Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-26T12:20:54.667Z Has data issue: false hasContentIssue false

Age-Related Considerations in the Treatment of ADHD

Published online by Cambridge University Press:  07 November 2014

Extract

Although the symptoms of attention-deficit/hyperactivity disorder (ADHD) can be found in many “normal” people, these symptoms are present to a greater extent in those affected by the disorder. In these patients, ADHD symptoms cause substantial functional impairment. Therefore, the goal of treatment is not simply to reduce core symptoms, but also to decrease the level of impairment caused by these symptoms.

Common impairments in adolescents and adults include academic and occupational problems that are particularly evident in the context of tasks requiring a high degree of organization or attentional function. These impairments result in problems related to task completion, prioritizing work and other obligations, and time management, etc. These symptoms often impact successful completion of tasks in school or at work, and can also result in a variety of problems in initiating and managing relationships (Slide 1).

Mood and anxiety disorders often co-occur with ADHD in adults. The accumulation of experiences related to impaired academic and/or occupational performance, and or persistent relationship problems, due to the symptoms of ADHD, can lead to either depressed mood or anxiety related to performance and/or social situations. Therefore, in treating adults with ADHD, reduction of those co-occurring symptom presentations is also an important goal.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Barkley, RA. Attention-Deficit Hyperactivity Disorder. A Handbook for Diagnosis and Treatment. 2nd ed.New York, NY: Guilford Press; 1998.Google Scholar
2.Barkley, RA, Fischer, M, Smallish, L, Fletcher, K. Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry. 2006;45:192202.CrossRefGoogle ScholarPubMed
3.Biederman, J, Faraone, SV, Spencer, TJ, Mick, E, Monuteaux, MC, Aleardi, M. Functional impairments in adults with self-reports of diagnosed ADHD: a controlled study of 1001 adults in the community. J Clin Psychiatry. 2006;67:524540.CrossRefGoogle ScholarPubMed
4.Safren, SA, Otto, MW, Sprich, S, Winett, CL, Wilens, TE, Biederman, J. Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behav Res Ther. 2005;43:831842.CrossRefGoogle ScholarPubMed
5.Safren, SA. Cognitive-behavioral approaches to ADHD treatment in adulthood. J Clin Psychiatry. 2006;6(suppl 8):4650.Google Scholar
6.Solanto, MV, Marks, DJ, Mitchell, K, Wasserstein, J, Kofman, MD. Development of a new psychosocial treatment for adult ADHD. J Atten Disord. 2007. In press.Google ScholarPubMed
7.Wilens, TE, McBurnett, K, Bukstein, O et al. , Multisite controlled study of OROS-methylphenidate in the treatment of adolescents with attention-deficit/hyper-activity disorder. Arch Pediatr Adolesc Med. 2006;160:8290.CrossRefGoogle Scholar
8.Wolraich, ML, Greenhill, LL, Pelham, W et al. , Randomized, controlled trial of OROS methylphenidate once a day in children with attention-deficit/hyperactivity disorder. Pediatrics. 2001;108:883892.CrossRefGoogle Scholar
9.Gutgesell, H, Atkins, D, Barst, R et al. , Cardiovascular monitoring of children and adolescents receiving psychotropic drugs: a statement for healthcare professionals from the Committee on Congenital Cardiac Defects, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 1999;99:979982.CrossRefGoogle Scholar
10.Wilens, TE, Biederman, J, Lerner, M, and the Concerta Study Group. Effects of once-daily osmotic-release methylphenidate on blood pressure and heart rate in children with attention-deficit/hyperactivity disorder: results from a one-year follow-up study. J Clin Psychopharmacol. 2004;24:3641.CrossRefGoogle ScholarPubMed
11.Spencer, TJ, Biederman, J, Wilens, TE, Faraone, SV. Novel treatments for attention-deficit/hyperactivity disorder in children. J Clin Psychiatry. 2002;63(suppl 12):1622.Google ScholarPubMed
12.Prudhomme White, B, Becker-Blease, KA, Grace-Bishop, K.Stimulant medication use, misuse, and abuse in an undergraduate and graduate student sample. J Am Coll Health. 2006;54:261268.CrossRefGoogle Scholar
13. Concerta [package insert]. Mountain View, CA: Alza Corporation; 2007.Google Scholar
14. Adderall [package insert]. Wayne, PA: Shire; 2007.Google Scholar
15.Biederman, J, Boellner, SW, Childress, A, Lopez, FA, Krishnan, S, Zhang, Y. Lisdexamfetamine dimesylate and mixed amphetamine salts extended-release in children with ADHD: A double-blind, placebo-controlled, crossover analog classroom study. Biol Psychiatry. 2007;62:970976.CrossRefGoogle ScholarPubMed
16.Krishnan, S, Montcrief, S. Toxicity profile of lisdexamfetamine dimesylate in three independent rat toxicology studies. Basic Clin Pharmacol Toxicol. 2007;101:231240.CrossRefGoogle ScholarPubMed