What is it?

Most people are aware of Attention Deficit Hyperactivity Disorder (ADHD) in Children. ADHD, as the name suggests is a disorder that presents with problems in Attention along with Hyperactivity and Impulsivity. Common problems observed in childhood with ADHD include-

  • Over activity
  • Easy distractibility
  • Impulsivity
  • Concentration difficulties

Whilst some degree of sustaining attention or being hyperactive/impulsive may be normal, the diagnosis of the disorder is made only when the symptoms start causing problems in the functioning of the individual in various domains including home life, social life, occupational life and/or relationship problems.

Progression

With time and increasing age, some of the symptoms improve but some symptoms persist and can get worse. Often, over activity/hyperactivity improves (most people learn to control their behaviours with growing age) but impulsivity, difficulties sustaining attention/concentration and risk-taking may persist. These symptoms lead to underperformance in various domains of the individual’s life.

Comorbid anxiety, depression and/or drug and alcohol misuse can be often associated with the disorder.

Diagnosis

The diagnosis of Adult ADHD is made only after a comprehensive assessment process that involves-

  • Historical information- Developmental and school years
  • Site of school reports and/or information from parents/guardians
  • Problems as a result of symptoms in the past
  • Current problems
  • Assessment of functioning and impact of symptoms in various domains of life
  • Assessment of comorbidities
  • Previous ADHD diagnosis as a child
  • Assessment of treatments and their effects, if already been diagnosed with ADHD as a child

The assessment for Adult ADHD can take up to 3-4 hrs and we often use comprehensive interview tools to capture all the relevant information before ruling in or ruling out Adult ADHD.

Treatments

Both medications and psychological therapies are used for treating the disorder. Cognitive Behavioural Therapy (CBT) approaches can help with planning and organising tasks and improve performance. They can also help in addressing low self esteem and other comorbidities often seen with Adult ADHD.

Medications

Both stimulant and non- stimulant medications are used to treat Adult ADHD. These include-

Stimulants

  • Methyphenidate
  • Dexamfetamine
  • Lisdexamfetamine

Non- Stimulants

  • Atomoxetine

Many of the drugs are not licensed in Adult ADHD and are prescribed ‘off-license’ and as per NICE Guidelines.

In addition to the above many other drugs are gradually emerging from clinical experience and research trials.

The choice and monitoring of medication depends on various factors and these are discussed in detail prior to starting treatment.