Disease: Attention Deficit Hyperactivity Disorder (ADHD) in Adults

Adult attention deficit hyperactivity disorder (ADHD) facts

  • Attention deficit hyperactivity disorder is a behavioral condition characterized by distractibility, impulsivity, and/or hyperactivity.
  • Although there is no single cause for ADHD, there are a number of biological and social factors that seem to increase the risk of a person developing the disorder.
  • ADHD affects from 2%-6% of adults, men and women equally.
  • Adults with ADHD may show little to no hyperactivity but for those who do, the hyperactivity, impulsivity, and inattention symptoms are quite similar to those in children and adolescents.
  • There are three kinds of ADHD: predominately inattentive type, predominately hyperactive/impulsive type, and the combined (inattentive, hyperactive/impulsive) type.
  • In assessing a person for ADHD, a health professional will conduct a medical interview and physical examination. Lab tests are performed and patients are screened for ADHD as well as other mental-health symptoms.
  • Psychological treatments for ADHD in adults include education about the illness, participation in an ADHD support group, and skills training on a variety of topics.
  • ADHD in adults are often prescribed a long-acting stimulant medication. They may also benefit from a nonstimulant medication.
  • Home remedies, including dietary restrictions and vitamin supplements for ADHD in adults, have little research on their effectiveness.
  • The prognosis for ADHD individuals tends to be influenced by the person's severity of symptoms, intelligence, whether or not the ADHD sufferer has other mental-health conditions, as well as the person's family issues.

What is attention deficit hyperactivity disorder (ADHD)?

Attention deficit hyperactivity disorder, often referred to as ADHD or ADD, is a behavioral disorder that is characterized by symptoms of distractibility, impulsivity, and/or hyperactivity. This condition often has a significantly negative impact on an adult's ability to make and keep relationships and do well at work and/or in the community in general.

What are causes and risk factors for adult ADHD?

Although there is no single cause for ADHD, there are a number of biological and social factors that seem to increase the risk of a person developing the disorder. Children who have ADHD are at risk for growing into teens and adults with the condition. Brain-imaging studies show that characteristics of the brains of people with ADHD include a tendency to be smaller, to have fewer connections between certain parts of the brain, and less regulation of the neurochemical dopamine compared to people who do not have the disorder.

Learn more about: dopamine

Risk factors for ADHD that can occur in the womb include maternal stress, as well as smoking during pregnancy and low weight at birth. Being male and having a family history of ADHD increase the likelihood that an individual is diagnosed with ADHD. Socially, low family income and low paternal education are risk factors for developing ADHD.

How prevalent is adult ADHD?

About 2%-6% of adults are affected by ADHD. Of note, adult ADHD actually begins during childhood rather than having adult onset. While this disorder is thought to afflict more boys than girls in childhood, it seems to occur in men and women equally. About 60% of children with ADHD continue to have some symptoms of the disorder as an adult, and about 50% continue to suffer from symptoms that are numerous and severe enough to continue to qualify for the ADHD diagnosis. Other pertinent statistics include that over 90% of adults with ADHD recognize that they suffer from trouble paying attention and more than half have a combination of inattention and hyperactivity/impulsivity, while more than one-third only have inattention.

What are symptoms and signs of adult ADHD?

As a result of maturity, adults with ADHD may show little to no evidence of suffering from hyperactivity. For those who do, the symptoms and signs of hyperactivity as well as impulsivity and inattention associated with adult ADHD are generally similar to those in children and adolescents. However, how those symptoms are demonstrated tend to vary with age. Symptoms of ADHD include the following:

Inattention:
  • Often makes careless mistakes or fails to pay adequate attention to details
  • Trouble paying attention during work or leisure activities
  • Does not seem to be listening when spoken to directly
  • Frequently fails to complete instructions or to complete work tasks or chores
  • Often has trouble organizing a task or activity
  • Frequently avoids, dislikes, or resists participating in tasks that require sustained focus
  • Often loses things needed to complete tasks or activities
  • Easily distracted by extraneous input or unrelated thoughts
  • Often forgetful
Hyperactivity/impulsivity:
  • Often fidgety or taps hands or feet
  • Frequently has trouble staying seated
  • Often feels restless
  • Has trouble engaging in leisure activities quietly
  • Engages in multiple activities at once
  • Talks excessively
  • Frequently interrupts others talking
  • Trouble waiting his or her turn
  • Often intrudes on others

How is ADHD in adults diagnosed?

In order to be diagnosed with ADHD, a child must demonstrate six symptoms of inattention or six symptoms of combined hyperactivity and impulsivity, while an older teen or adult need only exhibit five of each group of symptoms. The symptoms should start before 12 years of age, be present in more than one setting (for example, home and work), be severe enough to cause problems for the individual, and not be able to be better explained by another condition for the diagnosis of ADHD. There are three kinds of ADHD: predominately inattentive type, predominately hyperactive/impulsive type, and the combined (inattentive, hyperactive, and impulsive) type.

Many health-care professionals, including licensed mental-health therapists, primary-care providers, psychiatrists, psychologists, psychiatric nurses, and social workers may help diagnose ADHD in adults. One of these professionals will likely conduct or refer for an extensive medical interview and physical examination as part of the assessment. As ADHD is sometimes associated with a number of other mental-health problems, such as depression, bipolar disorder, obsessive compulsive disorder, and other anxiety disorders, Asperger's syndrome, and other autism-spectrum disorders, the evaluator will likely screen for signs of depression, manic depression, anxiety, and other symptoms of mental illness. The symptoms of adult ADHD may also be the result of a number of medical conditions or can be a side effect of various medications. For this reason, routine laboratory tests are often performed during the initial evaluation to rule out other causes of symptoms. Occasionally, an X-ray, scan, or other imaging study may be needed. As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help establish the diagnosis. Some symptom checklists for children have been adapted and revised to effectively screen for ADHD in adults. Examples of such checklists include Conners' Adult ADHD Rating Scale, or CAARS, as well as the Adult Self Report Scale.

What is the treatment for adult ADHD? What medications treat adult ADHD?

Psychological treatments for ADHD in adults include education about the illness, participation in an ADHD support group, and skills training in a variety of issues, like job, organizational, parenting, financial, and time-management skills. Some adults with the disorder may benefit from cognitive behavior therapy, which is a form of psychotherapy that focuses on helping the ADHD sufferer alter negative thinking patterns that may impede their functioning.

Similar to the treatment of ADHD in children, adults often benefit from being prescribed a stimulant medication. Perhaps the oldest prescribed stimulant for the treatment of ADHD is Ritalin. However, given the longer days that teens and adults have compared to young children, stimulants that last much longer are usually prescribed in adults. Examples of such medications include long-acting preparations of methylphenidate, like Daytrana patches, Concerta, Quillivant, and dexmethylphenidate (Focalin-XR), as well as the long-acting amphetamine salt Adderall-XR. Long-acting stimulants also include lisdexamfetamine (Vyvanse). However, adults who have a more variable schedule, as in college students who may take day classes some days and night classes other days, may prefer shorter-acting stimulants like amphetamine salt (Adderall) and dextroamphetamine sulfate (Zenzedi), or methylphenidate preparations, like Focalin and Metadate, so they can vary the time they take the medication without being concerned that they'll have trouble sleeping at night. While modafanil (Provigil) is used to treat sleep attacks (narcolepsy) and is also a stimulant, some studies indicate a potential use in the treatment of ADHD while others do not demonstrate its effectiveness.

Learn more about: Ritalin | Concerta | Focalin | Vyvanse | Metadate

Some adults may need to take a nonstimulant medication for treatment of ADHD. For adults whose symptoms early in the morning or late in the evening are an issue, stimulants may not be the optimal medication treatment. For others, side effects like low appetite, insomnia, tremors, squelched exuberance, less frequently tics, and rarely hallucinations may make it unwise for the person to take a stimulant medication. Stimulant treatment of people with ADHD who have no history of drug abuse tends to contribute to a decreased likelihood of developing a substance-abuse problem later on. Those who have a recent history of alcohol or other drug abuse may consider avoiding the small but present addiction potential of stimulants. Long-term effects of addiction to Adderall or other stimulants may be serious, including stroke or heart attack. For individuals who either experience suboptimal effects, side effects, or significant side effects of stimulants, nonstimulant medications like guanfacine (Tenex or Intuniv), clonidine (Catapress or Kapvay), or atomoxetine (Strattera) or treatment with the specialized delivery system of the prescription supplement phosphatidylserine-omega-3 (Vayarin) may be in order.

Learn more about: Adderall | Tenex | Intuniv | Kapvay | Strattera

People who suffer from ADHD are at higher risk for developing mood problems during adulthood. They may therefore benefit from medications that have been found to be helpful for people who have both ADHD and depression or anxiety, like buproprion (Wellbutrin) or venlafaxine (Effexor).

Learn more about: Effexor

Are there any home remedies for adult ADHD?

While further research is needed to determine the potential effectiveness of natural remedies for treatment of ADHD, a number of parents use such alternative treatments in an attempt to help their children. Such remedies include dietary restrictions and vitamin supplements. A significant limitation of these remedies includes the difficulty in implementing them. Also, the already limited research available on the effectiveness of these remedies generally does not include studies on adults.

Lifestyle improvements have been found to help reduce some symptoms in children and therefore should be considered for adults as well. Such improvements include regular exercise and ensuring the person receives adequate sleep each night.

What are complications of adult ADHD?

Adults with ADHD are at higher risk for having low self-esteem, more depression, anxiety, and less adaptive social skills compared to adults who do not have the disorder. Developing other mental-health conditions (co-morbidity) is more common in adults who have hyperactivity and impulsivity rather than inattention as characteristics of ADHD. ADHD adults are also more likely to be in more motor-vehicle accidents, smoke cigarettes, use drugs, have anger problems, and to engage in antisocial behaviors, particularly if untreated.

Relationships/family life

Adults with ADHD tend to have more trouble with self-control and marital problems, as well as problems with peers and authority figures. They may be socially isolated.

Education and career

Adults with ADHD tend to complete fewer years of education. These individuals seem to be attracted to careers that often provide excitement, like sales. They tend to be plagued by procrastination, frequent changes in jobs, as well as lose more jobs and have difficulty organizing work tasks.

What is attention deficit hyperactivity disorder (ADHD)?

Attention deficit hyperactivity disorder, often referred to as ADHD or ADD, is a behavioral disorder that is characterized by symptoms of distractibility, impulsivity, and/or hyperactivity. This condition often has a significantly negative impact on an adult's ability to make and keep relationships and do well at work and/or in the community in general.

What are causes and risk factors for adult ADHD?

Although there is no single cause for ADHD, there are a number of biological and social factors that seem to increase the risk of a person developing the disorder. Children who have ADHD are at risk for growing into teens and adults with the condition. Brain-imaging studies show that characteristics of the brains of people with ADHD include a tendency to be smaller, to have fewer connections between certain parts of the brain, and less regulation of the neurochemical dopamine compared to people who do not have the disorder.

Learn more about: dopamine

Risk factors for ADHD that can occur in the womb include maternal stress, as well as smoking during pregnancy and low weight at birth. Being male and having a family history of ADHD increase the likelihood that an individual is diagnosed with ADHD. Socially, low family income and low paternal education are risk factors for developing ADHD.

How prevalent is adult ADHD?

About 2%-6% of adults are affected by ADHD. Of note, adult ADHD actually begins during childhood rather than having adult onset. While this disorder is thought to afflict more boys than girls in childhood, it seems to occur in men and women equally. About 60% of children with ADHD continue to have some symptoms of the disorder as an adult, and about 50% continue to suffer from symptoms that are numerous and severe enough to continue to qualify for the ADHD diagnosis. Other pertinent statistics include that over 90% of adults with ADHD recognize that they suffer from trouble paying attention and more than half have a combination of inattention and hyperactivity/impulsivity, while more than one-third only have inattention.

What are symptoms and signs of adult ADHD?

As a result of maturity, adults with ADHD may show little to no evidence of suffering from hyperactivity. For those who do, the symptoms and signs of hyperactivity as well as impulsivity and inattention associated with adult ADHD are generally similar to those in children and adolescents. However, how those symptoms are demonstrated tend to vary with age. Symptoms of ADHD include the following:

Inattention:
  • Often makes careless mistakes or fails to pay adequate attention to details
  • Trouble paying attention during work or leisure activities
  • Does not seem to be listening when spoken to directly
  • Frequently fails to complete instructions or to complete work tasks or chores
  • Often has trouble organizing a task or activity
  • Frequently avoids, dislikes, or resists participating in tasks that require sustained focus
  • Often loses things needed to complete tasks or activities
  • Easily distracted by extraneous input or unrelated thoughts
  • Often forgetful
Hyperactivity/impulsivity:
  • Often fidgety or taps hands or feet
  • Frequently has trouble staying seated
  • Often feels restless
  • Has trouble engaging in leisure activities quietly
  • Engages in multiple activities at once
  • Talks excessively
  • Frequently interrupts others talking
  • Trouble waiting his or her turn
  • Often intrudes on others

How is ADHD in adults diagnosed?

In order to be diagnosed with ADHD, a child must demonstrate six symptoms of inattention or six symptoms of combined hyperactivity and impulsivity, while an older teen or adult need only exhibit five of each group of symptoms. The symptoms should start before 12 years of age, be present in more than one setting (for example, home and work), be severe enough to cause problems for the individual, and not be able to be better explained by another condition for the diagnosis of ADHD. There are three kinds of ADHD: predominately inattentive type, predominately hyperactive/impulsive type, and the combined (inattentive, hyperactive, and impulsive) type.

Many health-care professionals, including licensed mental-health therapists, primary-care providers, psychiatrists, psychologists, psychiatric nurses, and social workers may help diagnose ADHD in adults. One of these professionals will likely conduct or refer for an extensive medical interview and physical examination as part of the assessment. As ADHD is sometimes associated with a number of other mental-health problems, such as depression, bipolar disorder, obsessive compulsive disorder, and other anxiety disorders, Asperger's syndrome, and other autism-spectrum disorders, the evaluator will likely screen for signs of depression, manic depression, anxiety, and other symptoms of mental illness. The symptoms of adult ADHD may also be the result of a number of medical conditions or can be a side effect of various medications. For this reason, routine laboratory tests are often performed during the initial evaluation to rule out other causes of symptoms. Occasionally, an X-ray, scan, or other imaging study may be needed. As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help establish the diagnosis. Some symptom checklists for children have been adapted and revised to effectively screen for ADHD in adults. Examples of such checklists include Conners' Adult ADHD Rating Scale, or CAARS, as well as the Adult Self Report Scale.

What is the treatment for adult ADHD? What medications treat adult ADHD?

Psychological treatments for ADHD in adults include education about the illness, participation in an ADHD support group, and skills training in a variety of issues, like job, organizational, parenting, financial, and time-management skills. Some adults with the disorder may benefit from cognitive behavior therapy, which is a form of psychotherapy that focuses on helping the ADHD sufferer alter negative thinking patterns that may impede their functioning.

Similar to the treatment of ADHD in children, adults often benefit from being prescribed a stimulant medication. Perhaps the oldest prescribed stimulant for the treatment of ADHD is Ritalin. However, given the longer days that teens and adults have compared to young children, stimulants that last much longer are usually prescribed in adults. Examples of such medications include long-acting preparations of methylphenidate, like Daytrana patches, Concerta, Quillivant, and dexmethylphenidate (Focalin-XR), as well as the long-acting amphetamine salt Adderall-XR. Long-acting stimulants also include lisdexamfetamine (Vyvanse). However, adults who have a more variable schedule, as in college students who may take day classes some days and night classes other days, may prefer shorter-acting stimulants like amphetamine salt (Adderall) and dextroamphetamine sulfate (Zenzedi), or methylphenidate preparations, like Focalin and Metadate, so they can vary the time they take the medication without being concerned that they'll have trouble sleeping at night. While modafanil (Provigil) is used to treat sleep attacks (narcolepsy) and is also a stimulant, some studies indicate a potential use in the treatment of ADHD while others do not demonstrate its effectiveness.

Learn more about: Ritalin | Concerta | Focalin | Vyvanse | Metadate

Some adults may need to take a nonstimulant medication for treatment of ADHD. For adults whose symptoms early in the morning or late in the evening are an issue, stimulants may not be the optimal medication treatment. For others, side effects like low appetite, insomnia, tremors, squelched exuberance, less frequently tics, and rarely hallucinations may make it unwise for the person to take a stimulant medication. Stimulant treatment of people with ADHD who have no history of drug abuse tends to contribute to a decreased likelihood of developing a substance-abuse problem later on. Those who have a recent history of alcohol or other drug abuse may consider avoiding the small but present addiction potential of stimulants. Long-term effects of addiction to Adderall or other stimulants may be serious, including stroke or heart attack. For individuals who either experience suboptimal effects, side effects, or significant side effects of stimulants, nonstimulant medications like guanfacine (Tenex or Intuniv), clonidine (Catapress or Kapvay), or atomoxetine (Strattera) or treatment with the specialized delivery system of the prescription supplement phosphatidylserine-omega-3 (Vayarin) may be in order.

Learn more about: Adderall | Tenex | Intuniv | Kapvay | Strattera

People who suffer from ADHD are at higher risk for developing mood problems during adulthood. They may therefore benefit from medications that have been found to be helpful for people who have both ADHD and depression or anxiety, like buproprion (Wellbutrin) or venlafaxine (Effexor).

Learn more about: Effexor

Are there any home remedies for adult ADHD?

While further research is needed to determine the potential effectiveness of natural remedies for treatment of ADHD, a number of parents use such alternative treatments in an attempt to help their children. Such remedies include dietary restrictions and vitamin supplements. A significant limitation of these remedies includes the difficulty in implementing them. Also, the already limited research available on the effectiveness of these remedies generally does not include studies on adults.

Lifestyle improvements have been found to help reduce some symptoms in children and therefore should be considered for adults as well. Such improvements include regular exercise and ensuring the person receives adequate sleep each night.

What are complications of adult ADHD?

Adults with ADHD are at higher risk for having low self-esteem, more depression, anxiety, and less adaptive social skills compared to adults who do not have the disorder. Developing other mental-health conditions (co-morbidity) is more common in adults who have hyperactivity and impulsivity rather than inattention as characteristics of ADHD. ADHD adults are also more likely to be in more motor-vehicle accidents, smoke cigarettes, use drugs, have anger problems, and to engage in antisocial behaviors, particularly if untreated.

Relationships/family life

Adults with ADHD tend to have more trouble with self-control and marital problems, as well as problems with peers and authority figures. They may be socially isolated.

Education and career

Adults with ADHD tend to complete fewer years of education. These individuals seem to be attracted to careers that often provide excitement, like sales. They tend to be plagued by procrastination, frequent changes in jobs, as well as lose more jobs and have difficulty organizing work tasks.

Source: http://www.rxlist.com

Psychological treatments for ADHD in adults include education about the illness, participation in an ADHD support group, and skills training in a variety of issues, like job, organizational, parenting, financial, and time-management skills. Some adults with the disorder may benefit from cognitive behavior therapy, which is a form of psychotherapy that focuses on helping the ADHD sufferer alter negative thinking patterns that may impede their functioning.

Similar to the treatment of ADHD in children, adults often benefit from being prescribed a stimulant medication. Perhaps the oldest prescribed stimulant for the treatment of ADHD is Ritalin. However, given the longer days that teens and adults have compared to young children, stimulants that last much longer are usually prescribed in adults. Examples of such medications include long-acting preparations of methylphenidate, like Daytrana patches, Concerta, Quillivant, and dexmethylphenidate (Focalin-XR), as well as the long-acting amphetamine salt Adderall-XR. Long-acting stimulants also include lisdexamfetamine (Vyvanse). However, adults who have a more variable schedule, as in college students who may take day classes some days and night classes other days, may prefer shorter-acting stimulants like amphetamine salt (Adderall) and dextroamphetamine sulfate (Zenzedi), or methylphenidate preparations, like Focalin and Metadate, so they can vary the time they take the medication without being concerned that they'll have trouble sleeping at night. While modafanil (Provigil) is used to treat sleep attacks (narcolepsy) and is also a stimulant, some studies indicate a potential use in the treatment of ADHD while others do not demonstrate its effectiveness.

Learn more about: Ritalin | Concerta | Focalin | Vyvanse | Metadate

Some adults may need to take a nonstimulant medication for treatment of ADHD. For adults whose symptoms early in the morning or late in the evening are an issue, stimulants may not be the optimal medication treatment. For others, side effects like low appetite, insomnia, tremors, squelched exuberance, less frequently tics, and rarely hallucinations may make it unwise for the person to take a stimulant medication. Stimulant treatment of people with ADHD who have no history of drug abuse tends to contribute to a decreased likelihood of developing a substance-abuse problem later on. Those who have a recent history of alcohol or other drug abuse may consider avoiding the small but present addiction potential of stimulants. Long-term effects of addiction to Adderall or other stimulants may be serious, including stroke or heart attack. For individuals who either experience suboptimal effects, side effects, or significant side effects of stimulants, nonstimulant medications like guanfacine (Tenex or Intuniv), clonidine (Catapress or Kapvay), or atomoxetine (Strattera) or treatment with the specialized delivery system of the prescription supplement phosphatidylserine-omega-3 (Vayarin) may be in order.

Learn more about: Adderall | Tenex | Intuniv | Kapvay | Strattera

People who suffer from ADHD are at higher risk for developing mood problems during adulthood. They may therefore benefit from medications that have been found to be helpful for people who have both ADHD and depression or anxiety, like buproprion (Wellbutrin) or venlafaxine (Effexor).

Source: http://www.rxlist.com

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