Treatment of ADHD (Attention Deficit Hyperactivity Disorder)

First-Line Treatment Principles

• ✓Establish accurate diagnosis with standardised rating scales (PHQ-9, GAD-7, YMRS, PANSS)
• ✓SSRIs or SNRIs as first-line for depression, anxiety disorders, OCD, and PTSD
• ✓Lithium or valproate as mood stabilisers in bipolar disorder
• ✓Antipsychotics for schizophrenia; clozapine for treatment-resistant cases
• ✓Psychotherapy (CBT, IPT, DBT) as first-line or adjunct in most psychiatric conditions

What to Do Now

1. Learn your personal risk factors for ADHD (Attention Deficit Hyperactivity Disorder) (family history, age, lifestyle)
2. Attend regular health check-ups and screening tests appropriate for your age and risk
3. Track new or changing symptoms, especially those associated with ADHD (Attention Deficit Hyperactivity Disorder)
4. Use our AI symptom checker to assess whether your symptoms fit an early ADHD (Attention Deficit Hyperactivity Disorder) pattern
5. Discuss preventive strategies and early monitoring with your GP
6. Build a personalised management plan with your GP or specialist
7. Adhere consistently to prescribed medications — do not stop without medical advice
8. Adopt a ADHD (Attention Deficit Hyperactivity Disorder)-appropriate diet (anti-inflammatory, low-glycaemic, or disease-specific)

Medications Used in ADHD (Attention Deficit Hyperactivity Disorder)

Non-Pharmacological Management

• •Psychotherapy: CBT for depression, anxiety, OCD, PTSD; DBT for borderline PD; ACT for chronic conditions
• •Regular aerobic exercise: 150 min/week — reduces depression scores comparably to antidepressants in mild-moderate MDD
• •Sleep hygiene: critical in depression, bipolar, and anxiety — circadian rhythm stabilisation
• •Alcohol and substance avoidance: major driver of psychiatric deterioration
• •Social support and peer support groups
• •Mindfulness-based cognitive therapy (MBCT) to prevent MDD relapse
• •Crisis planning: safety plan, emergency contacts, medication access

Treatment Goals

Monitoring Parameters

• ◆Validated symptom scales: PHQ-9 (depression), GAD-7 (anxiety), MADRS, YMRS — at each visit
• ◆Side effect monitoring: weight, metabolic parameters (antipsychotics), thyroid (lithium), LFTs (valproate)
• ◆Lithium levels: 5–7 days after initiation/dose change; then every 3–6 months when stable (target 0.6–1.0 mmol/L)
• ◆ECG: QTc monitoring with antipsychotics (ziprasidone, amisulpride, haloperidol)
• ◆Metabolic syndrome screening: waist circumference, BP, fasting glucose, lipids — annually on antipsychotics
• ◆AIMS for tardive dyskinesia (antipsychotics) — 6-monthly

Red Flags — When to Escalate

• ⚠Any of the characteristic symptoms of ADHD (Attention Deficit Hyperactivity Disorder) — even mild — in a high-risk individual
• ⚠Progressive worsening of early warning signs over weeks
• ⚠Laboratory abnormalities (e.g., blood sugar, inflammatory markers) without full symptoms
• ⚠Unexplained weight loss, night sweats, or fatigue persisting >2 weeks
• ⚠Strong family history of ADHD (Attention Deficit Hyperactivity Disorder) combined with new relevant symptoms
• ⚠Sudden worsening of ADHD (Attention Deficit Hyperactivity Disorder) symptoms despite established treatment

Escalation Criteria

• →Active suicidal ideation with intent/plan → emergency psychiatric assessment; hospitalisation if risk confirmed
• →Psychotic relapse in schizophrenia → urgent psychiatric review; consider clozapine if ≥2 antipsychotic failures
• →Bipolar manic episode → inpatient; optimise mood stabiliser; antipsychotic augmentation
• →Treatment-resistant depression (≥2 failed SSRI trials) → augmentation (lithium, aripiprazole), referral, TMS/ECT consideration

Special Populations

Clinical Insights