Treating ADHD in adults
The most appropriate treatment for adults with attention deficit hyperactivity disorder (ADHD) will largely depend on their individual circumstances and the type of problems being caused by the condition.
Most adults who have ADHD develop their own strategies for dealing with the disorder. Some may try using relaxation techniques or turn to self-help groups for support, while others may find doing sports helpful.
Some adults with ADHD need more help to successfully cope with their disorder. In their case, medication and/or psychotherapy may be good treatment options. Medication can effectively reduce the main ADHD symptoms of hyperactivity, impulsiveness and inattentiveness. Behavioral therapy can help you learn different ways to better cope with behavioral problems and the effects they have in everyday life.
How does ADHD medication work?
The medicines most commonly used to treat ADHD usually contain the drug methylphenidate (found in medicines like “Medikinet adult” or “Ritalin adult”). One of the things these medicines do is increase the levels of the chemical messengers dopamine and noradrenaline in the brain. These two chemicals carry information between nerve cells and play an important role in our memory formation and learning processes. For instance, they help the brain filter information from the outside world. This helps to improve concentration and focus better. Treatment with lisdexamfetamine (trade name: Elvanse or Vyvanse) is possible, too – as long as the treatment was started before the age of 18.
If these medications don’t help, atomoxetine (Strattera) is an alternative option. Atomoxetine works in a different way, but it also increases levels of noradrenaline in the brain.
Can medication help adults who have ADHD?
Research has suggested that methylphenidate can improve concentration and reduce hyperactivity and impulsiveness in adults as well. There is less good-quality research on the medication in adults than in children and teenagers, though. The studies were small, and the participants were only observed for a few weeks. The side effects of methylphenidate include loss of appetite, weight loss and insomnia.
If treatment with methylphenidate isn't effective, atomoxetine is an option. There has hardly been any good-quality research on this medication either. The potential side effects of atomoxetine include loss of appetite, a dry mouth and insomnia. It can also cause erection problems or loss of interest in sex.
ADHD drugs can sometimes increase both blood pressure and heart rate. For this reason, doctors will check your heart before prescribing any medication.
ADHD medication is usually only prescribed by suitably qualified doctors. These include psychiatrists, specialists for psychosomatic medicine, psychotherapists or neurologists. Medication should only be prescribed as part of a more comprehensive therapy approach that may include psychological treatment.
When might psychological treatment help?
Psychological treatment such as behavioral therapy can help with mental or emotional problems that medication can't do anything about. It might also be an alternative option if medication doesn't work or you would prefer not to take it. It can be helpful for people who are diagnosed with ADHD as adults and are struggling to better understand and cope with the disorder. And it can be a good idea for people who have other mental health problems too, such as depression or anxiety disorders.
There are fewer studies on the benefits of psychological treatment in adults with ADHD than there are on the benefits of medication in adults with ADHD. The available studies suggest that psychological treatment can be effective, though. But not many psychotherapists in Germany have specialized in ADHD in adults. And it may take several weeks or even months to get an appointment.
There is currently no good-quality research on treatments for adults other than medication and psychological treatment.
Canadian Agency for Drugs and Technologies in Health (CADTH). Pharmacological and non-pharmacological therapies for adults with attention-deficit/hyperactivity disorder: systematic review and meta-analysis of clinical evidence. 09.2011.
Castells X, Blanco-Silvente L, Cunill R. Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults. Cochrane Database Syst Rev 2018; (8): CD007813.
Deutsche Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (DGKJP), Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Deutsche Gesellschaft für Sozialpädiatrie und Jugendmedizin (DGSPJ). Langfassung der interdisziplinären evidenz- und konsensbasierten (S3) Leitlinie "Aufmerksamkeitsdefizit- / Hyperaktivitätsstörung (ADHS) im Kindes-, Jugend- und Erwachsenenalter". AWMF-Registernr.: 028-045. May 2017.
IQWiG health information is written with the aim of helping
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