Text adapted from: "The adult patient with attention-deficit/ hyperactivity disorder," in Psychiatry in primary care by Umesh Jain (CAMH, 2019).
Overview
Attention-deficit/hyperactivity disorder (ADHD) is highly treatable. Providing treatment when symptoms are present givens patients an opportunity to live to their potential. It is one of the few conditions in psychiatry where patients actually get to a level that is better than their premorbid functioning.
When to refer to a specialist
Finding a clinician who specializes in adult ADHD is often difficult, and it may seem impossible. Few psychiatrists understand or specialize in ADHD, which means that treatment often takes place in primary care settings. However, this is slowly changing because ADHD is now on board certification exams.
Consider making a referral when the patient has:
- comorbid conditions that require multiple medications
- complicated medical problems that may require a multi-specialty approach, although you as the primary care practitioner may be coordinating treatment
- medication side-effects that require management (e.g., sleep problems, problems with memory)
- medico-legal or advocacy situations that are beyond the expertise of primary care practitioners (e.g., disability claim applications, job-related conflicts, learning assessments)
- failure to respond adequately to a medication after a trial period.