Attention-deficit/hyperactivity disorder has long been viewed as a pediatric condition, but it often lasts into adulthood.
Attention-deficit/hyperactivity disorder (ADHD) has long been viewed as a pediatric condition, but it often lasts into adulthood.
Some older patients may have never been diagnosed as a child, and there is evidence suggesting that more adults are just now seeking treatment for ADHD.
There are a few ways pharmacists can assist these patients. When pharmacists dispense ADHD medications to adults, for instance, they can ask what other medications the patients are currently taking or have discontinued, Charles H. Brown, MSPharm, RPh, CACP, previously wrote.
One of the reasons for this is that some patients with ADHD may be at higher risk for stroke, heart attack, and sudden death, so any medication should be monitored for its effects on cardiovascular health. Adderall or Ritalin may create problems for older patients with cardiac or blood pressure issues, for example.
In addition, pharmacists should ask patients if their ADHD medication seems to be working, if they are experiencing any adverse effects, and if they have questions about their medication.
“When buying an OTC cold/allergy medication containing pseudoephedrine, all patients should be cautioned about the risks of taking an ADHD stimulant drug concurrently,” Brown noted.
Another way pharmacists can help is directing patients to take an online screening test at ADDadult.com as a starting point.
Some of the screening questions may address whether patients feel overly active or suddenly compelled to do something, whether they have a hard time remembering appointments, and whether they are easily distracted by noise or activity.
The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth edition (DSM-5) updated its definition of ADHD to “more accurately characterize the experience of affected adults.” The DSM-5 recognized that earlier definitions of ADHD did not provide sufficient guidance for diagnosing adults.
Here are 5 things pharmacists should know about their adult patients with ADHD.
1. Inattention, hyperactivity, and impulsivity are the cornerstone ADHD symptoms.
To be diagnosed with ADHD, adults typically must show 5 symptoms of inattention, hyperactivity, and/or impulsivity criteria.
These symptoms may include having a hard time paying attention to details or organizing tasks, as well as having trouble staying seated in appropriate situations, fidgeting, or talking excessively. Patients who feel as though they are being driven by a motor may have hyperactivity.
Adults with ADHD may have trouble paying the correct amount of money due for bills, or they may be consistently late to meetings. These patients may have a tendency to quit or lose their jobs frequently.
Loved ones may complain that the individual does not seem to listen to what they are saying.
2. The updated DSM-5 definition of ADHD stemmed from almost 2 decades of research into adult ADHD.
The DSM-5 cited research that followed adults after years or decades after their childhood ADHD diagnosis. “The results showed that ADHD does not fade at a specific age,” the manual noted.
New research suggested that a lower threshold of symptoms was appropriate in diagnosing adults with ADHD, the DSM-5 pointed out.
3. Genetics may have something to do with ADHD odds.
According to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), a twin has about a 70% to 80% chance of having ADHD if the other twin has been diagnosed with the condition.
If a parent has ADHD, then the child has a 57% chance of having the condition, too, according to CHADD.
4. Patients with ADHD may be more at risk for suicide.
A 2008 study found that adults who were diagnosed with ADHD in childhood were 2 times more likely to have considered or attempted suicide than their counterparts without ADHD.
5. Because adult ADHD was recognized relatively recently, there could be a growing number of newly diagnosed adults or adults seeking advice for their symptoms.
David Goodman, who specializes in adult ADHD at Johns Hopkins School of Medicine, told NPR that he is seeing more adult diagnoses of ADHD.
Older adults seeking help from health care providers about their symptoms could be concerned that they are showing signs of dementia. However, symptoms such as forgetting about meetings or misplacing keys could be a sign of either dementia or ADHD.
Thomas Brown, associate director of the Yale Clinic for Attention and Related Disorders at the Yale School of Medicine, told The New York Times that most doctors don’t think to consider ADHD diagnoses for patients older than 60 years. He called for better training on adult ADHD among health care professionals.