Adult ADHD: Treatment Overview

Many people with attention deficit hyperactivity disorder (ADHD) don’t know they have it until they’re adults. It was there all along, but they never got tested for it. Others have known they had it since childhood. But the symptoms -- and the stress it adds to life -- can change with age.

For example, you might be less hyperactive as an adult. But there’s a good chance you still have symptoms that affect your quality of life. Adults can have problems with paying attention, controlling impulses, and staying organized. And that can affect your work, relationships, and self-esteem.

The same treatments used for kids with ADHD also treat adults. For most people, it’s a combination of medicine and talk therapy. Sometimes the meds you took as a child may work differently because your brain, body, and symptoms may have changed. As an adult, you also might need different skills to stay organized and manage your time. And you may need treatment for other issues like depression or anxiety.

To get the most from any treatment, it’s good to know specifically how ADHD affects you. Does it make it hard to meet deadlines at work? Are you struggling in relationships with your spouse or child? If you know, you can better seek care that’s tailored for you. And you’ll be better able to tell if it’s working.

What Meds Work?

Drugs are the main treatment for ADHD. But finding the one that works best for you may take some trial and error, and what works at first may not do so well. Also, while many drugs work for both children and adults with ADHD, clonidine (Catapres, Jenloga, Kapvay), guanfacine (Intuniv, Tenex), and modafinil (Provigil) haven’t been well-researched for adults and aren’t prescribed much.

Stimulants. These are often the first choice for ADHD, and they tend to work the best. Usually, you start at a low dose. You then increase it every 7 days until you hit a sweet spot where you control your symptoms and limit side effects.

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For most adults, long-acting stimulants -- such as Adderall XR, Concerta, Daytrana, Focalin XR, and Vyvanse -- work best. They last 10-14 hours, so you don’t have to remember to take as many pills. Plus, your symptoms usually improve more smoothly.

Once you get the dosage right, you’ll have regular follow-ups to make sure the drug keeps working and any side effects are minor. Most adults with ADHD will need to keep taking medications, but some will be able to stop. Your doctor may suggest:

  • Going off the meds once a year to see if you still need them.
  • Taking a drug holiday so your body doesn’t get too used to it. Otherwise, you might need a higher dose.

You may be able to manage your side effects by changing the dose or time of day you take it. Common side effects include:

Stimulants are effective, but they’re not for everyone. For some, the side effects can be too much. And you want to avoid stimulants if you have certain conditions, such as:

Non-stimulants. When stimulants aren’t an option, another choice is atomoxetine (Strattera). This was the first non-stimulant drug approved just for ADHD. The full effects don’t kick in quite as fast as with stimulants, but some people find it works well for them.

When you’re starting out, you typically raise the dosage every 5-14 days until you find the right balance. The side effects are similar to stimulants and may also include constipation, lower sex drive, and an upset stomach.

Antidepressants. You don’t have to be depressed for a doctor to prescribe these for ADHD. They aren’t usually the first choice for the condition, but they can help some people. One of the more common options is bupropion (Wellbutrin). Your doctor might recommend it if you have a substance abuse problem or mood disorder, as well as ADHD.

Note: a common type of antidepressant, selective serotonin reuptake inhibitors (Celexa, Paxil, Prozac, Zoloft), won’t work for ADHD.

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Can Talk Therapy Help?

In a word: yes. The right medicine, along with a good therapist, is a powerful combo. Talk therapy can help you and your family members learn more about how ADHD works and how to better deal with the problems it can create.

There are many types of talk therapy. Two common ones for ADHD are:

Cognitive behavioral therapy. You learn to change your thoughts and actions in a way that gives you more control over your life. It can help with challenges in school, work, and relationships. And it’s used to address issues like substance abuse and depression.

Marriage counseling and family therapy. You and your family members learn how to communicate better and spot patterns that may cause issues. The counseling can help loved ones understand that the problems aren’t simply about your being messy or forgetful.

What About an ADHD Coach?

You can learn practical skills, including how to make plans, set goals, manage time, and stay organized. A coach can share suggestions and tips and keep you focused and motivated to make the changes you want. Studies show that coaching can help you reach goals, manage stress, and achieve more in your life.

What if I Have Other Conditions, Too?

Adults with ADHD are more likely to have mental health issues like anxiety, depression, and drug abuse. These types of conditions, and the medicines you take to treat them, can affect ADHD, and vice versa.

Sometimes, a single medication may do the trick. Other times, though, it takes some work between you and your doctor to find the right mix of drugs to keep your symptoms in check.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on June 30, 2017

Sources

SOURCES:

Mayo Clinic: “Attention deficit hyperactivity disorder (ADHD).”

U.S. National Library of Medicine: “Treatment of adults with attention-deficit/hyperactivity disorder.”

HelpGuide.org: “ADHD in Adults.”

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD): “Treatment, Medication Management, Coaching.”

American Family Physician: “Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults.”

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