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Answer 2
  1. Trial of a long-acting amphetamine given once in the morning. A long-acting stimulant should be initiated first because of the advantage of a simpler dosing regimen as compared with immediate- release stimulant formulations.2 SSRIs are not indicated for ADHD. Because this patient’s symptoms are interfering with her day-to-day activities, reassurance and clinical monitoring is not appropriate. The patient should be advised about potential side effects of stimulant treatment, including anorexia, dry mouth, insomnia, and headache.3,4

    2. Stein MA. Treating adult ADHD with stimulants. CNS Spectr 2008;13(9 Suppl 13):8–11.

    3. Biederman J, Spencer TJ, Wilens TE, et al; SLI381.304 Study Group. Long-term safety and effectiveness of mixed amphetamine salts extended release in adults with ADHD. CNS Spectr 2005;10(12 Suppl 20):16–25.

    4. Weisler RH, Biederman J, Spencer TJ, et al. Mixed amphetamine salts extended-release in the treatment of adult ADHD: a randomized, controlled trial. CNS Spectr 2006;11:625–39.

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