Simulated driving changes in young adults with ADHD receiving mixed amphetamine salts extended release and atomoxetine.

BACKGROUND: Psychostimulant treatment may improve simulated driving performance in young adults with attention-deficit/hyperactivity disorder (ADHD). METHOD: This was a randomized, double-blind, placebo-controlled, crossover study of simulated driving performance with mixed amphetamine salts-extended release (MAS XR) 50 mg/day (Cohort 1) and atomoxetine 80 mg/day (Cohort 2) in young adults with ADHD. RESULTS: Adults aged 19 to 25 years with AD/HD (N = 19) who were administered MAS XR significantly improved overall simulated driving performance versus placebo up to 12 hours after dosing. In contrast, there were no statistically significant differences in simulated-driving-performance scores between atomoxetine and placebo. At endpoint, MAS XR reduced ADHD Rating Scale scores > or = 30% in 80% of subjects, whereas atomoxetine achieved this level of improvement for 40%. LIMITATIONS: Small sample size and use of simulated driving may limit generalizability of the findings. CONCLUSION: MAS XR in young adults with ADHD yields significant improvements in simulated driving performance and ADHD symptoms.

The Federal Aviation Administration's role in evaluation of pilots and others with alcoholism or drug addiction.

The author explores the FAA Medical Standards, including old and new approaches toward rehabilitation; special issuance; and pilot initiatives. The current treatment model is also seen in various impaired physician programs around the U.S.