Untreated attention deficit disorder (ADHD / ADD) can be devastating for both adults and children. Up to 60% of children with ADHD continue to experience symptoms during adulthood. An estimated 4% of the adult population have ADHD, mostly untreated. As a doctor who specializes in both ADHD and drug addiction, I have seen how adult patients with attention deficit problems are many times more likely to experience substance abuse problems, such as dependence on prescription drugs and / or alcoholism. Sufferers of ADHD previously develop problems with drug addiction, and it is more difficult for them to overcome their addictions than those who do not have this condition. In addition, I have seen the financial and personal chaos that ADHD can create. There are effective treatments for adults with ADHD, including drugs that are specifically approved by the FDA for adults. These include stimulants, such as amphetamines and methylphenidate, as well as non-stimulants, such as amoxetine. In my practice, I found that over 90% of patients will improve with a stimulant. Some patients respond better to one class of stimulants (i.e. amphetamines) than others, so there are several trial and error associated with the prescription. Some patients are nervous about taking stimulants, fearing insomnia or unnerving feelings. Fortunately, these symptoms usually improve after a few days. If not, the dosage may be reduced or you can try a different type of stimulant. You can also use a non-stimulant drug, although in general, stimulants are more effective for most people. It is important for a doctor to get a good health history and make sure that it is safe to give stimulants, as they can cause serious problems in patients with major heart problems. Later, patients will ask if they can become addicted to stimulants. The answer is that the use of stimulants almost never leads to addiction to patients with ADHD, if they are taken in accordance with the prescriptions. Since the main problem with ADHD is associated with a deficiency of neurotransmitters, including dopamine and norepinephrine, in the synaptic gap between the neurons in the brain, medications are the basis for treating ADHD. Although training and counseling for ADHD usually helps, I rarely see significant improvement without the use of medication. When the most appropriate type of drugs and doses are determined, the results are dramatic. Patients can pay more attention, think more clearly and make better decisions.
I am often asked about additional or alternative treatments for ADHD.
Most of the research studies on this topic have studied the effects on children, not adults, but I would expect the effects on adults to be similar.
In 2009, one large, randomized controlled trial was conducted in which a significant neurofeedback advantage was found for children with ADHD. (The goal of neurofeedback is to teach people to control certain brain waves and increase brain activity associated with good states of attention. In particular, patients learn to reduce activity in the theta band of the electroencephalogram (EEG) (4-8 Hz) and increase activity in the beta range ( 13-20 Hz).)
In a 2009 study, the effect was “moderate.” There have been some methodological problems with this study, as well as with other past neurofeedback studies for the treatment of ADHD, and research by the government in this area is ongoing. After reviewing existing research and visiting the updated neurofeedback clinic in Israel in November, I believe that neurofeedback is an effective treatment for both children and adults with ADHD.
The following treatments have not been scientifically proven to be useful for ADHD: acupuncture, zinc / magnesium / iron supplements, polyunsaturated fatty acids (including fish oil), Ginko Bilobum, and St. Louis. Jones Wort. Eliminating diets is usually not helpful. However, I firmly believe that the elimination of monosodium glutamate and other glutamates from products (i.e., natural flavor, natural flavor, malt barley, hydrolyzed protein, yeast extract, etc.) in humans are sensitive to these chemicals. substances that help to significantly alleviate the symptoms of ADHD.
Thus, neurofeedback seems to be the most promising additional treatment for ADHD in 2012. At the Atlanta Center ADHD for adults, we often recommend this treatment in combination with the FDA approved medication described above.
