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Attention-deficit/hyperactivity disorder: Treatment

Support and education

  • Education is key to improving the outcomes of people with attention-deficit/hyperactivity disorder (ADHD).
  • Education is most effective for people over age 8 and empowers them to function as well as possible.
  • Lifestyle management is important. Psychoeducation trains people to manage sleep and anger issues and helps them to develop organizational skills.

Psychotherapy

  • Cognitive-behavioural therapy (CBT) is helpful for children and adults with ADHD. Many people with ADHD have low self-esteem and self-confidence, as well as difficulties in personal relationships. CBT can help to reframe these problems.
  • Group therapy is useful for adults, who can learn from one another.
  • The primary care provider should be positive and boost the client's self-esteem to counter the negative messages people with ADHD often encounter.
  • Although research is limited, relaxation techniques can help people with ADHD who often have low tolerance for frustration. Techniques include meditation, yoga, deep breathing exercises and music.
  • ADHD is highly heritable, so family therapy can be useful to address family relationship problems.

Pharmacotherapy

  • Short- or long-acting stimulants such as methylphenidate and amphetamines are most commonly prescribed for ADHD. Long-acting medications are preferred because they have a better outcome.
  • If a medication works for one family member, it is likely to also work for other family members with ADHD.
  • It is common to combine medications for ADHD with antidepressants or mood stabilizers. Review potential drug interactions.
  • All ADHD medications pose a risk to the cardiovascular system, so clients with a history of cardiac problems should be referred for assessment before they begin treatment.
  • Principles for medical treatment, including pharmacological guides, can be found in the Canadian ADHD Practice Guidelines produced by the Canadian ADHD Resource Alliance.

Educational and vocational interventions

  • The school environment is often difficult for students with ADHD. Accommodations can help. These include seating the student away from distractions and allowing movement breaks, fidget toys, chewing gum and headphones.
  • Teachers with a firm, organized and flexible style will have the most success with students who have ADHD. Providing reminder lists and homework buddies, and allowing the student to submit work after deadlines, are helpful strategies.
  • Vocational testing by Grade 11 can help students with ADHD plan for future studies or careers.
  • The CanLearn Society provides links and resources for parents, students and professionals.
  • The Centre for ADHD Awareness offers information for schools, teachers, parents and doctors, including a guide to classroom accommodations.

Evidence summary

Canadian ADHD Resource Alliance (CADDRA). (2011). Canadian ADHD Practice Guidelines (3rd ed.). Toronto ON: Author.

Jain, U. (2011). The adult patient with ADHD. In D. Goldbloom & J. Davine (Eds.), Psychiatry in Primary Care: A Concise Canadian Pocket Guide (pp. 191–206). Toronto, ON: Centre for Addiction and Mental Health.


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