ADHD in Adults
Patient Education

Doctors Who Treat ADHD in Adults

If inattention, hyperactivity or impulsive behavior continually disrupts your life, it’s time to talk to your doctor. Below are the doctors and healthcare workers who often diagnose and treat adults with ADHD.

General Practitioners — A family physician or general practitioner will most commonly diagnose and treat ADHD. General practitioners typically treat this disorder by prescribing stimulant medications. If required, they may also refer you to a specialist.

Psychologists — A healthcare worker who will provide counseling and psychotherapy to treat adult ADHD

Psychiatrists — This doctor specializes in diagnosing and treating behavioral and mental disorders. Psychiatrists can prescribe ADHD medications, as well as provide individual and family therapy.

Holistic Practitioner — A doctor who views the body overall, considering physical, mental, and spiritual components. Herbs and nutritional supplements are considered in addition to meditation, cleansing, diet and exercise protocols.

Social Worker — A healthcare worker who is able to treat adult ADHD with psychotherapeutic services, including social skills training and behavioral modification therapy

How to Prepare for Your ADHD in Adults Doctor Visit

Having made your appointment with a healthcare provider, there are certain actions that you need to take in order to maximize the benefit of your doctor visit, which are listed in this adult HDHD patient education guide:

• Note any symptoms that you noticed or that has caused any problem to you
• Note key personal information like major stresses or recent life changes
• Make a list of medications that you are taking including vitamins or supplements. Include your dosage.

Questions to Ask Your Doctor About ADHD in Adults

From your initial diagnosis throughout your treatment and care, you will have questions about your adult ADHD. Below is a list of helpful questions for you and your doctor to discuss so you can make informed decisions about your condition.

Questions About My Diagnosis

• Other than the most likely cause, are there other possible causes for my symptoms?
• What kinds of tests do I need?

Questions About My Treatment

• What's the best treatment? How long my treatment will continue?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Should I see a specialist such as a psychiatrist or psychologist?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend?
• What are the side effects of the medications you’ve prescribed? Is there a generic alternative?

Questions About My Lifestyle and Family

• What changes should I make in my lifestyle to overcome my condition?
• Should my family and friends be aware of my condition?
• How will ADHD affect my work?
• Will I pass this condition on to my children?
• How will my condition and its treatment affect my daily routine?
• Are there any specific instructions to deal with daily routine?

Common Tests or Labs to Diagnose ADHD in Adults

There is no specific test for adult ADHD. Gathering as much information on your symptoms is the best way to get an accurate diagnosis and to rule out other possibilities.

Psychiatric Assessments

Individuals suspected to have ADHD are administered a psychiatric assessment using the DSM-IV (Diagnostic and Statistical Manual of Mental Disorder) as a reference. Below outlines what is measured:

IA. Six or more of the following signs of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level.
Inattention:

1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
2. Often has trouble keeping attention on tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
5. Often have trouble organizing activities.
6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
7. Often loses things needed for tasks and activities (such as toys, school assignments, pencils, books, or tools).
8. Is often easily distracted.
9. Often forgetful in daily activities.

IB. Six or more of the following signs of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level.
Hyperactivity:

1. Often fidgets with hands or feet or squirms in seat.
2. Often gets up from seat when remaining in seat is expected.
3. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
4. Often has trouble playing or enjoying leisure activities quietly.
5. Is often "on the go" or often acts as if "driven by a motor".
6. Often talks excessively.

Impulsiveness

1. Often blurts out answers before questions have been finished.
2. Often has trouble waiting one's turn.
3. Often interrupts or intrudes on others (example: butts into conversations or games).

II. Some signs that cause impairment were present before age 7 years.

III. Some impairment from the signs is present in two or more settings (such as at school/work and at home).

IV. There must be clear evidence of significant impairment in social, school, or work functioning.

V. The signs do not happen only during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder. The signs are not better accounted for by another mental disorder.

Medical Assessments

Along with the above DSM IV diagnostic criteria, a physical examination and other tests are required to rule out other conditions.

Test	Why Test?	What Happens?	Normal Result
Thyroid function test and vitamin deficiency test	To rule out thyroid disorder and vitamin deficiencies – common cause of memory loss and lack of concentration	Blood is drawn with a syringe, usually from the arm	Thyroid Function test: TSH – 0.4 to 6mlU/L Total T4 – 4.5 to 12.5mg/dL Free T4 – 0.7 to 2.0ng/dL T3 – 0.2 to 0.5ng/dL
Regular blood test	To know lead level, common cause for permanent behavioral disorder.	Blood is drawn with a syringe, usually from the arm	Normal lead level range – 5 to 10 mcg/dl
CT Scan and MRI	To rule out any lesion causing ADHD like symptom	This noninvasive medical test takes a picture of the bones, soft tissues and blood vessels. A dye may be injected into the patient by a syringe to help produce a clearer image	Clear, normal structure of brain is expected.
Psychological tests	Performed to rule out disorders like sleep disorder and memory impairment	IQ test given by a psychologist; physical observation is conducted to rule out sleep disorders	Sleep disorders and memory impairment may cause symptoms which overlap with the cardinal symptoms of ADHD.
Electric encephalography (EEG)	To measure electrical activity of the brain	Electrodes are placed on the scalp with a conductive gel or paste. Typically a 20-30 min procedure.	Wave patterns and rhythm is observed to determine normal brain function.

Common Medications and Treatments for ADHD in Adults

Most ADHD treatments include a combination of both medication and alternative therapies.

Medication

Prescription drugs are the first-line treatment of ADHD in adults. Experts estimate that ADHD drugs, when used properly, are 70 to 90 percent effective. Choosing the right medication for a patient with ADHD is often about avoiding making other health problems worse.

Drug Category	How it Works
Stimulants	They stimulate the part of the brain that maintains focus and keeps impulses in check. Extended-release formulations work for longer periods of time.
Non-stimulants	These drugs also alter brain chemistry but are considered less effective than stimulants. Atomoxetine is the first non-stimulant drug approved for ADHD and may produce fewer side effects than stimulants.
Antidepressants	Prescribed to reduce tics and insomnia caused by other ADHD medications; also helps to reduce aggression associated with ADHD
High blood pressure medications	Helps to balance neurotransmitters in brain to control severe symptoms of ADHD for a short period; dosage varies depending upon the severity of the symptoms

Psychotherapy

Treatment	How it Works
Cognitive-behavioral therapy	Helps develop organizational skills and helps to map out day-to-day coping strategies

Alternative Therapy

Treatment	How it Works
Acupuncture	A mode of treatment in which you learn to control your heart rate, blood pressure, and muscle tension
Meditation	Doing regular meditation routines may help treat symptoms of ADHD.
Homeopathy and Naturopathy	Evidence has shown that these modes of treatment help to treat adult ADHD with no significant side effects.
Neurofeedback training	This treatment involves regular sessions in which you focus on certain tasks while using a machine that shows brain wave patterns.