ADHD in Adults - Treatment Options
ADHD is a well-known neurological disorder that affects around 4,4% of the population. It is accompanied by high levels of comorbidity (depression, anxiety, substance abuse) and significant emotional, social, and occupational impairments.
Both medication and psychotherapy are effective treatments for adults with ADHD. The most frequently prescribed medications are stimulants like methylphenidate or amphetamine.
Medicines
Many adults with ADHD report significant improvements in their symptoms as well as functioning in response to medications. Because of the different ways that people react to medications, it is essential for those with ADHD to find a combination that works best.
Adults with ADHD are prescribed stimulants, such as amphetamines and methylphenidate. These stimulants are available in tablets or liquids in an immediate-release (short acting) formulation. They can be taken every three to four hour. Some adults may supplement an immediate-release dose with an extended-release or longer-acting drug that is taken daily to reduce the requirement for frequent doses throughout the day.
Desipramine and other antidepressants have also been found to be effective in the treatment of adults suffering from ADHD. This class of drugs can be employed together with stimulants or in isolation to boost their effects. However, they can increase the risk of serious cardiovascular adverse effects like an increased heart rate, EKG changes, and orthostatic hypotension.
Alpha-2 adrenergic agonists like alprazolam and clonidine can also be used for the treatment of people suffering from ADHD. These medications were originally developed to treat hypertension. They have a calming affect and can help improve focus and reduce hyperactivity and impulse control in certain adults. These medications can lead to very low blood pressure if they suddenly stop, or the dosage is decreased.
Psychotherapy is also beneficial for adults suffering from ADHD. Individual talk therapy can help them deal with feelings of shame and embarrassment over their ADHD, as well as anger toward supervisors, colleagues teachers, and family members who may nag or criticize them. Counseling for families and marriage is a great method to help couples suffering from ADHD better understand each other and improve their communication.
Behavioral Therapy
Psychosocial therapy for adults with ADHD seeks to improve everyday functioning by educating people on strategies and skills. Psychotherapy can also aid those with ADHD overcome their low self-esteem and feelings of failure that is often associated with this condition.
Cognitive behavioral therapy (CBT) helps people change the negative thoughts that cause problems in their lives. It also helps to develop new ways of thinking and feeling, as well as doing. This short-term, goal-oriented kind of psychotherapy has been proven to be effective for a variety of disorders such as anxiety and depression. It can be used in conjunction with other treatments or alone.
CBT can include group therapy. This is particularly beneficial for people with ADHD because it enables them to connect with other people who have similar struggles and discover how they deal with their ADHD symptoms. It can be delivered in person or via phone. In one study, CBT was compared to the standard treatment for adults suffering from ADHD. Both treatments improved self-report measures such as symptoms, functioning, and quality of life.
Several studies have compared CBT with other psychosocial treatments for people with ADHD and all have shown significant reductions in self-reported ADHD symptoms, with medium to large effect sizes. These improvements were linked to a variety of modalities such as cognitive and interpersonal behavioral therapy, social skill training, problem-solving training and mindfulness meditation.
However, caution is required when comparing the effectiveness of different treatments for adults with ADHD. It is likely that different outcomes of the treatments are due to a variety of variables that include treatment characteristics, measures employed as well as the backgrounds of the patients. Few studies have examined the effectiveness of neurofeedback. This technique involves wearing a hat with electrodes while doing cognitive tasks to determine brain regions where there is excessive or insufficient activity. The person is then taught to regulate these patterns.
Counseling
Many people suffering from ADHD have anxiety or mood disorders that require treatment. Counseling can help to address these problems, which may be contributing to ADHD symptoms. Certain psychotherapy strategies include interpersonal therapy to improve a person's ability to build meaningful relationships and to resolve conflicts. Cognitive behavioral therapy is designed to help people manage impulsive, self-destructive, and negative behaviors that could create difficulties at school or at work.
In some cases, psychotherapy can be used in combination with medication for adults with adhd treatment. Patients suffering from co-occurring disorders like substance abuse, depression, and bipolar disorder need to be assessed to ensure that their symptoms aren't made worse through the use of medications to treat ADHD. Patients with certain medical conditions such as thyroid disorders, lead poisoning and seizures in the past, have to be treated with more vigor because they are at higher risk for complications from the medications.
Outpatient intensive programs may be suggested if the individual's ADHD is so severe that it significantly interferes with their daily functioning and quality of life. These programs offer a more intense and structured treatment than traditional outpatient therapy.
Cognitive behavioral therapy (CBT) is a form of cognitive therapy, helps people with ADHD to improve their ability to manage time, impulse control, planning and executive function. It teaches them to recognize and express their emotions and utilizes exercises and worksheets to make the learning interesting. Mindfulness meditation training enhances CBT and enhances the ability of a person to concentrate and manage their emotions. It also improves a person's ability to handle stress and arousal. It can assist them in dealing with anger, sadness, and other difficult feelings that could be contributing to their ADHD.
Occupational Therapy
Adults with ADHD experience difficulties at work and at home. These issues can also impact relationships and cause financial issues. Therapy that addresses these issues will allow you to improve your self-esteem and address the root of the issue. It will also assist you in developing healthy coping strategies.
Cognitive-behavioral therapy can be a beneficial treatment for adults with ADHD because it teaches you how to change your negative beliefs and behavior. It focuses on teaching time management techniques and overcoming thinking distortions that can lead to negative moods and the perception that there are only a few choices.
Many people with ADHD have depression or anxiety disorders that are comorbid. These psychiatric disorders can diminish 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 then monitor its response to medication before proceeding to treatment of the other condition.
Occupational therapy can help you learn ways to organize your life and work, set up routines that are predictable, manage time and money and build an optimistic self-image. adhd in adults untreated can also help you master relaxation techniques that can reduce your hyperactivity and impulsivity. In adhd in adults symptoms and treatment and other exercises can help you focus better by stabilizing the body in different postures.
Counseling for families and marriage can assist adults suffering from ADHD to overcome the problems they cause their spouses, kids and friends. They frequently complain of being unstable, unorganized, forgetful and often prone to making impulsive choices. You can strengthen your relationships by informing your spouses and family members about ADHD. It can aid you and your family members to understand that the issues are caused by ADHD instead of a lack in caring or an unwillingness to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder that is very prevalent. It is accompanied by a high rate of comorbidity, including anxiety, depression and substance abuse disorders. Treatment options include medication and psychosocial interventions. There are a variety of treatments for adults suffering from ADHD. Some of these medications have been tested in trials. These studies have highlighted both the strengths and the limitations of the drugs.
Adults suffering from ADHD suffer from the same issues as children, however it isn't always easy to identify them since childhood symptoms may not persist until adulthood. In addition, adults with ADHD might not have a family history of the disorder in their family or they may not even remember having symptoms. It is important to have an extensive medical history to determine if the symptoms are due to an illness, such as thyroid problems, sleep apnea or hearing and vision problems.
Adults with ADHD are treated with stimulants or non-stimulants. Stimulants have the highest response rates for adults with ADHD. Their response rates range between 70 and 80%. The most frequently used stimulants are methylphenidate and amphetamine compounds. Methylphenidate is also available in a transdermal system that allows for continuous drug delivery throughout the day.
Adults with ADHD can take non-stimulant drugs that are based on norepinephrine, or dopamine. Desipramine, the most studied tricyclic, has been proven to be effective in adult ADHD patients. It is a low-dose medication that should be increased every seven days by 50mg until the desired effect is seen.
Bupropion XL is a second antidepressant that has been shown to be effective in adults with ADHD. It is a dopamine agonist that works by blocking the reuptake of norepinephrine in the presynaptic transportation system, thus increasing its availability in the brain. This drug has been shown to improve mood and decrease hyperactivity in adults, but it isn't as effective as stimulants in improving cognitive performance or concentration.