Attention-deficit hyperactivity disorder (ADHD) is associated with substantial personal and social impairments. Besides psychosocial interventions, current guidelines recommend a therapy with methylphenidate (MPH). This prospective, non-interventional study aims to investigate the efficacy and tolerability of MPH treatment of adult ADHD patients in a real-world setting. 468 adult patients with newly diagnosed ADHD were observed for 12–14 weeks. Primary efficacy endpoint was the clinical global impression (CGI) by the physician. Secondary endpoints comprise patient evaluation (Wender–Reimherr self-report, WR-SR), safety, tolerability, and dosage of MPH. With a mean daily dose of 35.8 (±17.0) mg MPH, the population of patients being severely/most extremely ill or markedly ill decreased by 64% and 61%, respectively. According to physicians’ assessment (CGI), 74.5% of patients were identified as treatment responders. The total score of patient-based assessment (WR-SR) improved by 23.5% (50.1 ± 40.3 points) with the most profound improvement in attention deficit (−30.0%), disorganization (−26.6%), and hyperactivity / unrest (−23.3%). Self-evaluation revealed a responder rate of 35.4%. In summary, MPH treatment improves the degree of ADHD severity under routine conditions. In addition, activities of daily living were facilitated when taking MPH. The rather poor responder rates determined by patient assessment as well as the comparatively low applied mean daily dose of 35.8 mg (median 40 mg) indicate sub-optimal dosing under routine conditions, not exploiting the full beneficial therapeutic potential of MPH.

注意力缺陷多动障碍（ADHD）与严重的个人和社交障碍有关。除了社会心理干预外，当前指南还推荐哌醋甲酯 (MPH) 治疗。这项前瞻性、非干预性研究旨在调查现实世界中 MPH 治疗成人 ADHD 患者的疗效和耐受性。对 468 名新诊断的 ADHD 成年患者进行了为期 12-14 周的观察。主要疗效终点是医生的临床总体印象（CGI）。次要终点包括患者评估（Wender-Reimherr 自我报告，WR-SR）、安全性、耐受性和 MPH 剂量。平均每日剂量为 35.8 (±17.0) mg MPH 时，重症/病情最严重或病情显着的患者人数分别减少了 64% 和 61%。根据医生评估 (CGI)，74.5% 的患者被确定为治疗有效者。基于患者的评估 (WR-SR) 总分提高了 23.5%（50.1 ± 40.3 分），其中注意力缺陷（−30.0%）、混乱（−26.6%）和多动/不安（− 23.3%）。自我评估显示应答率为 35.4%。总之，MPH 治疗在常规条件下改善了 ADHD 的严重程度。此外，服用 MPH 后日常生活活动也得到了促进。由患者评估确定的相当差的反应率以及相对较低的平均每日剂量 35.8 mg（中位 40 mg）表明常规条件下的次优剂量，没有充分利用 MPH 的有益治疗潜力。