A double-blind, placebo-controlled, randomized, 6-week trial examined whether patients receiving sustained-release bupropion showed an improvement in their symptoms of ADHD compared to patients receiving a placebo. The inclusion criteria for this study were adults between ages 20 and 59 with with DSM-IV ADHD, have had chronic symptoms of ADHD between childhood and adulthood, and had moderate and/or severe impairment because of those symptoms (n=40). Patients were excluded if they had a history of heart arrhythmias or seizures, chronic medical conditions, unstable psychiatric conditions, bipolarism, any organic brain disorders, mental disabilities, current usage of psychotropics, and any drug dependency/abuse in the previous 6 months prior to the study. To assess improvements in the treatment group compared to placebo group, the study looked at the changes in ADHD, depression, and anxiety symptoms. ADHD symptoms were assessed at baseline and every weekly visit while depression and anxiety were assessed only at baseline and at the end of the study. The study calculated that statistical power was 0.89.2In terms of results, the study identified a statistically significant difference between the bupropion and placebo groups in terms of the 18 DSM-IV specific symptoms of ADHD that was examined. Under a Fisher’s exact test, the bupropion-treated group showed improvement with all 18 symptoms compared to only 8 out of the 18 symptoms with the placebo group (p<0.001). With symptoms of depression and anxiety, a Wilcoxon rank-sum test found no significant difference between the bupropion and placebo groups (p>0.05). In terms of adverse effects, there was no significant difference between bupropion and placebo (p>0.05, Fisher’s exact test. In conclusion, the authors stated that the results indicated that bupropion demonstrated a clinical and statistical superiority over a placebo when it came to the improvement of ADHD symptoms.2 Another double-blind, placebo-controlled, randomized, 6-week trial also examined the short-efficacy of sustained release bupropion in adults with ADHD. The inclusion criteria for patients in this study was that they had to be at least 18 years of age, have a score of at least 15 on the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS), and meet the criteria for ADHD under both the DSM-IV as well as the more restrictive Utah criteria. Patients were excluded if they had a bipolar, depressive mood, schizophrenic, borderline personality, or antisocial personality disorder under the Utah criteria. Other exclusion criteria included any history of stimulant drug abuse, eating disorders, seizure disorders, history of head trauma, prior treatment with bupropion, and being at risk for suicide. This study used the Clinical Global Impressions-Improvement (CGI-I) and WRAADDS to determine whether bupropion had an effect in treating ADHD. A reduction in the WRAADDS of at least 50% or a CGI-I score of 1 (very much improved) or 2 (much improved) were considered to be responding to the treatment. Of the 59 patients (n=59; 43 males, 16 females) enrolled in this study, 60% were assigned to the bupropion SR group and 40% were assigned to the placebo group in the hope that they would be able to enroll the patients in the bupropion group in a longer-term study. Additionally, patients were required to have a close family member willing to attend the clinical visits to report on the patient’s symptoms in the form of a joint interview.