ADHD Treatment

ADHD is treated by a combination of medication and behavioral therapy. Stimulant medications are considered the first line of therapy for Adult ADHD but may not be suitable for certain patients such as those with certain heart conditions or a history of drug abuse. For patients who cannot tolerate stimulant based medications, there are a number of non-stimulant alternatives that have been proven to improve ADHD symptoms.
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Stimulant therapy is currently the most effective treatment for adult ADHD. Multiple clinical trials have been conducted that have confirmed the benefits of stimulant therapy in the treatment of Adult ADHD. Approximately 70% of Adults with ADHD will have a positive response to stimulant therapy.
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Adult ADHD is associated with decreased functioning in multiple areas of life and can lead to significant professional, personal and legal consequences. Furthermore patients with ADHD are more likely to have issues with depression, anxiety, and drug/alcohol abuse. More sobering was a large study published in 2015 that demonstrated a 2-fold increase in death from all causes in individuals diagnosed with ADHDH when compared to individuals without the diagnosis.

There has been a great deal of literature confirming the safety and benefits of medical therapy for Adult ADHD. In fact, a large-scale trial published in JAMA in 2011 followed over 150,000 middle age adults (25-64 years old) treated with Stimulants for ADHD over a period of 20 years failed to show any evidence of an increased risk of serious heart-related events (e.g. heart attacks, heart failure, sudden cardiac death. A recent systematic review of the data on stimulant use and cardiovascular outcomes (the Westover review published in 2023), have demonstrated mixed reviews - with some trials stating a slight increase in heart attacks/strokes and other studies actually demonstrating a reduction in these outcomes in patients on Stimulant therapy. The bottom line is that overall risk is relatively low but it is important to have a full discussion about your total health profile before electing to start on ADHD therapy.

Benefits of Therapy for Adult ADHD include:
- Improvement in symptoms associated with ADHD
- improved work function and productivity
- improved self esteem
- a 40% reduction in car accidents.

Side effects and risks depends on the choice of either a stimulant vs a non-stimulant therapy. In general the most concerning risks of ADHD medication is heart safety. Stimulant use can be associated with increased blood pressure, abnormal heart rhythms, and heart attacks if used in an individual with underlying health risk factors. Also, stimulants are a controlled medication with the risk of abuse, at Valuemed we take specific precautions to avoid issues pertaining to abuse of stimulant medications.

More common side effects include
- Dry mouth/dehydration
- insomnia
- poor appetite/weight loss
- headaches
- irritability
- depressed mood.

Given the wide variety of both stimulant and non-stimulant options for the treatment of Adult ADHD, the choice of therapy will be determined by your own individual needs in conjunction with a thorough 1-hr consultation with a licensed provider

Yes, certain individuals may not benefit from therapy, and in some cases, may be harmed by therapy. Examples of such patients include the following:

- patients with unstable blood pressure or heart disease
- patients with a history of stroke or TIA (mini-stroke).
- Patients with certain vascular disorders.
- Patients with a history of Drug abuse, especially stimulant abuse
- patients with more complex mental health conditions such as bipolar disorder, schizophrenia, severe major depression or anxiety, substance abuse, or suicidal thoughts will need a more thorough evaluation by a liscensed mental health professional prior to being recommended for ADHD therapy.