Treating ADHD in adults

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.

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. 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.

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.