Suggested treatment for adult ADHD is to include a combined approach of psychosocial interventions (behavioural or cognitive), medication, vocational interventions, and regular follow-up support. Medications
Medications to help treat ADHD include psychostimulants and non-stimulants. Guidelines and availability of the different options available for medication may vary depending on what country the person lives in. Stimulants
Stimulants have moderate-to-high effects, which have higher average effects than non-stimulant medications. For adults, amphetamines in particular are the most efficacious medications and they (along with methylphenidate) have the least adverse effects. While there is some debate about whether to treat ADHD adults with substance use disorder (SUD) with stimulants, the 2019 Updated European Consensus Statement on diagnosis and treatment of adult ADHD notes that "in SUD patients, treatment of ADHD [with stimulants] can be useful to reduce ADHD symptoms without worsening the SUD, and should not be avoided".Amphetamine and its derivatives, prototype stimulants, are available in immediate and long-acting formulations. Amphetamines act by multiple mechanisms including reuptake inhibition, displacement of transmitters from vesicles, reversal of uptake transporters and reversible MAO inhibition. Thus amphetamines actively increases the release of these neurotransmitters into the synaptic cleft. In the short term, methylphenidate, a benzylpiperidine and phenethylamine derivative stimulant medication, is well tolerated. As of a 2008 review, long-term studies had not been conducted in adults, although no serious side effects had been reported to regulatory authorities.In the UK, clinical guidelines recommend that psychostimulants are used as a first-line treatment.
The DSM-IV criteria for ADHD were, however, tailored towards the type of symptoms that children would show, and might therefore have underestimated the prevalence of ADHD in adults. In 2013, the newer DSM-5 reviewed some of these criteria, with more lenient requirements for the diagnosis, especially in adults, and the age limit for symptoms first arising raised to twelve years. Signs and symptoms
ADHD is a chronic condition, beginning in early childhood that can persist throughout a persons lifetime. It is estimated that 33–66% of children with ADHD will continue to have significant ADHD-related symptoms persisting into adulthood, resulting in a significant impact on education, employment, and interpersonal relationships.Individuals with ADHD exhibit deficiencies in self-regulation and self-motivation which in turn foster problematic characteristics such as distractibility, procrastination, and disorganization. They are often perceived by others as chaotic, with a tendency to need high stimulation to be less distracted and function effectively. The learning potential and overall intelligence of an adult with ADHD, however, is no different from the potential and intelligence of adults who do not have the disorder.Whereas teachers and caregivers responsible for children are often attuned to the symptoms of ADHD, employers and others who interact with adults are less likely to regard such behaviors as a symptom. In part, this is because symptoms do change with maturity; adults who have ADHD are less likely to exhibit obvious hyperactive behaviors.