AbstractAlthough attention deficit hyperactivity disorder (ADHD) has been officially recognized as persisting into adulthood for more than 25 years, only recently has the condition been studied in adults. There is great syndromatic continuity between childhood and adult ADHD, and thus much of the medication management of adults with ADHD can be based on the experience gained from treating children and adolescents. Stimulant medications remain the treatment of choice and are generally as effective in adults as they are in children. Several extended‐release delivery systems that improve convenience and compliance have become available. Several second‐line medications are also reviewed. The medications must be fine‐tuned to the needs of the individual patient in regard to the dose and timing of dose that achieve optimal therapeutic benefit. Medication adjustment must be done by trial and error because no parameter yet identified predicts the molecule or dose that will provide optimal performance. © 2005 Wiley Periodicals, Inc. J Clin Psychol/In Session 61: 589–606, 2005.