The key word in the title of this page is “Adult.” If you’re looking for treatment options for your kid you should look somewhere else. Crazymeds deals with conditions and treatments for adults. While almost all of the FDA-approved drugs are for both adults and children, the off-label treatments are not necessarily recommended for anyone under 18.

1.  How Much of a Problem…Look! a Puppy!

Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are usually considered a childhood disorders. As such, many people think they go away by the time you reach 18. They don’t. ADD and ADHD are just diagnosed more often in children than they are in adults. Since parents and doctors are actively looking for them, ADD & ADHD are more often misdiagnosed in children. The same applies to adults, just for different reasons. In kids the hyperactive form is pretty obvious, in adults…not so much. Unless you had an ADHD diagnosis as a child, being diagnosed with ADHD as an adult is rare. It’s far too easy to confuse ADHD with bipolar disorder. Compare this screening test for ADHD with this screening test for bipolar mania. To confuse things even more, 10-35% of adults with bipolar disorder have a form of ADD/ADHD. I think those numbers are a bit low.

2.  Pay Attention

As with most brain cooties, ADD and ADHD have non-drug treatment options that can be tried before medication. In fact the PI sheets for all of the meds approved to treat ADD & ADHD, whether stimulant or non-stimulant, have the following wording (or something similar):

1.3 Need for Comprehensive Treatment Program 
STRATTERA is indicated as an integral part of a total treatment program for ADHD that may include other measures (psychological, educational, social) for patients with this syndrome. Drug treatment may not be indicated for all patients with this syndrome. Drug treatment is not intended for use in the patient who exhibits symptoms secondary to environmental factors and/or other primary psychiatric disorders, including psychosis. Appropriate educational placement is essential in children and adolescents with this diagnosis and psychosocial intervention is often helpful. When remedial measures alone are insufficient, the decision to prescribe drug treatment medication will depend upon the physician’s assessment of the chronicity and severity of the patient’s symptoms.Strattera Full US PI sheet

Sort of how you’re supposed to eat less and better, and exercise more in order to lose weight; and if those aren’t enough then take medication as well. Even the sometimes-dangerous snake oil they sell on TV tells you to eat less and exercise more in order to make the stuff work.

So what is a “Comprehensive Treatment Program” for adults with ADD/ADHD? It’s a lot easier to define than do.

2.1  Attitude Adjustments

  • Learn how to organize your life with various tools like:
    • large wall or desktop calendars (helpful hint: it’s easier to prevent a wall calendar from being covered by other stuff)
    • lists
    • reminder notes (post-its or Alexa/Siri or both)
    • having specific places for keys, mail and other paperwork, children and other pets, etc.
    • a filing system for the above mentioned mail and paperwork
  • Break down large tasks into smaller, often easier ones.
    • Several small steps are easier to manage than one large one.
    • Completing each part of the larger task gives you a sense of accomplishment.
    • Write your lists in such a way that your smaller tasks are part of the larger ones. That way you get to cross off more things and feel even better about it.
    • Just don’t fall into this trap.
    • Organizing tips
  • Psychotherapy, especially cognitive behavioral therapy, is an essential part of the ADD/ADHD treatment program.
    • Even if you were diagnosed with ADD/ADHD as a kid, you (and other people) may still consider yourself a lazy good-for-nothing slob. While you can blame only so much on having ADD/ADHD, there’s no need to live down to the expectations you and/or other people have about you due to being clinically unable to get your act together.
    • It really does need a therapist to get some people to think before acting or saying the first thing that pops into their head (AKA ready, fire, aim), or learn how to resist the urge to take unnecessary risks.
  • In addition to seeing a therapist and going to a support group, there’s mutual life coaching. Kids have parents to make them do all of this stuff, adults with ADD/ADHD have each other.

2.2  Even a Stopped Analog Clock is Right Once or Twice a Day

Believe it or not, many of the usual suggestions the mentally interesting get from people who don’t have any brain cooties, but insist we shouldn’t be taking drugs as meds are always worse than whatever it is we have1, are actually helpful when it comes to ADD/ADHD.

  • Eat better and exercise more. No wonder that wording about a comprehensive treatment program looked familiar.
    • While mileage always varies on which diet is going to work best, when it comes to ADD/ADHD more protein and fewer carbs is the rule of thumb.
    • You’ll also want to eat several smaller meals throughout the day instead of two or however many large ones.
    • As for the exercise, while going to the gym is all well and good, walking in a park is better.
    • When it comes to adults the rate of ADD/ADHD is much higher in urban than rural areas, but that could be due to cultural differences and/or access to shrinks. The data are mixed with kids, but lean toward not much difference between the two populations.
    • Still: fresh air and exercise.
  • Meditation
  • Get plenty of sleep

2.3  Drugs Approved to Treat ADD/ADHD in Adults

FDA-approved drugs to treat ADD/ADHD in adults come in two categories, stimulants and non-stimulants. Most people prefer non-stimulants because stimulants sound scarier. Stimulants are far more likely to be abused than non-stimulants, so a history of drug abuse or addictive behavior certainly rules them out. Unless you have a history of cardiovascular problems or chronic insomnia, stimulants aren’t necessarily any more problematic than the non-stimulant medications.

FDA-Approved Non-Stimulant Drugs to Treat Adult ADD/ADHD
FDA-Approved Stimulants to Treat Adult ADD/ADHD
  • Adderall (dextroamphetamine and amphetamine)2
  • Cylert (pemoline)
  • Desoxyn (methamphetamine)
  • Dexedrine (dextroamphetamine sulfate)
  • Ritalin (methylphenidate HCl) and its variants
    • Concerta (extended-release methylphenidate HCl)
    • Focalin-XR (dexmethylphenidate hydrochloride)
  • Vyvanse (lisdexamfetamine dimesylate)

2.4  Drugs Used Off-Label to Treat ADD/ADHD in Adults

  • clonidine
  • Nuvigil (armodafinil)
  • Provigil (modafinil)
  • Wellbutrin (bupropion)

1 Which is probably only a character flaw in the first place. So quit being such a pussy and just walk it off already.

2 Only the old immediate-release version of Adderall is approved to treat ADD/ADHD in adults.

Treatment Options for Adult Attention Deficit / Attention Deficit Hyperactivity Disorder by Jerod Poore is copyright © 2012 
Author: Jerod Poore. Date created: 08 September 2012 Last edited: 2015–05–08 Last edited by: JerodPoore on 2015–05–08