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Treatment of Adult ADHD; Adult ADHD Treatment

Abstract: ADHD can be a severe problem also for adults. Adult ADHD treatment needs to be adjusted for each patient, but can include psychotherapy and medicines.

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Treatment of Adult ADHD; Adult ADHD Treatment

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Written by: Martin Winkler
First version: 22 Jul 2008.
Latest revision: 24 Jul 2008.

I am 25 and have lived with Add and never been on medication, as I am getting older I am seeing more and more reason why I should be. It is effecting my relationship, my job, and my overall quality of life. Would it be recommended to use medication for adult ADHD, and what are the alternatives for treatment of adult ADHD?

Answer:

To consider different treatment options for adults with ADHD needs an individual diagnostic process evaluating the personal resources and deficits of the person. ADHD should cause severe impairments in different areas of life and has to be present since early childhood. But many adults have developed functional or dysfunctional ways to cope with the everyday problems of this disorder.

Treatment options for adults with ADHD include psycho-education about symptoms and consequences of this disorder. Sometimes this is already the most important part of therapy, because the client can now accept some common problems of life and already uses appropriate ways to handle these problems.

To get professional help to cope with organization and other aspects of daily functioning a coaching approach can be very useful. A coach helps to set priorities and to define realistic plans to change certain areas of life which caused problems.

There is only very little research about appropriate psychotherapeutic ways to treat ADHD. I would recommend a cognitive-behavioural therapy (self-management approach), but sometimes other methods are also very useful (to cope with low self-esteem or other problems secondary to ADHD).

Medication can be the essential part of a good therapy, but it is not always necessary to take pills. There are (at least) two possible approaches to use medication for adults with ADHD. The most effective treatment choice is to use stimulants like methylphenidate or amphetamines. Very often adults need a lower dose than children, but they have a longer day so they need additional daily doses or longer acting stimulants (e.g. Concerta, Ritalin LA or Adderall XR). Psychostimulants are not approved for the treatment of adult ADHD, but they have been used for a long time with excellent results. (Actually, the amphetamine Adderall XR is going to get FDA approval very soon.)

Atomexetine (Strattera) is an antidepressant but has also a positive effect for ADHD. There is a lot of advertisement in America for this kind of medication. It is approved for adult ADHD, but there is only limited experience on the effects for adults compared to psychostimulants. It has an effect for 12 to 24 hours, but it takes a couple of weeks until you have the full effects of this drug.

Best effects have been reported for patients with inattentive ADHD. I think atomoxetine is second choice compared to psychostimulants, because the correct doses and possible side effects are relevant.

So there are different possible treatment choices. To find the best treatment for you needs a good clinical diagnosis and consultation of a doctor with special experience in this area. I would recommend joining a self-help group to get further information and support.

Alternative therapies have not shown a benefit for adult ADHD. You might consider complementary methods to lower your stress and subjective impairments with a positive influence on your well-being. But this usually does not influence the basic attentional and executive dysfunctions of ADHD.

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