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ADHD in adults Therapeutics Initiative (University of British Columbia)

Description

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition originally diagnosed in children but increasingly recognized in adults. Overdiagnosis of ADHD and prescribing of stimulant drugs such as lisdexamfetamine (Vyvanse) are contributing to a rise in prescriptions, often based on subjective rating scales. Competent diagnosis requires detailed clinical assessment. Aims: This Therapeutics Letter examines the challenges in diagnosing and treating adult ADHD, highlighting the limitations of currently evidence on drug safety and efficacy, as well as the need for careful diagnosis, conservative prescribing, and regular monitoring of patients by prescribers. Recommendations: Clinicians should carry out comprehensive assessments, including childhood symptom documentation, and use rating scales with caution. When prescribing stimulant medications such as lisdexamfetamine, ongoing monitoring for both efficacy and safety is essential. Considering the high costs and uncertain benefits of lisdexamfetamine over other medications, consideration of alternative treatments, including non-pharmacological options, is recommended.

Item Metadata

Title
ADHD in adults
Alternate Title
Therapeutics Letter 144
Creator
Therapeutics Initiative (University of British Columbia)
Date Issued
2023-09
Description
Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition originally diagnosed in children but increasingly recognized in adults. Overdiagnosis of ADHD and prescribing of stimulant drugs such as lisdexamfetamine (Vyvanse) are contributing to a rise in prescriptions, often based on subjective rating scales. Competent diagnosis requires detailed clinical assessment. Aims: This Therapeutics Letter examines the challenges in diagnosing and treating adult ADHD, highlighting the limitations of currently evidence on drug safety and efficacy, as well as the need for careful diagnosis, conservative prescribing, and regular monitoring of patients by prescribers. Recommendations: Clinicians should carry out comprehensive assessments, including childhood symptom documentation, and use rating scales with caution. When prescribing stimulant medications such as lisdexamfetamine, ongoing monitoring for both efficacy and safety is essential. Considering the high costs and uncertain benefits of lisdexamfetamine over other medications, consideration of alternative treatments, including non-pharmacological options, is recommended.
Subject
Atomoxetine; Attention Deficit Disorder with Hyperactivity; Diagnosis; Drug Costs; Drug-Related Side Effects and Adverse Reactions; Lisdexamfetamine; Methylphenidate; Overdiagnosis
Genre
Other
Type
Text
Language
eng
Notes
The UBC TI is funded by the BC Ministry of Health to provide evidence-based information about drug therapy. We neither formulate nor adjudicate provincial drug policies.
Date Available
2024-09-25
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0445445
URI
http://hdl.handle.net/2429/89286
Affiliation
Medicine, Faculty of; Anesthesiology, Pharmacology and Therapeutics, Department of
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International