ADHD in Adults: Understanding Symptoms, Diagnosis, and Treatment
Translated & summarized from Srugim by baba
Adults with ADHD often experience procrastination and forgetfulness, with diagnosis sometimes occurring late in life. Treatment involves therapy, practical tools, and stimulant medications like Attent, which contains amphetamines and carries risks of misuse. Before starting medication, cardiac health is assessed due to potential increases in heart rate and blood pressure. Common side effects include appetite loss and sleep issues, while serious psychiatric effects are rare but require medical attention. Medication aids in managing symptoms but does not replace the need for behavioral coping strategies.
The story in 5 lines · by baba
- ADHD in adults can manifest as procrastination and forgetfulness, often diagnosed later in life.
- Attent, an ADHD medication containing amphetamines, requires special prescriptions due to misuse potential.
- Adult ADHD treatment combines therapy, practical tools, and stimulant medications.
- Cardiac health must be assessed before starting stimulant medication due to potential heart rate and blood pressure increases.
- Common side effects of ADHD stimulants include appetite suppression and sleep disturbances.
Attention Deficit Hyperactivity Disorder (ADHD), once considered a childhood condition, is now recognized as persisting into adulthood for many, presenting differently than in children. While hyperactivity may lessen, adults often experience increased procrastination, forgetfulness, missed payments, and a constant feeling of being overwhelmed. Some adults are diagnosed only after their child receives an ADHD diagnosis or following a significant life change that disrupts their coping mechanisms. Diagnosis in adults is conducted by a psychiatrist or specialist and involves assessing childhood history, the pervasiveness of symptoms across life domains (work, home, relationships), and ruling out other conditions like anxiety, depression, sleep disorders, or thyroid issues that can mimic ADHD. Receiving a diagnosis can bring relief and sometimes anger over past struggles without understanding.
Treatment typically includes psychoeducation about the disorder, cognitive behavioral therapy, practical organizational tools, and often medication. Attent, a stimulant medication prescribed in Israel for ADHD, contains a mixture of amphetamine salts, known as Adderall in the US. It is available in 10, 20, and 30 mg immediate-release tablets and is also approved for narcolepsy. Amphetamine is classified as a dangerous drug in Israel, requiring a special, limited-validity prescription and meticulous pharmacy record-keeping. The consumer leaflet warns of a high potential for misuse and addiction, a risk that doctors discuss upfront.
Stimulant medications for ADHD fall into two main categories: methylphenidate (Ritalin, Concerta) and amphetamines (Attent). Both increase dopamine and norepinephrine availability, crucial for attention and motivation. Methylphenidate primarily blocks reuptake, while amphetamines also enhance neurotransmitter release. The choice of medication depends on individual response, medical history, lifestyle, and required duration of effect, often requiring several weeks of adjustment to find the right drug and dosage.
Before starting stimulant medication, adults undergo a cardiac assessment, as these drugs can elevate heart rate and blood pressure. This is particularly crucial for individuals with pre-existing heart conditions, uncontrolled high blood pressure, or arrhythmias. The Attent leaflet lists contraindications including heart disease, atherosclerosis, moderate to severe hypertension, hyperthyroidism, glaucoma, severe anxiety, and a history of substance abuse. Doctors will inquire about family cardiac history, measure vital signs, and may order an ECG or cardiology referral. These measurements are repeated during treatment, especially after dosage changes. Patients experiencing chest pain, shortness of breath, or abnormal palpitations should seek immediate medical attention.
Common side effects reported by adults include appetite suppression and sleep disturbances. Doctors advise eating a good breakfast and planning meals, even without hunger, and avoiding late-day medication intake to prevent insomnia. Other listed side effects include stomach aches, irritability, and nervousness. More serious, though rarer, effects can include increased anxiety, aggression, or psychotic symptoms, all of which warrant a doctor's consultation. Alcohol consumption is also discouraged.
Medication is not a substitute for learning coping skills; it creates an environment where implementing learned strategies becomes easier. Regular follow-ups are essential to assess ongoing need for medication and integrate it into a broader treatment plan. For adults diagnosed later in life, this process can be a first opportunity for self-understanding, with the diagnostic questionnaire serving as just the starting point for ongoing conversations and adjustments.