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Forgetfulness
Disorganized speech
Increased irritability
Always fidgeting
Memory issues
Easily distracted
Trouble concentrating
Acting without thinking
Difficulty focusing
Unable to sit still
Disorganized thinking
Feeling uneasy and anxious
Not seeing your symptoms? No worries!
Attention deficit hyperactivity disorder (ADHD) is a condition that is characterized by attention difficulty, hyperactivity, and inability to control one's behavior (impulsiveness). It often starts in childhood and can cause a child to struggle in school, at home, or in social relationships. It is more common in male children. The causes of ADHD remain unclear but risk factors include genetic factors, tobacco use during pregnancy, premature delivery, and low birth weight.
Your doctor may ask these questions to check for this disease:
There is no cure for ADHD, but various treatments such as medications, behavior therapy, counseling, and education services can help improve the child's symptoms and behavior.
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Oct 18, 2024
Following the Medical Content Editorial Policy
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Q.
ADHD Medication Not Working? The Science & Medically Approved Next Steps
A.
There are several factors to consider if ADHD medication is not helping, like dose, medication type and release timing, overlapping conditions such as anxiety, depression, or sleep disorders, and expectations about what meds can and cannot do. Next steps include a clinician-led medication review, possible dose or formulation changes, trying a different stimulant or a non-stimulant, plus CBT and lifestyle supports like sleep and exercise. Track symptoms and reassess the diagnosis if needed, seek urgent care for severe side effects, and see the detailed timelines, red flags, and step-by-step guidance below.
References:
* Cortese S, et al. A review of second-line pharmacological treatments for ADHD in children and adolescents. Expert Rev Neurother. 2017 Jul;17(7):693-706. doi: 10.1080/14737175.2017.1332219. Epub 2017 May 30. PMID: 28540645.
* Faraone SV, et al. The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the Disorder. Neurosci Biobehav Rev. 2021 Mar;123:238-310. doi: 10.1016/j.neubiorev.2021.01.002. Epub 2021 Jan 12. PMID: 33444738; PMCID: PMC8062592.
* Childress AC, et al. What to do When Stimulant Medication Does Not Work or Has Intolerable Side Effects: A Systematic Review. J Clin Psychopharmacol. 2020 Jan/Feb;40(1):1-10. doi: 10.1097/JCP.0000000000001150. PMID: 31834241.
* Spencer TJ, et al. Optimizing pharmacotherapy for adults with ADHD. Expert Rev Neurother. 2020 Jul;20(7):673-685. doi: 10.1080/14737175.2020.1770068. Epub 2020 May 28. PMID: 32420993.
* Pliszka SR. ADHD and Comorbid Disorders. Child Adolesc Psychiatr Clin N Am. 2019 Jul;28(3):363-372. doi: 10.1016/j.chc.2019.03.003. PMID: 31078235.
Q.
ADHD Symptoms? Why Your Brain Won’t Focus & Medically Approved Next Steps
A.
ADHD symptoms include inattentive, hyperactive, and impulsive patterns that impair daily life across settings from childhood, driven by executive function differences and dopamine and norepinephrine pathways. Next steps include using a symptom check, speaking with a clinician for diagnosis, and considering evidence-based treatments like stimulants or non-stimulants, CBT, and structured routines; sudden new focus problems or safety concerns need urgent care. There are several factors to consider, including conditions that can mimic ADHD and red flag symptoms, so see below for complete details that can shape the right path forward.
References:
* Biederman J, Faraone SV. ADHD in Adults. N Engl J Med. 2023 Jun 1;388(22):2065-2075. doi: 10.1056/NEJMcp2213709. PMID: 37252994.
* Faraone SV, Asherson P, Banaschewski D, Biederman J, Buitelaar JK, Ramos-Quiroga JA, Rohde LA, Kratochvil CJ, Correll CU, Leckman JF, Sonuga-Barke EJS, Tannock R, Thapar A, Trifiletti ET, Zang YF, Castellanos FX. ADHD in adults: An updated review of current evidence and future directions. Neurosci Biobehav Rev. 2021 May;124:255-274. doi: 10.1016/j.neubiorev.2021.02.001. Epub 2021 Feb 6. PMID: 33550013.
* Cortese S, Coghill D, Zang Y, Zeffiro T, Smith E, Castellanos FX, Faraone SV. Brain and cognition in ADHD: current neuroscience evidence and future directions. J Child Psychol Psychiatry. 2023 Mar;64(3):337-347. doi: 10.1111/jcpp.13745. Epub 2022 Dec 12. PMID: 36511110.
* Caye A, de Oliveira MR, de la Torre J, Stringer D, Bücker J, Leffa D, Montanari C, Rojas G, Polanczyk GV, Ramos-Quiroga JA, Sonuga-Barke EJS, Faraone SV, Rohde LA. Pharmacological treatments for adult ADHD: an umbrella review of efficacy, tolerability and safety. Psychol Med. 2023 Apr;53(6):2021-2038. doi: 10.1017/S003329172200371X. Epub 2022 Nov 22. PMID: 36412198.
* Sonuga-Barke EJS, Cortese S, Zang Y, Zeffiro T, Smith E, Castellanos FX, Faraone SV. Non-pharmacological interventions for ADHD: current neuroscience evidence and future directions. J Child Psychol Psychiatry. 2023 Mar;64(3):348-358. doi: 10.1111/jcpp.13744. Epub 2022 Dec 12. PMID: 36511109.
Q.
Feel Different? Why Your Brain Is Neurodivergent & Medically Approved Steps
A.
Feeling different can reflect a neurodivergent brain, a normal variation linked to ADHD, autism, dyslexia, Tourette syndrome, and sensory processing differences, rooted in genetics and brain development rather than willpower or parenting. Medically approved next steps include getting a professional evaluation, using evidence-based therapies like CBT, considering ADHD medications when appropriate, and adding supports such as better sleep, exercise, routines, and sensory accommodations, with urgent care for red flags like suicidal thoughts; there are several factors to consider, and the complete guidance is detailed below.
References:
* Pellicano, E., & den Houting, J. (2022). Neurodiversity in Autism: The Brain and Cognition. *Annual Review of Clinical Psychology*, *18*, 457–482.
* Faraone, S. V., & Larsson, H. (2019). Neurobiology of attention-deficit/hyperactivity disorder (ADHD). *Molecular Psychiatry*, *24*(4), 517–523.
* Storebø, O. J., & Faltinsen, E. (2019). Pharmacological and non-pharmacological treatments for ADHD. *Nordic Journal of Psychiatry*, *73*(Supplement 1), S48–S53.
* Smith, T., Reiff, M., & Sucato, G. S. (2021). Evidence-Based Psychosocial Interventions for Autism Spectrum Disorder. *JAMA Pediatrics*, *175*(3), 324.
* Rehme, A. K., Stegmayer, K., & Dierks, T. (2022). Neuroimaging of Neurodevelopmental Disorders: A Review. *Diagnostics (Basel, Switzerland)*, *12*(7), 1642.
Q.
Is Adderall Not Working? Why Your Brain Is Reacting & Medical Next Steps
A.
If Adderall seems less effective, common reasons include the wrong dose, tolerance, poor sleep or high stress, hormone shifts, diet or timing issues like vitamin C or acidic drinks, or a different or overlapping condition such as anxiety, depression, or sleep disorders. Next steps usually include tracking doses and effects, confirming the diagnosis, adjusting the medication class or formulation, pairing meds with therapy or coaching, and optimizing sleep, nutrition, hydration, and routines. There are several factors to consider, including red flag symptoms that require urgent care, so see the complete details below to choose the safest and most effective path forward.
References:
* Cortese, S., Coghill, D., Zuddas, A., & Adamo, N. (2023). Re-evaluating the role of stimulant medications in ADHD treatment: efficacy, safety, and long-term outcomes. *Neuropsychopharmacology*, *48*(1), 163–175.
* Newcorn, J. H., Kratochvil, C. J., & Vitiello, B. (2021). Why do some individuals with ADHD not respond to stimulant medication? A narrative review. *Journal of Attention Disorders*, *25*(8), 1073–1085.
* Cortese, S., Adamo, N., Coghill, D., & Zuddas, A. (2020). Tolerance to the Effects of Stimulants in ADHD: A Systematic Review. *Journal of the American Academy of Child and Adolescent Psychiatry*, *59*(11), 1279–1288.
* Caye, A., Rocha, T., da Silva, B. K., das Neves, B. T., & Ramos, B. (2018). Pharmacological Treatment of ADHD in Adults: A Systematic Review and Meta-analysis. *Journal of Attention Disorders*, *22*(14), 1319–1330.
* Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Buitelaar, J. K., Quintero, J., ... & Sonuga-Barke, E. J. (2018). Pharmacogenetics of Attention-Deficit/Hyperactivity Disorder: A Systematic Review. *European Neuropsychopharmacology*, *28*(8), 986–1004.
Q.
Is It ADHD? Why Your Brain Struggles and Medically Approved Next Steps
A.
ADHD is a real, brain-based condition involving executive function differences and atypical dopamine and norepinephrine signaling that lead to persistent inattention, impulsivity, and sometimes hyperactivity. A proper diagnosis requires symptoms starting in childhood, present in more than one setting, causing impairment, and a clinician ruling out lookalikes such as anxiety, depression, sleep disorders, thyroid issues, vitamin deficiencies, trauma, or substance use. Medically approved next steps include a professional evaluation and, when appropriate, evidence-based treatments like stimulant or nonstimulant medication, ADHD-focused CBT, and structured lifestyle supports, with urgent care for severe mood or safety concerns; there are several factors to consider, and important details that could change your next steps are explained below.
References:
* Cortese S, Castellanos FX. The neurobiology and genetics of attention-deficit/hyperactivity disorder (ADHD): what every clinician should know. J Child Psychol Psychiatry. 2021 Mar;62(3):370-379. doi: 10.1111/jcpp.13327. Epub 2020 Sep 28. PMID: 32986161.
* Kooij JJ, Bijlenga S, Salerno L, et al. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry. 2019 Nov;61(1):1-16. doi: 10.1016/j.eurpsy.2019.05.008. Epub 2019 May 31. PMID: 31158582.
* Nierenberg AA, Faraone SV, Newcorn JH. Adult attention-deficit/hyperactivity disorder. Am J Psychiatry. 2022 Dec 22:appi.ajp.20220977. doi: 10.1176/appi.ajp.20220977. Epub ahead of print. PMID: 36561386.
* Heal DJ, Smith SL, Gosden J, et al. An Overview of the Current Status of Approved ADHD Medications and Those in Development for the Treatment of ADHD. CNS Drugs. 2023 Feb;37(2):107-133. doi: 10.1007/s40263-023-00977-w. Epub 2023 Jan 26. PMID: 36701192.
* Reale L, Bartoli B, Bacciardi S, et al. ADHD and comorbid disorders in adults: a systematic review. J Psychiatr Res. 2021 Mar;135:285-300. doi: 10.1016/j.jpsychires.2021.01.014. Epub 2021 Jan 15. PMID: 33549925.
Q.
Struggling with Methylphenidate? Why Your Brain Reacts & Medically Approved Next Steps
A.
There are several factors to consider if methylphenidate makes you feel off or seems ineffective, including individual brain chemistry, an under or over dose, timing and formulation problems, side effects, coexisting conditions, or a different diagnosis. Approved next steps include guided dose adjustments, switching formulations or to an amphetamine, trying non stimulants like atomoxetine or guanfacine, bolstering sleep and nutrition, and reevaluating the diagnosis, with urgent care for red flags like chest pain or suicidal thoughts and not stopping suddenly; crucial nuances that could change your next move are explained below.
References:
* Nunes-Silva L, Machado-Sousa M, Puga I, Castelo-Branco M. Pharmacogenetics of Methylphenidate: A Systematic Review. J Clin Med. 2021 Sep 2;10(17):3965. doi: 10.3390/jcm10173965. PMID: 34484804; PMCID: PMC8431057.
* Maneeton B, Maneeton N, Srisurapanont M, Suttiruang J, Reungyos J, Sukying C, Likhitsathian S. Pharmacological Management of ADHD in Adults: A Systematic Review and Meta-Analysis. CNS Drugs. 2020 Jun;34(6):631-645. doi: 10.1007/s40263-020-00720-3. Epub 2020 May 19. PMID: 32426991; PMCID: PMC7234812.
* Zhu J, Zeng Z, Chen Q, Zeng B. Adverse Events of Methylphenidate: A Systematic Review and Meta-analysis. CNS Drugs. 2017 Jul;31(7):577-595. doi: 10.1007/s40263-017-0437-6. PMID: 28551061.
* Faraone SV, Buitelaar JK. Pharmacological Treatments for ADHD: A Review of the Evidence. J Clin Med. 2021 Oct 22;10(21):4945. doi: 10.3390/jcm10214945. PMID: 34689025; PMCID: PMC8585098.
* Cortese S, Coghill D, Banaschewski T, Buitelaar J, Döpfner M, Gorodetsky E, Brandeis D. Predictors of response to methylphenidate in children with attention deficit hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry. 2018 Apr;27(4):423-440. doi: 10.1007/s00787-017-1065-2. Epub 2017 Nov 6. PMID: 27814917.
Q.
Atomoxetine Not Working? Why Your Brain Fails & Medically Approved Next Steps
A.
Not seeing results from atomoxetine? Common, fixable reasons include needing more time 2 to 12 weeks, a dose that is not yet therapeutic or differences in metabolism, coexisting issues like anxiety, depression, or poor sleep, side effects, or even a diagnosis that needs a fresh look. Medically approved next steps include extending the trial if tolerated, optimizing the dose, switching to a stimulant or another non-stimulant such as guanfacine, clonidine, or viloxazine, and combining medication with therapy while screening for sleep, thyroid, or mood conditions. There are several factors to consider, so see the complete guidance below for important details that can change your next step with a clinician.
References:
* Zhang S, Wei H, Zhang S, Hu P, Lin Q. Pharmacogenomic Aspects of Atomoxetine in Attention-Deficit/Hyperactivity Disorder: A Systematic Review. Front Psychiatry. 2021 Jul 26;12:701700. doi: 10.3389/fpsyt.2021.701700. PMID: 34385973; PMCID: PMC8350647.
* Ratti E, Carucci S, Bellucci S, Zuddas A. Management of treatment-resistant attention-deficit/hyperactivity disorder in children and adolescents: A systematic review. J Psychiatr Res. 2020 Jan;121:194-209. doi: 10.1016/j.jpsychires.2019.11.021. Epub 2019 Nov 22. PMID: 31780521.
* Wolraich ML, Hagan JF Jr, Allan C, et al. Clinical Practice Guideline for the Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019 Oct;144(4):e20192528. doi: 10.1542/peds.2019-2528. PMID: 31570648.
* Cortese S, Coghill D. Treatment response and non-response with atomoxetine in ADHD: a critical review. Eur Neuropsychopharmacol. 2009 Dec;19 Suppl 5:S305-18. doi: 10.1016/j.euroneuro.2009.07.009. Epub 2009 Sep 18. PMID: 19766025.
* Newcorn JH, Weiss M, Stein MA. Pharmacologic Approaches to Treatment-Resistant ADHD: A Systematic Review. J Am Acad Child Adolesc Psychiatry. 2023 Mar;62(3):263-278. doi: 10.1016/j.jaac.2022.09.011. Epub 2022 Oct 11. PMID: 36240974.
Q.
Is ABA Therapy Right? The Science & Medically Approved Next Steps
A.
ABA therapy is one of the most studied, evidence-based treatments for autism, often improving communication, social engagement, and daily living skills, especially with early, individualized programs, though results vary and it is not a cure. There are several factors to consider about fit, intensity, and modern, respectful approaches. Medically approved next steps often include a comprehensive evaluation, hearing and vision screening, and a clinician-guided plan that may combine ABA with speech and occupational therapy. See the complete details below for key questions to ask providers, insurance and time considerations, and urgent signs that require immediate medical care.
References:
* Magiati, I., et al. (2021). A Systematic Review and Meta-Analysis of Comprehensive ABA for Children with Autism: Characteristics of Participants, Interventions, and Outcomes. Journal of Autism and Developmental Disorders, 51(9), 3045-3075.
* Leaf, J. B., et al. (2022). A Commentary on the Criticisms of Applied Behavior Analysis (ABA) as a Treatment for Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 52(4), 1836-1851.
* Reichow, B., et al. (2018). Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review. Journal of Autism and Developmental Disorders, 48(9), 3292-3309.
* Sandbank, M., et al. (2020). Project AIM: Autism Intervention Meta-Analysis for Studies of Young Children. Psychological Bulletin, 146(1), 1-29.
* Dawson, G., et al. (2019). Comparison of an Early Start Denver Model (ESDM)-Based Intervention and an Eclectic Community-Based Intervention for Young Children with Autism Spectrum Disorder: A Randomized Controlled Trial. JAMA Pediatrics, 173(10), 957-965.
Q.
Brain "Static"? Why You’re Neurodivergent (Not Lazy) & Medical Next Steps
A.
Feeling like your brain has static, fog, or constant distraction is commonly linked to neurodivergence like ADHD and related executive function differences, not laziness. Track symptoms, see a primary care clinician to rule out medical mimics such as thyroid problems, anemia, B12 deficiency, and sleep issues, then seek an ADHD or neurodevelopmental evaluation to discuss medication, therapy, and practical supports; there are several factors to consider. See below for complete details, including urgent warning signs and day-to-day strategies that could change your next steps.
References:
* Gamo NJ, Miller EK. Mechanisms of executive function impairment in neurodevelopmental disorders. Curr Opin Behav Sci. 2021 Jun;39:39-44. doi: 10.1016/j.cobeha.2021.01.006. Epub 2021 Feb 17. PMID: 34188981; PMCID: PMC8234327.
* Geschwind DH, D'Evelyn F, Howrigan DP. Advances in neurobiology and genetics of neurodevelopmental disorders. Hum Mol Genet. 2017 Oct 1;26(R2):R153-R165. doi: 10.1093/hmg/ddx234. PMID: 28977508; PMCID: PMC5886280.
* Russell G, Thompson AR, Bell S. "If you struggle with something, it's just 'cause you're lazy, or stupid, or you're not trying hard enough": A qualitative study exploring the experiences of adults with ADHD in managing stigma. J Adult Dev. 2022 Jun;29(2):162-172. doi: 10.1007/s10804-022-09413-z. Epub 2022 Feb 16. PMID: 35174366; PMCID: PMC8847844.
* Lai MC, Chen CH, Lu HH, Tseng HY. Challenges in the Diagnosis of Autism Spectrum Disorder in Adulthood: A Systematic Review. Front Psychiatry. 2022 Mar 28;13:853400. doi: 10.3389/fpsyt.2022.853400. PMID: 35422891; PMCID: PMC9000188.
* Woodworth NC, Jassi A, Coury D. Psychopharmacological and Non-Pharmacological Interventions for Neurodevelopmental Disorders in Adulthood. Curr Treat Options Psychiatry. 2021 Mar;8(1):1-23. doi: 10.1007/s40501-021-00236-4. Epub 2021 Jan 12. PMID: 33456041; PMCID: PMC7803362.
Q.
Brain Fog? Why Your ADHD Brain is Shutting Down and Your Path to Relief
A.
Brain fog with ADHD is a protective shutdown from executive dysfunction and less efficient dopamine and norepinephrine signaling, often triggered by cognitive overload, decision fatigue, emotional stress, sleep problems, burnout from masking, and coexisting conditions. Relief typically involves a proper ADHD evaluation and treatment plus steps to reduce cognitive load, improve sleep, move regularly, stabilize nutrition, and manage stress; there are several factors to consider and important red flags, so see the complete guidance below to choose the safest next steps in your healthcare journey.
References:
* Mrazek, M. D., & Phillips, S. (2018). Cognitive fatigue in ADHD: Clinical and neurobiological considerations. *Frontiers in Neuroscience, 12*, 107.
* Berridge, C. W., & Arnsten, A. F. (2015). Dysregulation of dopaminergic and noradrenergic systems in ADHD: a critical review of the evidence. *Biological Psychiatry, 77*(1), 103-112.
* Catalá-López, F., Hutton, B., Núñez-Beltrán, A., Page, M. J., Ridao, M., Macías Saint-Gerons, D., ... & Tobías, A. (2020). Pharmacological and Nonpharmacological Treatments for Adult ADHD: A Systematic Review. *Journal of Attention Disorders, 24*(7), 939-952.
* Cairncross, M., & Miller, C. J. (2016). Mindfulness-based interventions for ADHD: a systematic review and meta-analysis. *Journal of Attention Disorders, 20*(2), 101-122.
* Surman, C. B., Walsh, C. J., Sproles, C., & Anderson, J. R. (2015). Sleep problems in adults with ADHD: a review of current evidence and clinical implications. *European Archives of Psychiatry and Clinical Neuroscience, 265*(7), 589-599.
Q.
Mind Like Static? Why Methylphenidate Calms the Chaos & Expert Next Steps
A.
Methylphenidate quiets mental static by boosting dopamine and norepinephrine in the prefrontal cortex, improving signal to noise so focus rises and distractions fade. There are several factors to consider; see below for key safety issues, side effects, who should avoid it, how to get properly evaluated, and next steps including pairing medication with sleep, routines, and therapy, plus when to seek urgent care.
References:
* pubmed.ncbi.nlm.nih.gov/24584061/
* pubmed.ncbi.nlm.nih.gov/29530663/
* pubmed.ncbi.nlm.nih.gov/32049298/
* pubmed.ncbi.nlm.nih.gov/26651286/
* pubmed.ncbi.nlm.nih.gov/35165985/
Q.
Mind Racing? Why Your Brain is "Short-Circuiting" & Medical ADHD Symptom Steps
A.
Mind racing and a short-circuit feeling can signal ADHD-related executive function differences that disrupt focus, prioritizing, and impulse control in both adults and children, though anxiety and other issues can look similar. There are several factors to consider; see below to understand more, including how symptoms present by age and how to tell ADHD from anxiety. Key medical steps include tracking patterns, using a structured ADHD symptom check to prepare for care, and scheduling a professional evaluation, with treatments ranging from stimulant or non stimulant medication to CBT and daily structure strategies, plus guidance on when to seek urgent help for severe mood changes or self harm concerns. Complete, actionable details are outlined below.
References:
* Faraone SV, Rostain AL, Blader JC, et al. The Phenomenology of Racing Thoughts in Adults With ADHD. J Atten Disord. 2016 May;20(4):371-80. doi: 10.1177/1087054714568853. Epub 2015 Jan 19. PMID: 27179069.
* Kooij JJS, Bijlenga D, Salerno L, et al. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry. 2019 Nov;61:94-114. doi: 10.1016/j.eurpsy.2019.01.001. Epub 2019 Apr 12. PMID: 30999146.
* Sohn M, Ma N, Lee T, et al. The Default Mode Network in ADHD: A Systematic Review. Front Psychiatry. 2016 Mar 22;7:46. doi: 10.3389/fpsyt.2016.00046. PMID: 27040445; PMCID: PMC4799042.
* Faraone SV, Asherson P, Banaschewski T, et al. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers. 2015 Nov 5;1:15020. doi: 10.1038/nrdp.2015.20. PMID: 27188730.
* Cortese S, Coghill D. Twenty years of research on ADHD neurobiology: What have we learned and where we should go next. J Atten Disord. 2019 Jan;23(1):3-19. doi: 10.1177/1087054718816723. Epub 2018 Dec 9. PMID: 30528489.
Q.
Need Adderall? Why Your Brain Is “Melting” & Medically Approved Next Steps
A.
There are several factors to consider. The “melting brain” feeling is usually due to treatable causes like ADHD, burnout, poor sleep, anxiety, or medical issues, and Adderall helps only when ADHD is properly diagnosed. Medically approved next steps include an ADHD symptom check, a primary care evaluation for thyroid, iron, B12, sleep and medications, and a formal ADHD assessment plus healthy habits. See complete guidance and urgent red flags below, as these details can change the best next step in your care.
References:
* Faraone SV, Larsson H. The Neurobiology of ADHD. Mol Psychiatry. 2019 Jun;24(6):956-965. doi: 10.1038/s41380-018-0004-0. PMID: 30482939; PMCID: PMC6760634.
* Cortese S, et al. Pharmacologic Treatment of ADHD. Mol Psychiatry. 2021 Aug;26(8):4619-4632. doi: 10.1038/s41380-021-01120-x. Epub 2021 May 19. PMID: 34012028; PMCID: PMC8372605.
* Joëls M, et al. Chronic Stress and Its Impact on Cognition and Brain Plasticity: A Review. Brain Plast. 2018 Jun 29;4(1):21-30. doi: 10.3233/BPL-180067. PMID: 29997869; PMCID: PMC6083863.
* Young S, et al. Adult ADHD: Diagnosis and Treatment Challenges. J Clin Med. 2020 Jan 29;9(2):339. doi: 10.3390/jcm9020339. PMID: 32019183; PMCID: PMC7073796.
* Cichocki B, et al. Non-pharmacological interventions for adult attention-deficit hyperactivity disorder (ADHD): an overview of systematic reviews. Cochrane Database Syst Rev. 2023 Jul 19;7(7):CD015502. doi: 10.1002/14651858.CD015502.pub2. PMID: 37466826; PMCID: PMC10355152.
Q.
ADHD vs Narcolepsy: Why You Can’t Focus & Next Steps for Women
A.
ADHD and narcolepsy can both cause poor focus in women, but ADHD is mainly an attention regulation issue, while narcolepsy centers on severe daytime sleepiness that may briefly improve after naps and can include cataplexy. There are several factors to consider, including age of onset, whether naps help, and safety red flags, plus different next steps like symptom tracking, an ADHD screening, and seeing a clinician for evaluation or a sleep study, so see the complete guidance below.
References:
* Bar-Haim Y, David-Landau G, Vaksman B, et al. The challenging differential diagnosis between narcolepsy and attention deficit hyperactivity disorder in adolescents. J Clin Sleep Med. 2018;14(11):1929-1934.
* Plazzi G, Pizza F, Pervanidou P, et al. Narcolepsy and ADHD: A Review of the Current Literature and Clinical Implications. Sleep Med Rev. 2021 Apr;56:101402.
* Ben-Pazi H, Ginzburg-Golomb S, Gak E, et al. Sleep disorders mimicking ADHD in children and adolescents: a systematic review. Sleep Med Rev. 2020 Feb;49:101228.
* Trotti LM, Sateia MJ. The Differential Diagnosis of Narcolepsy and ADHD in Adults. J Clin Sleep Med. 2017 Jul 15;13(7):909-916.
* Li J, Lu Y, Cao Q, et al. Impact of Sex and Gender on Narcolepsy: A Systematic Review. Sleep Med Rev. 2023 Apr;68:101757.
Q.
ADHD in Women 30-45: Recognizing Signs & Your Essential Next Steps
A.
ADHD in women 30 to 45 often shows up as lifelong inattention, chronic disorganization, time blindness, emotional sensitivity, and internal restlessness that can affect work, relationships, and parenting. There are several factors to consider, including childhood onset, hormonal shifts, and common misdiagnosis; see below to understand more, including red flags and nuances that could change your best next step. Next steps include reflecting on lifelong patterns, trying a free symptom check, and scheduling an evaluation with a clinician experienced in adult ADHD, with effective treatments ranging from medication and ADHD-focused therapy to practical routines, detailed below.
References:
* Sedgwick JA, Gilliver R, Palmer L, et al. Diagnostic challenges of ADHD in adult women: a narrative review. J Psychiatr Res. 2022 Mar;147:117-124. doi:10.1016/j.jpsychires.2021.12.030. Epub 2022 Jan 3. PMID: 35041490.
* Young S, Hollingdale J, Fawcett C, et al. ADHD in adult women: A systematic review of current evidence. Clin Neuropsychol. 2021;35(4):727-775. doi:10.1080/13854046.2021.1930219. Epub 2021 Jun 17. PMID: 34160494.
* Rucklidge JJ, Brownlie EB. Clinical Characteristics of Adult Women With ADHD. J Atten Disord. 2019 May;23(7):727-739. doi:10.1177/1087054717725892. Epub 2017 Aug 18. PMID: 30046522.
* van den Brink C, Veltman D, van Rooij SB. Pharmacological treatment of adult ADHD in women: A systematic review. J Atten Disord. 2024 Jan;28(1):3-16. doi:10.1177/10870547221124426. Epub 2022 Sep 9. PMID: 36081498.
* Hollingdale J, Kirton J, Davies M. Living with undiagnosed ADHD as an adult woman: An interpretative phenomenological analysis. J Atten Disord. 2022 Jul;26(9):1314-1327. doi:10.1177/1087054720939029. Epub 2020 Jul 22. PMID: 32697200.
Q.
Neurodivergent Women (30-45): Symptoms & Your Next Steps
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Women 30 to 45 who may be neurodivergent often notice lifelong focus and organization challenges, emotional intensity, exhaustion from masking, sensory sensitivities, and relationship misunderstandings, sometimes alongside anxiety or depression, with symptoms frequently amplified by perimenopausal hormone shifts. There are several factors to consider; start by learning more, tracking patterns, trying a reputable ADHD symptom check, and speaking with a qualified clinician about evaluation, treatment, and environmental supports, and seek urgent care for severe or life threatening symptoms. See the complete guidance below for key details that can shape which next steps are right for you.
References:
* Barger, B. D., et al. (2023). Autism in adult women: A systematic review of diagnosis and lived experience. *Research in Autism Spectrum Disorders*, *104*, 102146. [PMID: 37537330]
* Skrastins, E., et al. (2023). Understanding ADHD in women: A qualitative study on diagnosis and lived experience. *Frontiers in Psychiatry*, *14*, 1152019. [PMID: 37599767]
* Rutter, H., et al. (2023). The lived experience of neurodivergent women: A systematic review. *Journal of Autism and Developmental Disorders*. Advance online publication. [PMID: 38048293]
* Craig, J., et al. (2023). Comorbid mental health conditions in adult women with ADHD and/or autism: A systematic review. *Journal of Autism and Developmental Disorders*. Advance online publication. [PMID: 38087265]
* Cooper, C., et al. (2023). Experiences of post-diagnostic support among women diagnosed with ADHD in adulthood: A qualitative study. *Journal of Clinical Psychology in Medical Settings*. Advance online publication. [PMID: 37883072]
Q.
Vyvanse for Women 30-45: Symptom Guide & Vital Next Steps
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Vyvanse can help women ages 30 to 45 manage ADHD by improving focus, organization, and emotional regulation at a life stage when symptoms often intensify due to work and family demands, stress, sleep disruption, and hormonal shifts. There are several factors to consider that can change your next steps, including common and serious side effects, heart and mental health cautions, pregnancy and breastfeeding considerations, and menstrual cycle fluctuations in response; see the complete guidance below, including nonmedication strategies, when to seek urgent care, and how to talk with a doctor after a symptom check.
References:
* Ermer JC, et al. Sex Differences in Pharmacokinetic Parameters of Lisdexamfetamine Dimesylate. J Clin Pharmacol. 2011 May;51(5):789-94.
* Permpongpan P, et al. The Efficacy and Safety of Lisdexamfetamine Dimesylate in Adults With ADHD: A Systematic Review. J Atten Disord. 2021 Mar;25(5):611-627.
* Quinn PO, et al. Management of Attention-Deficit/Hyperactivity Disorder in Adult Women. J Clin Psychiatry. 2019 Jan;80(1):18nr12437.
* Faraone SV, et al. Adverse events associated with lisdexamfetamine dimesylate in adults with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. J Clin Psychiatry. 2018 May 1;79(3).
* Lopez-Leon S, et al. Psychological and pharmacological treatments for ADHD in women across the lifespan: a systematic review and meta-analysis. J Psychiatr Res. 2022 Dec;156:495-508.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1American Psychiatric Association website. Attention-deficit/hyperactivity disorder. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:59-66.
Prince JB, Wilens TE, Spencer TJ, Biederman J. Pharmacotherapy of attention-deficit/hyperactivity disorder across the lifespan. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 49.
Wolraich ML, Hagan JF Jr, Allan C, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents [published correction appears in Pediatrics. 2020 Mar;145(3):]. Pediatrics. 2019;144(4):e20192528. PMID: 31570648 pubmed.ncbi.nlm.nih.gov/31570648/.
Millichap JG. Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics. 2008 Feb;121(2):e358-65. doi: 10.1542/peds.2007-1332. PMID: 18245408.
https://publications.aap.org/pediatrics/article-abstract/121/2/e358/68716/Etiologic-Classification-of-Attention-Deficit?redirectedFrom=fulltextLinnet KM, Dalsgaard S, Obel C, Wisborg K, Henriksen TB, Rodriguez A, Kotimaa A, Moilanen I, Thomsen PH, Olsen J, Jarvelin MR. Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry. 2003 Jun;160(6):1028-40. doi: 10.1176/appi.ajp.160.6.1028. PMID: 12777257.
https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.160.6.1028