*
  • Neuropsychological Tests
  • Psychomotor Performance*
  • Reaction Time / drug effects*
  • Time


  • Central Nervous System Stimulants