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To the Editor: The Contempo Update on attention-deficit/hyperactivity disorder (ADHD) by Dr Wilens and colleagues¹ presented pharmacologic treatment options. However, in discussing the use of stimulant medications, the authors did not address risks of addiction, tolerance, or habituation. I would like to know if the authors think that these risks are significant enough to warrant having patients sign a treatment contract acknowledging the risks and the conditions of ongoing care. I would also be interested in whether they think patients receiving stimulant treatment should be evaluated monthly in the office prior to refills and, if not, what other refill mechanisms they would recommend.

Marc Raphaelson, MD
raphaels4@aol.com
Frederick, Md

1. Wilens TE, Faraone SV, Biederman J. Attention-deficit/hyperactivity disorder in adults. JAMA. 2004;292:619-623. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292:2214.

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