A qualitative systematic thematic review of motivations for medical use of prescription stimulants among adults with ADHD.

Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity. Stimulant use among adults has increased, yet their motivations remain underexplored. This systematic thematic review synthesizes qualitative research on why adults use prescription stimulants for ADHD. A systematic search of five databases yielded 47 qualitative studies published between 1994 and 2023, each examining adult ADHD populations and their experiences with medical stimulant use. Data was thematically synthesized to identify recurring patterns of motivations, decision-making, and perceived outcomes. Four themes emerged: (1) Initial Motivation and Diagnosis: participants sought treatment to address tangible impacts on academic, occupational, and social functioning. (2) Benefits of Medication: stimulants improved focus, emotional regulation, and daily functioning. (3) Context of Use: medication was tailored to specific tasks or times. (4) Barriers: stigma, cost, and dependency concerns influenced adherence. Findings underscore the multifaceted motivations and barriers shaping adults' stimulant use. They highlight the need for patient-centred clinical practices that address personal goals, incorporate psychosocial support, and consider tailored medication regimens. Further research should explore how contextual factors, such as stigma and social expectations, influence adherence. Improving access to non-pharmacological interventions and updating treatment guidelines remain essential. A multi-modal approach is required to optimize outcomes for adults with ADHD.