ADHD in Adults - Treatment Options
ADHD is a well-known neurobiological disorder that affects 4.4% of the general population. It is accompanied by high rates of comorbidity (depression anxiety, anxiety, substance abuse) and significant emotional, social, and occupational impairments.
Psychotherapy and medications are both effective treatments for adults suffering from ADHD. The stimulants methylphenidate and amphetamine are the most commonly prescribed drugs.
Medicines
Many people who suffer from ADHD report significant improvement in their symptoms and functioning when they take medication. Due to the various ways that people respond to medication, it is important for individuals with ADHD to discover a combination that is effective.
Stimulants, like amphetamines and methylphenidate are the most commonly prescribed medications for adults with ADHD. These stimulants are available as liquid or tablet form in an immediate-release (short acting) formulation. They can be taken every three to four hours. Adults can augment an immediate-release medicine with an extended-release long-acting medication every week to lessen the requirement to take it regularly throughout the day.
Antidepressants like desipramine have also been proven to be effective in the treatment of adults suffering from ADHD. This class of drugs can be used on its own or in conjunction with stimulants to increase their effects. However, they could increase the risk of serious cardiovascular side effects, such as rapid heartbeat, EKG changes, and orthostatic hypotension.
Adults suffering from ADHD can also be treated with alprazolam or clonidine, which are both Alpha-2 antagonists of the adrenergic system. These drugs were initially developed to treat hypertension. They have a calming affect and can help improve focus and reduce hyperactivity and impulse control in some adults. These medications can cause very low blood pressure when they suddenly stop, or the dosage is reduced.
Psychotherapy is also useful for adults with ADHD. Individual therapy can help people deal with feelings of embarrassment, shame, and resentment towards co-workers and supervisors, teachers, and family members that may criticize or nag them. Additionally counseling for families and marriages can help couples with ADHD understand each other's problems and improve communication.
Behavioral Therapy
A key goal of psychosocial therapy for adult ADHD is to impart strategies and techniques that enhance function in everyday life. Psychotherapy can also help people with ADHD to overcome the low self-esteem and feeling of failure that often accompanies this condition.
Cognitive behavioral therapy (CBT) helps people change the negative thoughts that create problems in their lives. It also helps to learn new ways of thinking, feeling and acting. This short-term, goal-oriented psychotherapy has been proven to be effective in treating many conditions, including anxiety and depression. It can be used on its own or in combination with other treatments.
CBT can include group therapy. This is especially beneficial for people with ADHD because it enables them to connect with other people who face similar challenges and learn how they manage their ADHD symptoms. It can be offered in person or via phone. In one study, CBT was compared to standard therapy for adults suffering from ADHD. Both treatments helped improve self-reporting indicators like symptoms, functioning and quality of life.
Several studies have compared CBT with other psychosocial treatments for adults suffering from ADHD and all have shown significant reductions in self-reported ADHD symptoms with medium to large effect size. These improvements were attributed to diverse modalities like interpersonal and cognitive behavior therapy, social skills training, problem-solving training, and mindfulness meditation.
However, caution is required in comparing the effectiveness of various treatments for adult ADHD. It is likely that differences in outcomes results are due to a variety of factors, such as treatment characteristics and the measures used. A few studies have examined the effectiveness of neurofeedback, an approach that involves wearing an electrode-lined cap when performing cognitive tasks to pinpoint areas in the brain where there is too much or too little activity - and then instructing the person to manage these patterns.
Counseling
Many people who suffer from ADHD also suffer from comorbid mood or anxiety disorders that require treatment. Counseling can help address these problems, which may be contributing to ADHD symptoms. Interpersonal therapy is among the psychotherapy approaches that can help improve a person’s ability to manage conflicts and create lasting relationships. Cognitive behavioral therapy aims to transform negative behaviors and help manage self-destructive and impulsive behaviors that can cause problems at school or at work.
In certain cases, psychotherapy is used as an adjunct to the medication used for ADHD treatment for adults. Patients with comorbid disorders like bipolar disorder, and substance abuse need to be evaluated carefully to make sure they don't have symptoms that cannot be ameliorated by the medications used to treat ADHD. Certain medical conditions, such as thyroid disorders, lead poisoning and a history or seizures, must be treated with more vigor.
In-depth outpatient programs could be suggested if the individual's ADHD is such that it hinders their daily functioning and quality of life. These programs offer an organized therapy that is more intense than conventional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) helps adults suffering from ADHD improve their ability to manage time and impulse control, executive function, and planning. It helps them identify and express their feelings and employs worksheets and exercises to make the lessons more engaging. Mindfulness meditation training improves CBT, and it improves the ability of people to concentrate and control their emotions. It improves the ability of a person's ability to handle the effects of stress and arousal. It can help them deal with sadness, anger and other difficult emotions that could be causing their ADHD.
Occupational Therapy
Adults with ADHD report difficulties functioning at work and at home. These symptoms can also affect relationships and lead to financial issues. Therapy that addresses these issues can help you increase self-esteem, address the root causes of your issues and develop healthy coping strategies.
Cognitive-behavioral therapy is a useful treatment for adults with ADHD because it helps you modify your negative thoughts and behaviors. It is focused on teaching you how to utilize strategies for managing time and overcoming mental distortions that lead to negative moods and perceptions of limited choices.
Many adults with ADHD also suffer from comorbid anxiety or depression. These psychiatric conditions can decrease or even increase the effectiveness of certain medications that are used to treat ADHD. Therefore it is recommended that you treat the most severe comorbidity first and observe the effect of medication before proceeding to treatment of the other disorder.
Occupational therapy can help you learn ways to organize your life and work, establish routines that are predictable, manage money and time and develop a positive self-image. It can also help you learn relaxation techniques that could decrease your impulsivity and hyperactivity. Yoga and other exercises can also help you concentration by stabilizing your body in different poses.
Family and marriage counseling can help adults with ADHD to solve the problems they create for their children, spouses and others. They often complain about being unreliable and disorganized. adhd treatment for adults medication are also prone to forget things or make impulsive decisions. Therapy and classes in which spouses and other family members are educated on ADHD can help you develop more harmonious relationships. Additionally, it can aid you and your loved ones realize that these issues are linked to the patient's ADHD rather than a lack of caring or refusing to cooperate.
Clinical Trials
Adult ADHD is a common neurobiological disorder. It is often associated with other disorders that are comorbid, such as anxiety, depression and substance abuse disorders. Treatment options include medication and psychosocial interventions. A variety of medications are available for adults suffering from ADHD and some of them have been tested in clinical trials. These studies have revealed the strengths and drawbacks of the medications.
Adults who suffer from ADHD might experience the same symptoms as children do, but it is difficult to determine since childhood symptoms may not persist in adulthood. Adults suffering from ADHD may not have an ancestral history of the disorder or might not remember the symptoms. It is important to have an extensive medical history in order to determine whether the symptoms are related to an illness, such as thyroid problems or sleep apnea, and vision problems.
Medications for adults with ADHD generally fall into two categories: stimulants and non-stimulant medications. Stimulants are the most effective drugs for adults suffering from ADHD and their response rates are in the 70 - 80 percentage range. Amphetamine as well as methylphenidate are the most frequently prescribed stimulants. Methylphenidate is also accessible in a transdermal system, that allows for continuous supply of medication throughout the day.
Adults with ADHD can take nonstimulant medications that act on norepinephrine or dopamine. Desipramine is the most researched tricyclic drug and has been proven to be effective in adult patients suffering from ADHD. It is a low dose drug and should be increased by 50 mg every 7 days until the desired response is observed.
Bupropion XL is a second antidepressant that has been proven to be effective for adults suffering from ADHD. It is a dopamine agonist that works by blocking the reuptake of norepinephrine at the presynaptic transporter, thereby increasing its use in the brain. The drug is known to improve mood in adults and reduce hyperactivity however it's not as effective in improving concentration or cognitive function as stimulants.