ADHD (Attention-Deficit Hyperactivity Disorder)It seems like ADHD/ADD is becoming ubiquitous in society. Everybody is saying, “I just can’t seem to focus.” Daily I get at least 2-3 new referrals with people complaining about work, school or general performance issues. Now, after a thorough work-up several decisions have to be made but the most important one is, “Is there an indication for medication?” Of course we fight with the Christ Scientist and others about the efficacy vs. side-effects of medicating, but many people need some form of help. However, first things first, a good medical work-up is needed. A work-up for ADHD/ADD definitely should start with a thorough clinical examination, preferable by a licensed and boarded Psychiatrist. Although, any M.D. can make the medical diagnosis, our approach is just going to be a little different.
Pertinent Questions to ask in an initial evaluation:
- Do you have any other active medical problems?
- How long have you been experiencing these symptoms?
- Are you here because of performance issues at school or work?
- How has your mood been the past several months?
- When was your last physical with laboratory studies?
- Do you smoke any kind of “funny” cigarettes? (If you know what I mean)
Here is the thing, most people need a psycho-stimulant to master this illness. There are conservative approaches such as organizational techniques, verbal and written ques, and reminders. In most cases, clinically this is not enough. Now, if you come by my office, I am going to most probably start medication management. I will definitely see you every month to monitor your progress, success and dilemmas. It is important to stay in care, treatment and services. Please be advised that Scheduled drugs are monitored very closely because of the chemical content of the drugs that we prescribe. It is imperative that you keep all of your appointments and monitor your progress.
Are these drugs addictive? Well, too much of anything can be a problem is my dirty and quick answer. However, yes there is some addictive potential with the psycho-stimulants. That is why I encourage close engagement with your clinical provider. Parent’s your kids will be okay. Don’t worry too much about this potential pitfall. It is a rare instance, especially if you are directly followed by a conscientious physician.
When should you be evaluated for pharmacotherapy:
- School failures and suspensions of a child
- Progressive discipline in the workplace for failure to complete task of an adult
- Recurrent traffic violations; (speeding tickets and failure to obey signs) (both young adults and adults)
- Wandering and getting lost in-between classes (students)
- Academic probation for a college student that was previously doing well.
Can the ADHD be something else: