ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a complex neurological disorder that impacts the parts of the brain that help us plan, focus, organize, control impulses, and execute tasks. It's a long-term condition that occurs due to changes in the brain's structure and function, often during early development.

Individuals with ADHD often hyperfocus and lose track of time, frequently misplace or lose important daily items, and may blurt out or talk over others. Symptoms of ADHD/ADD can negatively impact many aspects of life, including school, work, relationships, social interactions, and overall mental well-being.

ADHD is most commonly diagnosed in children and adolescents, but it affects adults too. It’s not uncommon for ADHD to go unnoticed during childhood since many associated symptoms—such as inattention and hyperactivity—are common traits in children. Additionally, stigma often prevents individuals from seeking help when they are younger. Males are more readily diagnosed than females.

ADHD is not related to intelligence or IQ, nor is it a matter of "willpower." The disorder tends to run in families. If you have concerns about ADHD because it runs in your family and you were never diagnosed, schedule an appointment with Andrea for an evaluation. If you had ADHD as a child and you're struggling to manage your symptoms, Andrea can help.

ADHD symptoms include inattention, hyperactivity, and impulsivity.

• Inattention – Inattention in ADHD makes it hard to focus, follow through on tasks, and stay organized.

• Hyperactivity – Hyperactivity in ADHD causes fidgeting, restlessness, and the need to always be on the go.

• Impulsivity – Impulsivity is acting without thinking. People with ADHD may have difficulty waiting their turn, frequently interrupt others when they're speaking, and, in school, work, or social settings, blurt out answers to questions. This is not due to "being rude" but rather the brain being "excited" and impulsive.

You don't have to have all three of these symptoms to have ADHD.

Previously, attention deficit disorder (ADD) and ADHD were considered separate conditions, but ADHD is now the official diagnosis. Those diagnosed with ADHD are further classified into a type based on their most dominant symptom.

Three types of ADHD'.

1. ADHD, predominantly inattentive type

2. ADHD, predominantly hyperactive/impulsive type

3. ADHD, combination type 

Andrea conducts a thorough psychiatric diagnostic evaluation during your ADHD screening. She reviews your medical and mental health history, as well as your family history. She also asks about your childhood, academic performance, work, and social interactions, looking for symptoms of ADHD.

Additionally, she has you complete a symptom rating scale.

Andrea uses the information gathered during your evaluation and screening to develop a diagnostic impression and determine whether you meet the criteria for an ADHD diagnosis. Sometimes a neuropsychological evaluation with formal testing is required; patients would be referred out to a specialist for that.

New Patient Intake/Diagnostic Evaluation appointments are typically 60-75 minutes long.

Follow up visits are 15-25 minutes.

Andrea provides medication management for ADHD. She believes the best treatment strategies are multimodal—using a combination of complementary approaches that work together to reduce symptoms. This may include medication as well as nutrition, exercise, and behavior modifications.

ADHD treatment is not a "one-size-fits-all" approach; symptoms and treatments must be reassessed throughout a person’s lifespan. Men and women each benefit from individualized treatment options.

Medications that help control ADHD symptoms include:

Stimulants

Stimulants are considered the first-line treatment for ADHD. These medications work by increasing certain neurotransmitters in the brain to improve focus and executive function. They take effect quickly and do not always need to be taken daily.

There are two main classes of stimulant medications: methylphenidate and amphetamine (D/DL)—both generic names.

Examples of stimulants include:

• Adderall XR (amphetamine)

• Concerta (methylphenidate)

• Dexedrine (amphetamine)

• Focalin XR (dexmethylphenidate)

• Metadate CD (methylphenidate)

• Ritalin IR and LA (methylphenidate)

• Vyvanse (lisdexamfetamine dimesylate)

• Mydayis (amphetamine)

Nonstimulants Used for ADHD

Nonstimulants also increase brain chemicals that help improve focus, but these medications take longer to work. They are often prescribed to patients who do not tolerate or benefit from stimulants or have medical contraindications for using them.

The most common FDA-approved nonstimulant medications for ADHD include:

• Atomoxetine (Strattera)

• Guanfacine (Tenex/Intuniv)

• Clonidine (Catapres)

• Qelbree (Viloxazine)

Non-FDA-Approved Medications Used for ADHD

These nonstimulant medications are sometimes prescribed off-label for ADHD:

• Bupropion (Wellbutrin)

• Modafinil (Provigil) / Armodafinil (Nuvigil)

• Tricyclic Antidepressants

• SNRI Antidepressants

• Memantine (Namenda)

Psychopharmacological genetic testing (PGT) can be order and is covered by some insurance carriers to determine how you metabolize certain medications. This can be helpful if you have failed or had serious side effects on medications in the past. If you have questions, or want to order this test, ask Andrea for more details.