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Treatment Risks in Adult ADHD

Summary & Participants

Learn more about treatments for adults with ADHD, and some possible risks associated with these treatments.

Medically Reviewed On: July 17, 2008

Webcast Transcript

IT'S ESTIMATED THAT APPROXIMATELY EIGHT MILLION ADULTS IN THE U.S. HAVE ADHD, BUT MOST REMAIN UNDIAGNOSED OR UNTREATED

LENARD ADLER, MD: We think only about one in four adults are diagnosed and treated. And the fact that adults are not being diagnosed and treated creates a substantial burden for the individual in society.

AN UNDIAGNOSED OR UNTREATED ADULT CAN EXPERIENCE GREAT DIFFICULTIES IN LIFE

WILLIAM DODSON, MD: There are a lot of consequences for not treating ADHD. And just running through them real quickly, if you have untreated ADHD, your risk of developing a substance use diagnosis quadruples, your risk of an injury-producing accident severe enough to have produced a hospital record quadruples, your risk of contracting sexually transmitted diseases go up fourfold. And the risk of an unplanned out-of-wedlock pregnancy go up tenfold.

ADLER Driving is now something that's coming forward in terms of the impairments for adults with A - untreated ADHD and we know they're more likely to have more accidents, more severe motor vehicle accidents, more speeding tickets.

MANY TIMES THE MOTIVATION FOR TREATMENT WILL COME FROM SOMEONE OTHER THAN THE PATIENT

WILLIAM DODSON, MD: When a child is brought in by the parents, it's the parents having the motivation for treatment. The same with an adolescent. And very often with adults, it's the significant other, the spouse who really is the one saying, "Look, you've got to get in there and get this fixed."

ONCE DIAGNOSED, THE FIRST LINE OF TREATMENT IS STIMULANT MEDICATIONS

DAVID W. GOODMAN, MD: The efficacy of stimulants is very high. That is, stimulant medications for ADHD are amongst the most effective medications for any psychiatric indication in psychiatry.

LENARD ADLER, MD: The FDA approved medications for adult ADHD include the amphetamine preparation Adderall XR and the methylphenidate preparation, Focalin XR, and the non-stimulant, which is Strattera.

LIKE ALL MEDICATIONS, THERE CAN BE SIDE EFFECTS ASSOCIATED WITH STIMULANTS

DAVID W. GOODMAN, MD: The typical side effects with stimulant medications are dry mouth, mild constipation, headaches, difficulty falling asleep and decreased appetite.

DR. DAVID FEIFEL: Most of the time, if these side effects occur, they are transitory and with time the body acclimates to them

STIMULANTS ARE NOT ADDICTIVE, BUT THEY DO HAVE THE POTENTIAL FOR ABUSE OR MISUSE

DAVID W. GOODMAN, MD: Abuse is the use of these medications for the purpose of getting high. Now, you get high by injecting it in your veins or snorting it up your nose. There needs to be rapid rises in blood levels. Misuse would be the use of these medications for nonmedical purposes, for the purpose of increasing alertness and concentration. For example, college students might take this at night to stay up for a few extra hours to study, but typically when they do this, they're looking for stimulants that have a short duration of action, two, three, four hours. Many of the stimulant medications we use in ADHD now are once-a-day, long-acting medications, and those are not typically sought after for misuse.

NEW LONGER ACTING MEDICATIONS ARE BEING STUDIED THAT MAY FURTHER REDUCE THE ABUSE POTENTIAL FOR STIMULANTS

DAVID W. GOODMAN, MD: The area of ADHD is very exciting right now, because there is so much research going on. The research is reflected in the pipeline of medications that will soon be coming to market. Next year, we hope to see three new drugs or indications for existing drugs for adults with ADHD. The three compounds are - two of which are not on the market currently. One is an amphetamine that is tied to an amino acid, and because of that, it is not abusable. It's inactive until it gets metabolized in the body. That lasts up to 12 hours in clinical trials. Another medication is an amphetamine-based compound that will be for adults that lasts 14 to 16 hours. And the third medication is a methylphenidate long-acting medication that will get an approval for adults.

DOCTORS SAY THAT THE LIVES OF ADULTS WITH ADHD CAN GREATLY IMPROVE WITH PROPER DIAGNOSIS AND TREATMENT

LENARD ADLER, MD: We do have a lot of good treatments. And the risks of not treating the ADHD are substantial. Of course, there are good new therapies out there. It's important for individuals who are worried that they might have ADHD to go see their doctor, see if they have ADHD and if they do, get going on getting treated. It can be a life-changing experience.