Revista de Neurologia 2012-02-29

[Diagnosis and treatment of attention deficit hyperactivity disorder in adults].

Josep Antoni Ramos-Quiroga, Pablo J Chalita, Raquel Vidal, Rosa Bosch, Gloria Palomar, Laura Prats, Miguel Casas

Index: Rev. Neurol. 54 Suppl 1 , S105-15, (2012)

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Abstract

To review the latest data available concerning the diagnosis and treatment of adults with attention deficit hyper-activity disorder (ADHD).A number of different instruments for evaluating ADHD have been adapted to the adult patient and allow a reliable diagnosis of the disorder to be reached. Semi-structured interviews, like the Diagnostisch Interview Voor ADHD 2.0 (DIVA), simplify the task of performing a rigorous evaluation of both the symptoms of the disorder in adulthood and the dysfunctions generated by ADHD. Quick screening instruments that allow better detection of ADHD in adults, such as the Adult Self-Report Scale 1.1 (ASRS), have been validated. In recent years, there has been a notable increase in the number of studies focused on ADHD in adults and that research has provided solid data regarding the safety and effectiveness of different treatments. According to the recommendations of the European Consensus statement by the European Network Adult ADHD, the treatment ought to be multimodal, which means combining pharmacological interventions with psychological and psychosocial ones. Methylphenidate displays a high degree of effectiveness and safety in the treatment of adults at doses of around 1 mg/kg/day. Amphetamines, such as lisdexamphetamine, have also proved to be effective in the treatment of adults with ADHD. Among non-stimulant treatments, atomoxetine has proved to be effective and safe in adults in doses of about 80-100 mg/day. Excellent studies have been conducted on the cognitive-behavioural treatment of adults with ADHD, the results of which highlight its effectiveness in both the short and the long term.