Many of the medicines used to treat adults with ADHD (Attention Deficit Hyperactivity Disorder) are the same as those prescribed for children and adolescents with ADHD. ADHD affects 30 to 50 percent of adults who had ADHD in childhood. However, when prescribing medications for adults with ADHD, physicians should consider a number of important differences in the way these medications affect adults and children.
Prescribing Medicines for Adult ADHD
Accurate diagnosis and treatment of ADHD in adults is challenging and is complicated due to other psychiatric conditions that often accompany the disorder, like anxiety and depression. More than one medication may be prescribed to control symptoms of ADHD and accompanying disorders. Stimulants are used to treat hyperactivity and inattentiveness, non--stimulant medications are used in people who don't respond to or can't tolerate stimulants, and antidepressants are sometimes prescribed to manage moodiness. The following are some of the commonly prescribed medications for adults with ADHD.
Methylphenidate (MPH) is a stimulant that is available in short acting forms such as Ritalin, Metadate, Methylin, and generic MPH; its effects last only four hours. Extended or sustained-release forms include Ritalin SR, Metadate ER and Methylin ER. The newer extended-release MPHs are Concerta, Metadate CD and Ritalin LA. MPHs are prescribed off label for adults since they are not approved for adults by the FDA.
Amphetamines (AMPs) such as Dexedrine, Dextrostat and Adderall are immediate release stimulants that also last about four to six hours. Dexedrine Spansules and dextroamphetamine sulfate are sustained-release forms of AMPs. Adderall XR is a newer extended release AMP that has been effective when taken just once a day.
Atomoxetine (Non Stimulant)
Atomoxetine (Strattera) is used to treat ADHD in children, adolescents and adults. It is the first medication of any kind specifically approved for the treatment of ADHD in adults. It is taken once or twice a day and may be useful in adults with ADHD and depression and/or anxiety.
Antidepressants that increase the neurotransmitter norepinephrine (not serotonin like other antidepressants) may improve the symptoms of ADHD.
Tricyclic antidepressants (TCAs) like Desipramine (Norpramine) and nortriptyline are taken once a day and improve the anxiety and depression that can accompany adult ADHD.
Mono-amine Oxidase Inhibitors (MAOIs) help patients with depression, anxiety and adult ADHD. But they can raise blood pressure so patients need to stay on a strict diet to prevent blood pressure from rising.
Bupropion (Wellbutrin) is an antidepressant that is as helpful as some stimulants, but is thought to be more helpful than TCAs for patients with bipolar disorder.
Venlafaxine (Effexor) may be effective for adults with ADHD who also have depression and/or anxiety. Blood pressure monitoring is recommended as it may increase blood pressure.
The Importance of Customizing a Medication Plan for Adults with ADHD
Although there are a number of reliable medicines for adults with ADHD, fine tuning of medication types and dosages is necessary to obtain the most effective treatment. It is helpful if the adult with ADHD can chart their reaction to medications and document the symptoms they are experiencing to help the doctor find the right combination of medicines. Practical considerations regarding the patient's lifestyle and schedule should also be taken into effect when deciding to prescribe short or long-acting formulations. Addressing accompanying psychiatric disorders is an important part of the decision regarding medications work best for the adult with ADHD.
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