Text adapted from: "The adult patient with attention-deficit/ hyperactivity disorder," in Psychiatry in primary care by Umesh Jain (CAMH, 2019).
Overview
Psychoeducation is the first step in treatment. It can involve addressing questions at every visit and directing patients to websites and other resources. Psychoeducation is important for many reasons:
- Evidence shows that even people who are responding to ADHD treatment will deteriorate if they do not make lifestyle changes.
- ADHD causes significant impairment in many domains and the patient may want to rush the agenda by starting medications immediately.
- Resist the urge to initiate medications without adequately educating the patient.
- A patient who follows through on the treatment plan is also showing commitment to the process.
- There is much to know, and knowledge is power. This reduces dependence on the clinician.
Medication
Some patients only need medications in situations of high attentional load. However, the more common and ideal situation is that medication is used to promote functional behaviour patterns.
ADHD medications have a protective role in preventing the patient from self-medicating. Research has found that medication blocks reward pathways and prevents the binding of other energizing substances (Volkow, 2009).