Adult ADHD Specialty Clinic

ADHD often coexists with other psychiatric or neurologic conditions. Our providers are comfortable and confident in treating ADHD in the setting of other conditions such as depression, anxiety, autism, and previous substance abuse when appropriate.

We also take care to monitor potential physical effects of medications and will work with your primary care provider when applicable to form a treatment plan that addresses symptoms with consideration of other medical conditions such as high blood pressure.

Medications are the treatment of choice for ADHD. Although there are FDA-approved devices and there is certainly a role for psychotherapy for people with ADHD, medications have the longest track record of success and help the largest percentage of patients.

First-line treatments are with psychostimulants — medications that increase the activity of the brain in all areas, but especially in the parts of the brain that influence attention span, impulse control and excessive fidgeting behavior. These meds include methylphenidate, amphetamine and lisdexamfetamine. They are controlled substances and potentially addictive, so there are extra parameters to ensure wise use of them and they need close monitoring. However, they are also usually the most effective medications for ADHD.

Second-line treatment is with atomoxetine, which acts similarly to antidepressants and modifies the transmission of a chemical in the brain, norepinephrine, that is important in achieving ADHD control. An advantage of this approach is that it can be effective all day.

Third-line treatments are with alpha-agonist medications, such as guanfacine and clonidine. They help primarily with impulse control and hyperactivity and are relatively weaker. They are sometimes paired with the other meds to give a more beneficial effect overall.

Your provider will discuss in detail the relative advantages and disadvantages of these medications and, if appropriate, work with you to try them at different doses to see what is the most effective for you.