Stimulant medications are the most widely accepted treatment of attention deficit hyperactivity disorder (ADHD) in spite of controversy over their use. Stimulants have consistently been shown to potentiate noradrenergic brain transmission, a property also characteristic of the recently marketed antidepressant venlafaxine. Eighteen adults who met the Utah Criteria for ADHD in adults were enrolled in an open trial of venlafaxine. Progress was monitored with a recently refined rating scale designed to measure change in adult patients with ADHD. Among the 11 patients who could tolerate the medication, 8 showed a good response that was well maintained. They responded to dosages of 50 to 150 mg/day, with an average dose of 96 mg. Seven of the 18 had difficulty tolerating venlafaxine's side effects. These data suggest that controlled trials should be conducted with venlafaxine for ADHD.