Treatment Options

4 Steps to Successful ADHD Treatment for Adults

What ADHD medication works best for adults? The one paired with proper nutrition, exercise, coaching, and support. Here, get expert advice for making multi-modal treatment for attention deficit disorder work to better manage your symptoms in adulthood.

Close up of various ADHD medications for adults
Close up of various ADHD medications for adults

ADHD Medications for Adults

Research shows that multi-modal treatment — combining medications and psychosocial interventions — works best to treat ADHD in children. Clinical experience shows adults with ADHD benefit from the same approach.

Doctors use the same medications for adult ADHD as they do in children. Psychostimulants such as Ritalin, Adderall, Dexedrine and Concerta are the “first line” (usually the most effective and safe) medications.

Unfortunately, stimulants have a high potential for abuse. There is considerable debate over whether or not to use stimulant medications in adults who have a history of substance abuse, a problem that is especially common among adults with ADHD.

Some doctors refuse to prescribe stimulants to these patients. However, Paul Elliott, M.D., a Dallas, Texas physician who has worked with ADHD patients for over 25 years, disagrees. “Much of the substance abuse we see today is actually undiagnosed ADHD patients who are self-medicating.”

Elliott monitors these particular patients very closely. “I will not begin anyone on treatment for ADD with any of the abusable medications until they have been in successful recovery for at least 6 months. Furthermore, I advise the patient that their credibility in my eyes is very fragile and easily destroyed, and that I will not continue treating someone who fails to remain clean and sober; anyone who fails to keep appointments; and anyone who gives me any reason to believe he or she is misusing the medication in any way.”

Stimulants may not be appropriate for other reasons, including a patient’s high blood pressure or heart disease. For some of these patients, doctors may prefer antidepressants. Wellbutrin has shown promising results, has have tricyclic antidepressants. Some patients benefit from SSRI antidepressants like Prozac or Zoloft which are not generally considered a first choice for treatment.

How Can ADHD Medications Help?

Medication will not make you more punctual, well-organized, or easy to live with. But it can make it easier for you to overcome self-defeating habits and behaviors under the guidance of a well trained psychotherapist.

Psychotherapy is especially helpful for ADHD patients with co-morbid conditions such as mood disorders and anxiety. It can also help adults deal with the frustration and anger they feel because their ADHD was never addressed in childhood. In addition, psychotherapists can help us improve our social skills and our ability to deal with ADHD-unfriendly situations.

Insight-oriented psychotherapy can help us make sense of our lives and know ourselves better, but other kinds of psychotherapies (such as Cognitive Behavioral Therapy and Interpersonal Therapy) are designed to target the way we think — which can lead to major changes in how we behave.

How Can ADHD Coaching Help?

ADHD is a lifelong condition and while treating it helps us manage its symptoms, it is not a cure. Therefore, learning to live with your ADHD is an important part of taking control of your life and moving forward.

One way to help ensure that forward momentum is to hire an ADD Coach. Think of your coach as a personal trainer for your brain. This person is there to encourage you, to offer suggestions, and to hold you accountable to the goals that you set. Coaching is, by its very nature, goal oriented, which is important for people with ADHD.

Sandy Maynard, ADDitude’s own Coach on Call, works with clients in person in her Washington, DC office. She also works with clients from as far away as Israel and Norway, using email or the telephone.

You Can Do This!

It’s easy for the adult with ADHD to become discouraged. But many people with ADHD lead productive lives doing things they love to do. The trick is to accept yourself and find ways to maximize your strengths and minimize your weaknesses.

Michelle Novotni, co-author of the excellent book Adult ADD (Pinion Press, 1995), sums it up when she says “We believe the greatest difference in outcome is due not to the severity of the symptoms but to the attitude of the person with ADHD.”

“ADHD is not an excuse, a way to duck responsibility,” she writes. “It is a challenge that can be met and overcome. Those who meet the challenge of ADHD, rather than rolling over and playing dead, are the ones who succeed.”

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    1. That would be interesting to know, but it doesn’t sound like it will happen. I don’t think the proper weight is attached to not treating ADHD. To me it sounds a lot like going to the emergency room with a broken leg and being told they won’t treat you until you can walk for six months, and by the way if you miss an appointment you get nothing. If someone really becomes a meth addict because it actually helps their ADHD albeit with an extremely dangerous administration, that is going to severely impact them and their families. The risk of using a stimulant prescription seems a fair alternative. I would have expected less stigma and better understanding of motivational differences for some people with ADHD from what I consider a great source of information.

  1. Why is there still such ignorance about the paradoxical effect of stimulants on people with ADHD.
    Depression and anxiety lifts like magic when I have a low dose stimulant. The reason is my body is short of dopamine and nepenephrine. I am not short of seratonin and most people with ADHD are not. SSRI’s inhibit dopamine receptors ( they have been hijacked by the setatonin) usually making everything worse.
    I’m so tired of the blatant ignorance and bullshit not to mention malpractice by doctors. They need educated. The cause incredible harm with zero accountability.Years of blatant abuse by an ignorant psychiatrist. My life and so many other women’s ruined by ignorance. Dr. fought me getting a correct diagnosis and refused to assist me.
    I got off those horrible drugs, got a correct diagnosis and now I’m too old.

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