Attention-deficit hyperactivity disorder (ADHD), or hyperkinetic disorder (HKD)1,2 is a complex and diverse disorder that has a significant impact on patients’ lives.3-5
The diversity of ADHD and the variety of patient presentations and needs makes adopting a patient-centred management approach and designing an individualised treatment plan key to addressing patients’ needs.6-9 Goal-setting is also an important part of the ADHD treatment plan, and clinicians should set goals in conjunction with patients and their families or partner, and re-evaluate and adjust them regularly to assess progress.6-10
Read more: Goal-setting & re-assessment
Clinical guidelines for the diagnosis and management of ADHD are available on an international, European and national level and represent an important framework to ensure that the quality of care for adults and children with ADHD is in line with recommended best practices.6-10
Read more: Guidelines
Non-pharmacological and pharmacological treatment
Treatment for ADHD can include a range of non-pharmacological and pharmacological treatment options, and multimodal interventions should be available to all patients depending on their individual needs.6-9
Behavioural therapy and psychoeducation are recommended as first-line treatment for children and adolescents with moderate ADHD. When remedial measures prove insufficient, or for children/adolescents with severe ADHD, pharmacological treatments are recommended. These should be administered in combination with some form of psychosocial intervention. In adults with ADHD pharmacological treatment is recommended first-line alongside behavioural and psychological measures.6-9
Pharmacological therapies can be helpful in targeting the core symptoms of ADHD in children, adolescents and adults, and a range of stimulant and non-stimulant medications are available* as part of a comprehensive treatment programme.6-11 There are a number of considerations when choosing the appropriate pharmacological therapy for ADHD including the dose required to achieve symptom control, side effects experienced by the patient, patient history, treatment goals and patient lifestyle.6-11 Treatment should be frequently re-evaluated and adjusted if the clinician deems the response to be clinically inadequate.5-9
*Not all treatments that are licensed for ADHD in children and adolescents are licensed for the treatment of ADHD in adults
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. Washington, DC: American Psychiatric Association, 2013.
- World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Available at: www.who.int/entity/classifications/icd/en/bluebook.pdf. Last updated 1993; 1: 1-263. Last accessed March 2015.
- Klassen AF, Miller A, Fine S. Health-related quality of life in children and adolescents who have a diagnosis of attention-deficit/hyperactivity disorder. Pediatrics 2004; 114: e541-e547.
- Biederman J, Faraone SV, Spencer TJ, et al. Functional impairments in adults with self-reports of diagnosed ADHD: a controlled study of 1001 adults in the community. J Clin Psychiatry 2006; 67: 524-540.
- Harpin VA. The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child 2005; 90 Suppl 1: i2-i7.
- NICE (2008) Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE clinical guideline 72. Available at www.nice.org.uk/CG72 [NICE guideline]. Last accessed May 2015.
- Taylor E, Döpfner M, Sergeant J, et al. European clinical guidelines for hyperkinetic disorder – first upgrade. Eur Child Adolesc Psychiatry 2004; 13 (Suppl 1): I7-30.
- Kooij SJ, Bejerot S, Blackwell A, et al. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry 2010; 10: 67.
- The Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA). Canadian ADHD Practice Guidelines (CAP-Guidelines) Third Edition. 2011. Available at: http://caddra.ca/practice-guidelines/download. Last accessed March 2015.
- Remschmidt H. Global consensus on ADHD/HKD. Eur Child Adolesc Psychiatry 2005; 14: 127-137.
- Bolea-Alamañac B, Nutt DJ, Adamou M, et al. Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: Update on recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2014; 28: 3: 179-203.
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Childhood/Adolescent ADHD and the brain animation by Dr Mitul Mehta
Patient-centred management: every patient is different with unique needs – a Spanish perspective. Part 2: Treatment plans
Patient-centred management: every patient is different with unique needs – a Spanish perspective
Effect size interactive module: understanding the effect size of medications
New eLearning Module on the burden and diagnosis of adult ADHD, supported by Professor Philip Asherson, is now available.
New ADHD adult and the brain animation by Dr Mitul Mehta and Professor Philip Asherson is now available.