What is attention deficit hyperactivity disorder (ADHD)?

ADHD is one of the most well-recognized childhood developmental problems. This condition is characterized by inattention, hyperactivity, and impulsiveness. It is now known that these symptoms continue into adulthood for more than 50 percent of children with ADHD. However, few adults are identified or treated for ADHD.

ADHD in adults

Adults with ADHD might have difficulty following directions, remembering information, concentrating, organizing tasks, or completing work within time limits. If these difficulties are not managed appropriately, they can cause associated behavioral, emotional, social, vocational, and academic problems.

Common behaviors and problems of adult ADHD

The following behaviors and problems might stem directly from ADHD or might be the result of related adjustment difficulties:

• Chronic lateness and forgetfulness
• Anxiety
• Low self-esteem
• Employment problems
• Difficulty controlling anger
• Impulsiveness
• Substance abuse or addiction
• Poor organizational skills
• Procrastination
• Low frustration tolerance
• Chronic boredom
• Difficulty concentrating when reading
• Mood swings
• Depression
• Relationship problems

These behaviors might be mild to severe, and can vary with the situation or be present all of the time. Some adults with ADHD might be able to concentrate if they are interested in or excited about what they are doing. Others might have difficulty focusing under any circumstances. Some adults look for stimulation, but others avoid it. Adults with ADHD can be withdrawn and antisocial, or they can be overly social and unable to be alone.

Medicines to treat adult ADHD

If mild to moderate symptoms are present, stimulant medicines such as methylphenidate (Concerta, Ritalin) or dextroamphetamine (Dexedrine, Adderall) are often initially recommended as part of the treatment plan. These drugs stimulate the parts of the brain responsible for organization and management (which have been shown to be less active in individuals with ADHD) to better regulate attention, impulse and motor behavior. Stimulant medicines are effective in 70 percent to 80 percent of patients. The medicine atomoxetine (Strattera) is among those offering a non-stimulant alternative.

What other medicines are used to treat ADHD?

When stimulants and Strattera are ineffective or not well-tolerated, several other medicines are available to treat ADHD. These medicines include:

• Nortriptyline (Pamelor) or other tricyclic antidepressants
• Clonidine (Catapres) or guanfacine (Tenex)
• Bupropion (Wellbutrin)
• Venlafaxine (Effexor)

Behavioral treatments for adult ADHD

Adult ADHD might be treated with one or more of the following:

• Individual cognitive and behavioral therapy to enhance self-esteem
• Relaxation training and stress management to reduce anxiety and stress
• Behavioral coaching to teach the person strategies for organizing home and work activities
• Job coaching or mentoring to support better working relationships and improve on-the-job performance
• Family education and therapy

In-depth assessment, treatment planning, medicine management, individual therapy, education, and family support are all necessary to help the adult with ADHD function in new ways and build his or her self-esteem. Because ADHD is often associated with other conditions (such as specific learning disabilities, anxiety and mood disorders, obsessive compulsive disorder, and chemical dependency), in-depth assessment is the first step in developing a comprehensive, customized treatment plan.

Living with adult ADHD

Although most people don't outgrow ADHD, they do learn to adapt. If the difficulties associated with ADHD are managed appropriately throughout their lives, adults with ADHD can learn to develop personal strengths, and become productive and successful.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 8/1/2007…#11718