ADHD in Adults - Treatment Options
ADHD is a common disorder of the nervous system that affects around 4,4% of the population. It is accompanied by high rates of co-morbidity (depression, anxiety, addiction to drugs) and significant emotional, social, and occupational impairments.
Medications and psychotherapy are both effective treatments for adults with ADHD. The most frequently prescribed medications are stimulants like methylphenidate or amphetamine.
Medicines
Many people who suffer from ADHD have seen significant improvements in their symptoms and functioning in response to medications. Due to the many different ways people respond to medications it is crucial for people with ADHD to discover a combination that is most effective.
Adults suffering from ADHD are prescribed stimulants like amphetamines and methylphenidate. These stimulants are available as tablets or liquids in an immediate-release (short acting) formulation. They can be taken every three to four hour. Adults may supplement an immediate-release medicine with an extended release long-acting medication every week to lessen the requirement to take it often throughout the day.
Desipramine and other antidepressants have also been found to be effective in treatment of adults suffering from ADHD. This class of medications can be used alone or in conjunction with stimulants to increase their effects. They can also increase the danger of serious side effects, such as rapid heartbeats, EKG changes and orthostatic hypotension.
Adults suffering from ADHD can also be treated using alprazolam and clonidine, which are both Alpha-2 antagonists of the adrenergic system. These drugs were initially developed to treat hypertension. They have a calming effect and can help improve focus and decrease hyperactivity and impulseivity in certain adults. These medications can lead to very low blood pressure if they are abruptly stopped or the dosage is reduced.
Psychotherapy can also be beneficial for adults suffering from ADHD. Individual therapy helps them deal with feelings of shame, embarrassment, and resentment towards co-workers and supervisors, teachers and family members who may criticize or nag them. Family and marriage counseling can be a great option to help couples suffering from ADHD improve their understanding of each other and improve communication.
Behavioral Therapy
The primary goal of psychosocial therapy for adult ADHD is to teach strategies and skills that help improve function in everyday life. Psychotherapy can help individuals who suffer from ADHD overcome their self-esteem problems and the feeling of inadequacy they often feel.
Cognitive behavioral therapy (CBT) helps people change the negative thoughts that create difficulties in their lives and to discover new ways of thinking and feeling, as well as acting. This short-term, goal-oriented form of psychotherapy has been found to be effective for a variety of conditions such as anxiety and depression. It can be used in conjunction with other therapies or on its own.
CBT can involve group therapy, which is particularly beneficial for people with ADHD as it offers the opportunity to meet others with similar challenges and to learn from others how they manage their ADHD symptoms. It can be delivered in person or via the phone. One study compared the effects of CBT with that of standard therapy for adults with ADHD and found that both treatments led to improvement in self-report measures of functioning, symptoms and quality of life.
A number of studies have compared CBT with other psychosocial treatments for adults with ADHD and have all shown significant reductions in self-reported ADHD symptoms with medium to large effect size. These improvements were linked to a variety modalities including cognitive and interpersonal therapy as well as social skills training, problem-solving training, and mindfulness mediation.
It is crucial to evaluate the efficacy between different treatment options for adults with ADHD with caution. It is possible that the differences in outcome results reflect a number of variables, including treatment characteristics, measures used as well as the backgrounds of the patients. A few studies have looked into the effectiveness of neurofeedback. This method involves wearing an electrode-lined hat while performing cognitive tasks in order to identify brain areas where there is a lack or excess of activity. The person is then taught to regulate these patterns.
Counseling
Many people who suffer from ADHD also have anxiety or mood disorders that require treatment. Counseling can help with these problems, which may be contributing to ADHD symptoms. Interpersonal therapy is one of the psychotherapy techniques that can help improve the ability of a person to resolve conflicts and build lasting relationships. Cognitive behavioral therapy is designed to help manage self-destructive, impulsive, and negative behaviors that can create problems at school or work.
In certain cases psychotherapy is sometimes used in conjunction with medication for adults with adhd treatment. Patients with comorbid disorders such as depression, bipolar disorder, and addiction to drugs should be evaluated with care to make sure they don't have symptoms that cannot be ameliorated by the medications used to treat ADHD. People with certain medical issues, including thyroid disorders, lead poisoning and an history of seizures must be treated with more vigor because they are at a higher risk of complications from medications.
If ADHD is serious enough to affect the quality of life and daily functioning intensive outpatient programs could be suggested. These programs provide structured treatment that is more intense than conventional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) helps adults suffering from ADHD improve their abilities to manage time management and impulse control, as well as executive function, and planning. It helps them understand and express their emotions and utilizes worksheets and activities to make the learning more enjoyable. The practice of mindfulness meditation improves CBT and enhances the capacity of a person to focus and manage emotions. first line treatment for adhd in adults improves the ability of a person's ability to handle stress and arousal. It can help them deal with anger, sadness and other emotional issues which could be contributing to their ADHD.
Occupational Therapy
Adults suffering from ADHD report difficulties functioning at work and at home. In addition to affecting work performance, these conditions can cause problems with relationships and could cause financial problems. Therapy that addresses these issues can help boost your self-esteem, solve the root causes of your issues and develop healthy coping strategies.
Cognitive-behavioral therapy is an effective treatment for adults with ADHD because it helps them change their negative attitudes and behaviors. Particularly, it is focused on teaching you how to utilize time management strategies and overcome mental distortions that lead to negative moods and a perception of a limited range of choices.
Many adults with ADHD also have comorbid anxiety or depression. These psychiatric disorders can reduce or increase the effectiveness of some medications used to treat ADHD. It is recommended to first treat the most severe comorbidity and then monitor the response to the medication before treating 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 an optimistic self-image. It can help you learn ways to relax that could reduce impulsivity and hyperactivity. In the same way, yoga and other exercise can help you improve your focus by ensuring your body is stable in different postures.
Counseling for families and marriage can help address the issues that adults with ADHD often cause their children, spouses, and other family members. They often complain of being erratic and unorganized. They are also prone to forget things or make impulsive decisions. You can strengthen your relationships by educating your spouses and family members about ADHD. Moreover, it can aid you and your loved ones understand that these issues are due to the patient's ADHD rather than the lack of compassion or refusing to cooperate.
Clinical Trials
Adult ADHD is a highly common neurobiological disorder. It is accompanied by high rates of comorbidity, such as anxiety, depression and addiction disorders. The use of medication and psychosocial interventions is available as treatments. There are a range of medications available for adults with ADHD. Some of these medications have been evaluated in studies. These studies have exposed the strengths and weaknesses of the drugs.
Adults who suffer from ADHD might experience the same symptoms that children do, but it can be difficult to diagnose since childhood symptoms may not persist in adulthood. Adults suffering from ADHD may also not have any family history of the disorder or may not remember symptoms. A thorough medical history is necessary to help determine whether the symptoms are caused by a medical condition such as a thyroid problem or sleep apnea. It could also be due to issues with vision and hearing or lead poisoning.
Adults with ADHD are treated with stimulants or non-stimulants. Stimulants have the highest response rates for adults suffering from ADHD. Their response rates vary between 70 and 70% to 80%. The most frequently used stimulants are methylphenidate and amphetamine compounds. Methylphenidate can also be administered through a transdermal system. This allows for continuous medication delivery during the daytime.
Nonstimulant drugs for adults with ADHD are primarily tricyclic antidepressants that target dopamine and norepinephrine. Desipramine is the most studied tricyclic and has been shown to be effective in adult patients suffering from ADHD. It is a low dose medication that is recommended to be increased every seven days by 50mg until the desired effect is observed.
Bupropion XL is a different antidepressant which has been proven to be effective in adults with ADHD. It is a dopamine-agonist which is effective in blocking the reuptake of norepinephrine at the presynaptic transporter which increases its accessibility to the brain. This drug has been proven to improve the mood of adults and decrease hyperactivity, but it's not as effective in improving cognitive function or concentration as stimulants.