The fact that ADHD exists in adults was not fully recognized until the 1970s. Even then, most researchers did not recognize the extent of the problem. If up to 70% of children with ADHD continue to have symptoms into adulthood, there are many more adults suffering from ADHD symptoms than have thus far been identified or even suspected. Although the adult version of the disorder is becoming increasingly recognized, it may still be difficult to find a professional who knows much about it.
Almost 70% of adults with ADHD benefit from stimulant treatment, a rate that is almost as high as the children's rate of response. Using stimulants to treat adult ADHD is often controversial because many of these individuals have co-existing substance abuse problems. Mounting evidence suggests, however, that treating adult ADHD with stimulants can help reduce substance abuse issues by reducing the need to self-medicate (i.e., use illegal or over the counter drugs to control symptoms without the advice of a doctor).
Adults may benefit from a different medication dosing schedule. For example, adults may use medications to relax in the evening, instead of using them to increase focus during the day. However, longer-acting medications tend to be more effective with adults, because many individuals forget to take the second or third dose of the day. Therefore, some psychiatrists prefer to use Dexedrine with this population, because there are fewer side effects and the dose effects last longer. However, Dexedrine works slightly less well and in fewer people overall than does Ritalin. As with children, adults show variability in their response to medications. Trial and error (and a great deal of patience) will likely be required to determine the most effective medication and dosage for an adult with ADHD. Click here to return to our discussion of stimulant medication.
Strattera was the first non-stimulant approved by the FDA for adult ADHD use in November 2003. Click here to return to our discussion of this medication. Since it is not a stimulant, there is no abuse potential. Other medications (e.g., antidepressants) may also be prescribed for adults with ADHD to address co-existing psychological disorders such as depression, anxiety, bipolar disorder, etc.
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Contrary to the view of the general public and to media hype, stimulant medications are among the safest available medications. Long-term studies have demonstrated that teenagers who take Ritalin are less likely to have a substance abuse problem in their twenties than other teenagers. This is also true for most of the adult ADHD population. Most adults on Ritalin gradually lower their dose of stimulants across time rather than increasing the dose.
Stimulants increase blood pressure and pulse rate, which could lead to strokes and heart attacks. Adults with ADHD who also have heart disease risk factors and/or hypertension (i.e., high blood pressure) may not be able to take stimulant medications. Before starting any sort of medication for ADHD, adults should get a complete medical workup.