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Multi-Site Trial: Prefrontal TMS Improves Attention in Adult ADHD Off Medications

A 12-site sham-controlled trial of 360 adults with ADHD found six weeks of prefrontal TMS improved attention and working memory in patients who were not currently taking stimulant medications.

Clinical Trials May 12, 2025 · American Journal of Psychiatry ↗

A 12-site sham-controlled trial of 360 adults with attention-deficit/hyperactivity disorder reported that six weeks of left dorsolateral prefrontal cortex TMS improved attention and working memory scores compared with sham. The trial enrolled adults not currently taking stimulant medications, either by preference or due to contraindications.

Response, defined as a 30% or greater improvement on the ADHD Investigator Symptom Rating Scale, occurred in 41% of TMS-treated patients versus 19% in sham. Improvements were sustained at 12-week follow-up in roughly two-thirds of responders.

The trial does not establish TMS as superior to stimulant medication, which remains the most effective ADHD treatment with response rates of 70-80%. Rather, it positions TMS as a potential option for adults who cannot tolerate or who choose not to take stimulants — a group that has historically had limited evidence-based alternatives.

FDA clearance for ADHD is not yet pending. The investigators indicated they intend to seek breakthrough device designation based on the trial results, with a pivotal trial to follow.

Source

Reporting based on coverage from American Journal of Psychiatry. This article is editorial summary intended for general information; it is not medical advice.

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