Best Practices for Adult ADHD

Attention-deficit hyperactivity (ADHD) is most prevalent in children and adolescents, but adults are by no means immune. Numerous surveys have indicated that somewhere between 1% and 6% of the adult population has ADHD, and many of those cases are undiagnosed. The manifestations of ADHD are often less obvious in adults than children. Common symptoms may include forgetting appointments, difficulty completing tasks, reckless behavior, and problems with social interactions. Many adults with this disorder also have comorbid disorders such as depression, generalized anxiety, or substance abuse. Even for a trained psychiatrist, diagnosing adult ADHD is often a challenging proposition.

According to the latest clinical guidelines, a diagnosis of adult ADHD requires evidence of the disorder in childhood. If medical records are incomplete or the person has little memory of childhood behavior, then this condition is difficult to detect. Adults must also display a minimum number of behavioral conditions on a psychiatric inventory for ADHD. This inventory has recently been called into question, with some critics claiming that it’s excessively strict and includes parameters not appropriate for the adult population. Yet another obstacle to diagnosing ADHD in the adult population is the prevalence of comorbid conditions. The rate of psychiatric disorders and substance abuse issues is much higher in the ADHD population, and treating the whole person involves recognizing how each condition interacts with the others.

Psychostimulant medications, particularly Adderall (dextroamphetamine and amphetamine), are the most immediately effective treatment for adult ADHD. Research has shown that stimulant medication is useful in managing this condition in 70% to 80% of cases. Adderall works by both enhancing the release of dopamine and blocking its reuptake into the receptors on brain cells. Dopamine is an important neurotransmitter, serving a variety of functions within the brain. For those with ADHD, increased dopamine levels lead to better impulse control and “executive functioning”—the ability to carry out plans and make decisions. On the other hand, stimulants like Adderall have a strong potential for abuse. Taking double doses or more frequent doses eventually reduces the effectiveness of the medication and can result in a state of dependence.

ADHD is a significant but often overlooked challenge in adults. The psychostimulant medication Adderall, combined with behavioral therapy, is reportedly the most effective approach to this disorder. Behavioral interventions can help adults develop good study and work habits, cultivate healthier relationships, and overcome substance abuse issues. The goal of all treatment, of course, is the ability to maintain a healthy lifestyle.

PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Attention deficit hyperactivity disorder (ADHD). Retrieved April 16, 2012, from

Kolar, D., Keller, A., Golfinopoulos, M., Cumyn, L., Syer, C., Hechtman, L. (2008). Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatric Disease and Treatment, 4(2), 389-403.

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