Driving in young adults with attention deficit hyperactivity disorder: knowledge, performance, adverse outcomes, and the role of executive functioning. Motor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactivity disorder. Effects of two doses of methylphenidate on simulator driving performance in adults with attention deficit hyperactivity disorder. Effect of stimulant medication on driving performance of young adults with attention-deficit hyperactivity disorder: a preliminary double-blind placebo controlled trial. Controlled-release methylphenidate improves attention during on-road driving by adolescents with attention-deficit/hyperactivity disorder. Long-Acting Methylphenidate Reduces Collision Rates of Young Adult Drivers With Attention-Deficit/Hyperactivity Disorder Relative Benefits of Stimulant Therapy With OROS Methylphenidate Versus Mixed Amphetamine Salts Extended Release in Improving the Driving Performance of Adolescent Drivers With Attention-Deficit/Hyperactivity Disorder Executive Impairment Determines ADHD Medication Response: Implications for Academic Achievement Clinical evaluation of subjective and objective changes in motor activity and attention in children with attention-deficit/hyperactivity disorder in a double-blind methylphenidate trial. Impact of methylphenidate delivery profiles on driving performance of adolescents with attention-deficit/hyperactivity disorder: a pilot study. The effects of lisdexamfetamine dimesylate on the driving performance of young adults with ADHD: a randomized, double-blind, placebo-controlled study using a validated driving simulator paradigm. A double‐blind, parallel, multicenter comparison of L‐acetylcarnitine with placebo on the attention deficit hyperactivity disorder in fragile X syndrome boys Attention-Deficit Hyperactivity Disorder (ADHD) symptoms and smoking patterns among participants in a smoking-cessation program. Methylphenidate significantly improves driving performance of adults with attention-deficit hyperactivity disorder: a randomized crossover trial Clinical symptoms and performance on the continuous performance test in children with attention deficit hyperactivity disorder between subtypes: a natural follow-up study for 6 months Methylphenidate improves response inhibition in adults with attention-deficit/hyperactivity disorder Long-term stimulant treatment of children with attention-deficit hyperactivity disorder symptoms. A randomized, double-blind, placebo-controlled trial.
Past studies find that attention deficit hyperactivity disorder ( ADHD ) creates a higher risk for adverse driving outcomes . This study comprehensively evaluated driving in adults with ADHD by comparing 105 young adults with the disorder ( age 17 - 28 ) to 64 community control ( CC ) adults on five domains of driving ability and a battery of executive function tasks . The ADHD group self-reported significantly more traffic citations , particularly for speeding , vehicular crashes , and license suspensions than the CC group , with most of these differences corroborated in the official DMV records . Cognitively , the ADHD group was less attentive and made more errors during a visual reaction task under rule-reversed conditions than the CC group . The ADHD group also obtained lower sceres on a test of driving rules and decision-making but not on a simple driving simulator . Both self- and other-ratings showed the CC group employed safer routine driving habits than the ADHD group . Relationships between the cognitive and driving measures and the adverse outcomes were limited or absent , calling into question their use in screening ADHD adults for driving risks . Several executive functions also were significantly yet modestly related to accident frequency and total traffic violations after controlling for severity of ADHD . These results are consistent with earlier studies showing significant driving problems are associated with ADHD . This study found that these driving difficulties were not a function of comorbid oppositional defiant disorder , depression , anxiety , or frequency of alcohol or illegal drug use . Findings to date argue for the development of interventions to reduce driving risks among adults with ADHD PURPOSE To evaluate the motor vehicle driving knowledge , skills , and negative driving outcomes of older teens and young adults with attention deficit hyperactivity disorder ( ADHD ) . LOCATION A university medical center clinic for adult ADHD . SUBJECTS A total of 25 young adults with ADHD and 23 young adults without ADHD 17 to 30 years old drawn from the community and equated for age , gender , and educational level . MEASURES  Structured interview , behavior ratings by self- and others , video test of driving knowledge , computer simulated driving test , and official motor vehicle records .  RESULTS ADHD young adults were cited more often for speeding , were more likely to have had their licenses suspended , were involved in more crashes , were more likely to have had crashes causing bodily injury , and were rated by themselves and others as using poorer driving habits . Official driving records corroborated these negative outcomes . Although no group differences in driving knowledge were evident , young adults with ADHD had more crashes , scrapes , and erratic steering during the computer-stimulated driving test than did the control subjects . CONCLUSIONS Findings supported previous research suggesting that greater driving risks are associated with ADHD and suggested that ADHD does not interfere with driving knowledge so much as with actual performance ( motor control ) during vehicle operation INTRODUCTION Numerous studies have documented an increased frequency of vehicular crashes , traffic citations , driving performance deficits , and driving-related cognitive impairments in teens and adults with attention deficit hyperactivity disorder . METHOD The present study evaluated the effects of two single , acute doses of methylpheni date ( 10 and 20 mg ) and a placebo on the driving performance of 53 adults with ADHD ( mean age=37 years , range=18 - 65 ) using a virtual reality driving simulator , examiner and self-ratings of simulator performance , and a continuous performance test ( CPT ) to evaluate attention and inhibition . A double-blind , drug-placebo , within-subjects crossover design was used in which all participants were tested at baseline and then experienced all three drug conditions . RESULTS A significant beneficial effect for the high dose of medication was observed on impulsiveness on CPT , variability of steering in the st and ard driving course , and driving speed during the obstacle course . A beneficial effect of the low dose of medication also was evident on turn signal use during the st and ard driving course . An apparent practice effect was noted on some of the simulator measures between the baseline and subsequent testing sessions that may have interacted with and thereby obscured drug effects on those measures . CONCLUSIONS The results , when placed in the context of prior studies of stimulants on driving performance , continue to recommend their clinical use as one means of reducing the driving risks in ADHD teens and adults . IMPACT ON INDUSTRY Given the significantly higher risk of adverse driving outcomes associated with ADHD , industry needs to better screen for ADHD among employees who drive as part of employment so as to improve safety and reduce costs . Use of stimulants to treat the adult ADHD driver may reduce safety risks Driving performance of adult males with attention-deficit hyperactivity disorder ( ADHD ) was compared with matched controls in a double-blind ( Ritalin vs. placebo ) cross-over design , using a high-fidelity driving simulator . Seven ADHD and six non-ADHD drivers ( mean age 22 ) were screened to rule out comorbidity and assess for ADHD , and then admitted to the General Clinical Research Center to control diet and sleep before testing . At 0800 and 1530 , subjects consumed either a placebo or Ritalin pill in a counter-balanced manner , and at 0930 and 1700 , subjects drove the simulator . After both drives , subjects rated their driving performance . Compared with non-ADHD subjects , ADHD subjects had more career driving accidents ( p < .04 ) and motor vehicle violations ( p = .059 ) , drove worse on the simulator under placebo condition ( p < .05 ) , demonstrated significant improvement under the Ritalin condition ( p < .05 ) , rated themselves as driving poorer during the placebo condition ( p = .05 ) , and tended to perceive their driving to be better during the Ritalin condition ( p = .07 ) . This would suggest that individuals with ADHD should have the therapeutic benefit of a stimulant medication when operating a vehicle BACKGROUND Attention-deficit/hyperactivity disorder ( ADHD ) is associated with a 3- to 4-fold increase in both driving-related accidents and associated injuries .  Methylpheni date ( MPH ) is the most commonly prescribed psychostimulant medication for ADHD . It has been demonstrated to improve performance on a driving simulator . This study investigated whether a once-daily , long-acting , osmotic , controlled-release MPH formulation improves the driving performance of ADHD adolescents while driving their own car on an actual road segment . METHODS Twelve ADHD-diagnosed male adolescent drivers ( mean age , 17.8 years ) prescribed a st  and ard  dose of 1.0 mg/kg ( if they were not already taking methylpheni date ) of controlled-release MPH participated in this repeated- measures crossover study . On 2 separate occasions ( off/on medication r and omized ) , participants drove a st and ard 16-mile road course incorporating rural , highway , and urban streets . A rater , blind to medication conditions , sat in the back seat and rated impulsive ( eg , " cutting off " another driver ) and inattentive ( eg , drove past design ated turn ) driving errors . RESULTS Impulsive driving errors were observed to occur rarely under both medication and no medication conditions . Inattentive driving errors were more common and were significantly reduced while the subject was on medication ( 4.6 versus 7.8 ; P < .01 ) . The improvement in driving performance ( change in number of errors recorded ) from first to second testing was positively correlated with medication dosage ( r = 0.60 ; P < .01 ) . CONCLUSIONS Once-daily controlled-release MPH improves real-life driving performance of adolescent males diagnosed with ADHD . In particular , it significantly reduces driving errors arising from inattention Abstract This study investigated whether methylpheni date delivered through a long-acting transdermal system ( MTS ) would reduce collision rates of young adult drivers with attention-deficit/hyperactivity disorder ( ADHD ) . Seventeen young adults completing the study ( mean [ SD ] age , 20.82 [ 2.40 ] years ; 14 men and 13 white ) met the following inclusion criteria : ADHD diagnoses but not routinely taking ADHD medication , previously responsive to ADHD medication , active drivers with more than 1 collision or citation in the past 2 years , and no significant comorbidities . In this open-labeled , crossover design drivers were r and omly assigned either to the no-medication condition for 3 months and then MTS for 3 months or to the reverse sequence . In-car video monitoring of routine driving occurred during these 6 months . At baseline and after each condition , participants completed the Conners Adult ADHD Rating Scale and the Cox Assessment of Risky Driving Scale , and their blood pressure , heart rate , and body weight were monitored . Compared with the no-medication condition , participants in the MTS condition self-reported fewer total ADHD ( P < 0.04 ) and inattentive symptoms ( P = 0.014 ) and a trend for risky driving behaviors ( P = 0.059 ) and had fewer video-recorded collisions ( P < 0.005 ) and other problematic driving events . There were no significant changes in blood pressure , heart rate , or body weight across conditions or any significant skin reactions to the MTS patch . This is the first study demonstrating that long-acting methylpheni date improves activities of daily living among young adults with ADHD . Specifically , methylpheni date improved safety in routine driving while reducing ADHD symptoms with minimal adverse effects OBJECTIVE . Automobile accidents are the leading cause of death among adolescents , and collisions are 2 to 4 times more likely to occur among adolescents with attention-deficit/hyperactivity disorder . Studies have demonstrated that stimulants improve driving performance . This study compared 2 long-acting stimulant medications during daytime and evening driving evaluations . METHODS . Adolescent drivers with attention-deficit/hyperactivity disorder were compared on a driving simulator after taking 72 mg of OROS methylpheni date , 30 mg of mixed amphetamine salts extended release , or placebo in a r and omized , double-blind , placebo-controlled , crossover study design . During laboratory testing , adolescents drove a driving simulator at 5:00 pm , 8:00 pm , and 11:00 pm . Driving performance was rated by adolescents and investigators . RESULTS . The study included 35 adolescent drivers with attention-deficit/hyperactivity disorder ( 19 boys/16 girls ) . The mean age was 17.8 years . The overall Impaired Driving Score demonstrated that OROS methylpheni date led to better driving performance compared with placebo and mixed amphetamine salts extended release , whereas mixed amphetamine salts extended release demonstrated no statistical improvement over placebo . Specifically , relative to placebo , OROS methylpheni date result ed in less time driving off the road , fewer instances of speeding , less erratic speed control , more time executing left turns , and less inappropriate use of brakes .  OROS methylpheni date and mixed amphetamine salts extended release worked equally well for male and female adolescents and equally as well with teenagers who have combined and inattentive subtypes of attention-deficit/hyperactivity disorder . CONCLUSIONS . This study vali date s the use of stimulants to improve driving performance in adolescents with attention-deficit/hyperactivity disorder . In the study , OROS methylpheni date promoted significantly improved driving performance compared with placebo and mixed amphetamine salts extended release Methylpheni date ( MPH ) often ameliorates attention-deficit/hyperactivity disorder ( ADHD ) behavioral dysfunction according to indirect informant reports and rating scales . The st and ard of care behavioral MPH titration approach seldom includes direct neuropsychological or academic assessment data to determine treatment efficacy . Documenting “ cool ” executive-working memory ( EWM ) and “ hot ” self-regulation ( SR ) neuropsychological impairments could aid in differential diagnosis of ADHD subtypes and determining cognitive and academic MPH response . In this study , children aged 6 to 16 with ADHD inattentive type ( IT ; n = 19 ) and combined type ( n = 33)/hyperactive-impulsive type ( n = 4 ) ( CT ) participated in double-blind placebo-controlled MPH trials with baseline and r and omized placebo , low MPH dose , and high MPH dose conditions . EWM/ SR measures and behavior ratings/classroom observations were rank ordered separately across conditions , with nonparametric r and omization tests conducted to determine individual MPH response . Participants were subsequently grouped according to their level of cool EWM and hot SR circuit dysfunction . Robust cognitive and behavioral MPH response was achieved for children with significant baseline EWM/SR impairment , yet response was poor for those with adequate EWM/ SR baseline performance . Even for strong MPH responders , the best dose for neuropsychological functioning was typically lower than the best dose for behavior . Findings offer one possible explanation for why long-term academic MPH treatment gains in ADHD have not been realized . Implication s for academic achievement and medication titration practice s for children with behaviorally diagnosed ADHD will be discussed The aim of this study was to determine drug-dependent effects on attention and motor activity in children with attention-deficit/hyperactivity disorder ( ADHD ) in a double-blind methylpheni date ( MPH ) trial using both subjective behavior ratings and objective measures of function . In particular , we were interested in the relationship between changes of those subjective and objective measures . A total of 44 ADHD children with the combined subtype completed a r and omized , double-blind , placebo-controlled , crossover trial with 2 doses of MPH ( 0.25 ; 0.5 mg/kg body weight ) and placebo . In each condition , computerized attention tasks were performed , teacher-behavior ratings were obtained , and actigraph data were collected in both clinical and naturalistic setting s. Trend tests revealed linear effects of MPH dose on actigraph data in the test session ( p = 0.02 ) and at school ( p = 0.001 ) , as well as on sustained attention ( p < 0.001 ) , while inhibitory control showed a quadratic dose-response curve ( p < 0.001 ) . Multivariate regression analyses revealed that changes of both , hyperactive-impulsive symptoms ( 28 % ) and inattentive symptoms ( 23 % ) could be explained by objective changes of motor activity . Thus , for clinical practice , it should be taken into account that behavior ratings of ADHD symptoms seemed to be predominantly influenced by changes of motor activity OBJECTIVE Adolescents with attention-deficit/hyperactivity disorder ( ADHD ) are at high risk for driving accidents . One dose of methylpheni date ( MPH ) improves simulator driving performances of ADHD-diagnosed adolescents at 1.5 hours post-dose . However , little is known about the effects of different MPH delivery profiles on driving performance throughout the day . METHOD This r and omized , crossover , single-blind study compared osmotic , controlled-release oral system ( OROS ) MPH ( Concerta ) given q.d . to immediate-release MPH ( Ritalin ) given in equal doses t.i.d . on driving performance among six male ADHD-diagnosed adolescent drivers aged 16 to 19 years . Under each treatment condition , participants were maintained on their medication dosage for 7 days , then drove a sophisticated driving simulator at 2 p.m. , 5 p.m. , 8 p.m. , and 11 p.m. The primary outcome measure was each participant 's computer-quantified Impaired Driving Score ( IDS ) . RESULTS IDS worsened in the evenings for participants receiving MPH t.i.d . but remained stable when they received once-daily OROS MPH . Participants performed significantly better when receiving OROS MPH q.d . compared with MPH t.i.d . ( F = 9.3 , df = 1 , p = .004 ) . When MPH was given t.i.d . , IDS significantly worsened beginning at 8 p.m. compared to OROS MPH ( p = .01 ) . CONCLUSIONS Participants demonstrated significantly less variability and better driving performance when receiving OROS MPH q.d . compared to MPH t.i.d . , particularly in the evenings Young adults with Attention Deficit Hyperactivity Disorder ( ADHD ) have been shown to be at increased risk for impairment in driving behaviors . While stimulant medications have proven efficacy in reducing ADHD symptomatology , there is limited knowledge as to their effects on driving impairment . The main aim of this study was to assess the impact of lisdexamfetamine dimesylate ( LDX ) on driving performance in young adults with ADHD using a vali date d driving simulation paradigm . This was a r and omized , double-blind , 6-week , placebo-controlled , parallel- design study of LDX vs. a placebo on driving performance in a vali date d driving simulation paradigm . Subjects were sixty-one out patients of both sexes , 18 - 26 years of age , who met DSM-IV criteria for ADHD . Subjects were r and omized to receive LDX or placebo after a baseline driving simulation and completed a second driving simulation six weeks after beginning drug or placebo . Examination of reaction time across five surprise events at post-treatment showed a significant positive effect of medication status . LDX treatment was also associated with significantly fewer accidents vs. placebo . LDX treatment was associated with significantly faster reaction times and a lower rate of simulated driving collisions than placebo . These results suggest that LDX may reduce driving risks in young adults with ADHD Attention deficit hyperactivity disorder ( ADHD ) is a frequent behavioral problem in young boys with fragile X syndrome ( FXS ) , and its treatment is critical for improving social ability . The short‐term efficacy of stimulant medications like methylpheni date ( MPH ) is well established in children with ADHD . FXS boys treated with MPH have improved attention span and socialization skills ; however their mood becomes unstable at higher doses . Therefore , alternative pharmacological treatment of ADHD symptoms is desirable . A recent study showed that carnitine has a beneficial effect on the hyperactive – impulsive behavior in boys with ADHD without side effects . Our previous placebo‐controlled trial indicated that L‐acetylcarnitine ( LAC ) reduces hyperactivity in FXS boys . The objective of this study was to determine the efficacy of LAC in a larger sample of FXS boys with ADHD . The study design was r and omized , double blind placebo controlled , parallel , and multicenter ( with eight centers involved in Italy , France , and Spain ) . Sixty‐three FXS males with ADHD ( aged 6–13 years ) were enrolled ; 7 patients dropped out , 56 completed the one‐year treatment , and 51 were included in the statistical analysis . Both groups improved their behavior , showing that psychosocial intervention has a significant therapeutic effect . However , we observed a stronger reduction of hyperactivity and improvement of social behavior in patients treated with LAC , compared with the placebo group , as determined by the Conners ' Global Index Parents and the Vinel and Adaptive Behavior Scale . Our results show that LAC ( 20–50 mg/kg/day ) represents a safe alternative to the use of stimulant drugs for the treatment of ADHD in FXS children . © 2008 Wiley‐Liss , Previous research has suggested an increased liability to smoking among individuals with Attention-Deficit Hyperactivity Disorder ( ADHD ) . This link is thought to be attributable , in part , to nicotine 's beneficial effects on attention and performance . In the present study , we examined the association of ADHD symptoms of inattention and hyperactivity with smoking behavior in a sample of 226 male and female smokers ages 18 and older who were enrolled in a smoking-cessation program .  Prior to treatment , they completed measures of ADHD symptoms and st and ardized measures of smoking patterns . Hierarchical linear regression models were used to characterize the smoking patterns associated with ADHD inattention and hyperactivity symptoms , controlling for potential confounder variables . Smoking for stimulation purpose s and the urge to smoke to minimize withdrawal symptoms were the primary patterns associated with ADHD inattention symptoms , while hyperactivity symptoms were not associated with smoking patterns . Consistent with a self-medication hypothesis , these results suggest that smokers with frequent symptoms of inattention may use nicotine as a stimulant drug to help manage these symptoms . Future studies of the role of inattention symptoms in response to smoking treatment are warranted Although patients with attention-deficit hyperactivity disorder ( ADHD ) have reported improved driving performance on methylpheni date , limited evidence exists to support an effect of treatment on driving performance and some regions prohibit driving on methylpheni date . A r and omized , crossover trial examining the effects of methylpheni date versus placebo on highway driving in 18 adults with ADHD was carried out . After three days of no treatment , patients received either their usual methylpheni date dose ( mean : 14.7 mg ; range : 10—30 mg ) or placebo and then the opposite treatment after a six to seven days washout period . Patients performed a 100 km driving test during normal traffic , 1.5 h after treatment administration . St and ard deviation of lateral position ( SDLP ) , the weaving of the car , was the primary outcome measure . Secondary outcome measurements included the st and ard deviation of speed and patient reports of driving performance . Driving performance was significantly better in the methylpheni date than in the placebo condition , as reflected by the SDLP difference ( 2.3 cm , 95 % CI = 0.8—3.8 , P = 0.004 ) . Variation in speed was similar on treatment and on placebo ( -0.05 km/h , 95 % CI = -0.4 to 0.2 , P = 0.70 ) . Among adults with ADHD , with a history of a positive clinical response to methylpheni date , methylpheni date significantly improves driving performance Background The aims of this study were to determine the time course of improvements in attention deficit hyperactivity disorder ( ADHD ) clinical symptoms and neurocognitive function in a realistic clinical setting , and the differences in ADHD symptom improvement using different classifications of ADHD subtypes . Methods The Child Behavior Checklist ( CBCL ) was completed by parents of ADHD children at the initial visit . The  computerized Continuous Performance Test ( CPT ) , Swanson , Nolan , and Pelham , and Version IV Scale for ADHD ( SNAP-IV ) , and  ADHD Rating Scale ( ADHD-RS ) were performed at baseline , one month , three months , and six months later , respectively . Patient care including drug therapy was performed at the discretion of the psychiatrist . The ADHD patients were divided into DSM-IV subtypes ( Inattentive , Hyperactive-impulsive and Combined type ) , and were additionally categorized into aggressive and non-aggressive subtypes by aggression scale in CBCL for comparisons . Results There were 50 ADHD patients with a mean age of 7.84 ± 1.64 years ; 15 of them were inattentive type , 11 were hyperactive-impulsive type , and 24 were combined type . In addition , 28 of the ADHD patients were grouped into aggressive and 22 into non-aggressive subtypes . There were significant improvements in clinical symptoms of hyperactivity and inattention , and impulsivity performance in CPT during the 6-month treatment . The clinical hyperactive symptoms were significantly different between ADHD patients sub-grouping both by DSM-IV and aggression . Non-aggressive patients had significantly greater changes in distraction and impulsivity performances in CPT from baseline to month 6 than aggressive patients . Conclusions We found that ADHD symptoms , which included impulsive performances in CPT and clinical inattention and hyperactivity dimensions , had improved significantly over 6 months under pragmatic treatments . The non-aggressive ADHD patients might have a higher potential for improving in CPT performance than aggressive ones . However , it warrant further investigation whether the different classifications of ADHD patients could be valid for predicting the improvements in ADHD patients ' clinical symptoms and neurocognitive performance BACKGROUND Response inhibition is an executive function that requires voluntary control over responses when there is a change of context . The right inferior frontal cortex is necessary for response inhibition , and a deficit in right frontostriatal circuitry might underlie attention-deficit/hyperactivity disorder ( ADHD ) . Many studies of childhood ADHD have demonstrated impaired response inhibition and its amelioration by methylpheni date ( MPH ) . The current study tested response inhibition and the effect of MPH in adult ADHD . METHODS Response inhibition was assessed with the " tracking " stop-signal test in 13 adults with a diagnosis of ADHD , both while taking and while not taking medication , and 13 healthy , unmedicated , age- and intelligence quotient-matched control subjects . RESULTS Stop-signal reaction time was significantly slower in unmedicated adults with ADHD relative to healthy control subjects , and this deficit was significantly ameliorated by medication . CONCLUSIONS Adult ADHD patients had a response inhibition profile similar to that produced by lesions to the right inferior frontal cortex , which was remedied by stimulant medication BACKGROUND We wanted to study the effects of amphetamine on symptoms of attention-deficit hyperactivity disorder ( ADHD ) over a longer period than has been reported in previous studies of central stimulants in this condition . METHODS Sixty-two children , aged 6 to 11 years , meeting DSM-III-R symptom criteria for ADHD participated in a parallel-group design , r and omized , double-blind , placebo-controlled study of amphetamine treatment . Treatment was not restricted to children with " pure " ADHD , ie , some had comorbid diagnoses . In the amphetamine group , children received active treatment for 15 months . RESULTS Amphetamine was clearly superior to placebo in reducing inattention , hyperactivity , and other disruptive behavior problems and tended to lead to improved results on the Wechsler Intelligence Scale for Children -- Revised . Treatment failure rate was considerably lower and time to treatment failure was longer in the amphetamine group . Adverse effects were few and relatively mild . CONCLUSION The results of this long-term , placebo-controlled study of the central stimulant amphetamine in the treatment of ADHD indicate that there are remaining positive effects of the drug 15 months after starting treatment
In general , stimulants improved driving performance in ADHD patients ( either in RCTs conducted in simulators and /or cars ) .
MPH-OROS  improved driving performance compared with MAS-XR , placebo , or no-drug conditions .
Although MPH-OROS and MPH-IR produced similar improvements during the day , MPH-IR lost its efficacy in the evening .
MAS-XR also improved driving performance , but worsened driving performance in the evening .
Studies with ATX report conflicting results .
Improvement was more consistent in teenagers and young adults .
In general , treatment with psychostimulants or ATX in therapeutic dosages had no negative impact on driving performance of ADHD patients .
To conclude , treatment with stimulants in therapeutic doses improves driving performance in ADHD patients , especially teenagers and young adults
Adults with Attention Deficit Hyperactivity Disorder ( ADHD ) , especially teenagers and young adults , show important car driving impairments , including risky driving , accidents , fines and suspension of driver׳s license .
We systematic ally review ed the efficacy of stimulant and non-stimulant drugs on driving performance of ADHD patients .