Attention-Deficit/Hyperactivity Disorder in Adults: Evidence-Based Recommendations for Management

  title={Attention-Deficit/Hyperactivity Disorder in Adults: Evidence-Based Recommendations for Management},
  author={Anthony Leon Rostain},
  journal={Postgraduate Medicine},
  pages={27 - 38}
  • A. Rostain
  • Published 1 January 2008
  • Psychology, Medicine
  • Postgraduate Medicine
Abstract Attention-deficit/hyperactivity disorder (ADHD) is associated with impairments in educational, occupational, neuropsychological, and social functioning in adults. Successful diagnosis and treatment of the disorder in adults can be a challenge because recent and integrative clinical guidelines are lacking and diagnostic criteria are based on making a retrospective diagnosis of childhood-onset ADHD. To develop evidence-based recommendations for the treatment of ADHD in adults, the… 
Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults
Clinical guidelines recommend stimulants and the nonstimulant atomoxetine as first-line treatments, followed by antidepressants, and the combination of an antidepressant and stimulants has been shown to be safe and effective.
Aiming for remission in adults with attention-deficit/hyperactivity disorder: The primary care goal
This review provides primary care clinicians with a practical definition of remission in adults with ADHD, to emphasize that symptom reduction does not necessarily mean intact functionality, and to suggest a multidisciplinary approach aimed at achieving the greatest possible reduction of symptoms and normalization of functionality.
Attention-Deficit/Hyperactivity Disorder in a Chronic Care Paradigm
A clinical approach whereby adult ADHD is treated within a chronic care paradigm that prominently features the involvement of the PCP is described.
Bupropion for attention deficit hyperactivity disorder (ADHD) in adults.
Low-quality evidence that bupropion decreased the severity of ADHD symptoms and increased the proportion of participants achieving clinical improvement is found, suggesting a possible benefit in clinical improvement in adults with ADHD.
Comorbidities in Adult Attention-Deficit/Hyperactivity Disorder: A Practical Guide to Diagnosis in Primary Care
A review discusses disorders that may be comorbid with ADHD in adults, including anxiety, mood, substance use disorder, antisocial personality disorder, and borderline personality disorder.
The negative impact of attention-deficit/hyperactivity disorder on occupational health in adults and adolescents
Overall, ADHD in adults has a substantial economic impact as a result of absenteeism and lost productivity and Psychoeducation, combined with stimulant medications if necessary, is recommended as first-line treatment for adults with ADHD.
Recognizing and Treating Attention-Deficit/Hyperactivity Disorder in College Students
Traditionally diagnosed in children, attention-deficit/hyperactivity disorder (ADHD) is now regarded as a life span condition. The academic difficulties experienced by children and adolescents with
The Safety and Efficacy of Methylphenidate and Dexmethylphenidate in Adults with Attention Deficit/Hyperactivity Disorder
Based on the literature, increased doses are associated with better treatment response with moderate safety concerns, and methylphenidate and dexmethylphenidate are safe and effective medications to treat the symptoms of ADHD in adults.
Long-Term Safety of OROS Methylphenidate in Adults With Attention-Deficit/Hyperactivity Disorder: An Open-Label, Dose-Titration, 1-Year Study
OROS methylphenidate, in the flexible dosage range from 36 to 108 mg/d, was well tolerated for up to 1 year in adults with ADHD.
Neurofeedback for Adult Attention-Deficit/Hyperactivity Disorder: Investigation of Slow Cortical Potential Neurofeedback—Preliminary Results
This study investigated if any behavioral and electrophysiological changes reflected in the CNV can be observed after 15 sessions of SCP neurofeedback training, and a comparison of CNV amplitude in adults with ADHD and a healthy control group was conducted.


Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology
Initial guidance on managing ADHD in adolescents in transition and in adults is based on expert opinion derived from childhood evidence and it is hoped that, by the time these guidelines are updated, much evidence will be available to address the many directions for future research that are detailed here.
Stimulant treatment of adult attention-deficit/hyperactivity disorder.
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Under controlled conditions, the aggregate literature shows that the stimulants and noradrenergic antidepressants had a clinically and statistically significant beneficial effect on treating ADHD in adults.
ADHD in adults: a review of the literature.
  • M. Davidson
  • Psychology, Medicine
    Journal of attention disorders
  • 2008
The current state of knowledge regarding ADHD in adults and the combination of cognitive behavioral therapy and medication is critically examined to provide clinicians with practice-friendly information regarding assessment, diagnosis, and treatment.
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Adderall may be an effective agent for the treatment of adult forms of ADHD, with positive responses occurring at relatively low doses, at least for some individuals, but it may precipitate anxiety in vulnerable individuals.
Literature Review: ADHD in Adults
The current state of knowledge regarding ADHD in adults is critically examined to provide clinicians with practice-friendly information regarding assessment, diagnosis, and treatment and scientific research on psychosocial treatments is lacking.
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The available literature indicates the important role of psychopharmacological agents in the reduction of the core symptoms of ADHD and associated impairments.
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Robust doses of methylphenidate are effective in the treatment of adult ADHD, independent of gender, psychiatric comorbidity with anxiety or moderate depression, or family history of psychiatric disorders.
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  • Psychology
    Current psychiatry reports
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The status of cognitive-behavioral therapy (CBT) as an effective psychosocial treatment (when combined with pharmacotherapy) for adult ADHD is reviewed.
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Current results of epidemiology, etiology, clinical symptoms and comorbidity, diagnostic assessment, pharmacotherapy, and psychological interventions for adults with ADHD are discussed.