A 55-Year-Old Man With Attention-Deficit/Hyperactivity Disorder

Biederman, Joseph

doi:10.1001/jama.280.12.1086

Cited by 17 publications

(8 citation statements)

References 40 publications

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“…After two weeks, she and her family reported much improvement of concentration and overview over daily activities. A similar experience has been described in a 55-year-old man with ADHD [85]. Using three daily dosages of 10 mg methylphenidate, he reported an immediate effect helping him focusing and finishing tasks.…”

Section: Methylphenidatesupporting

confidence: 66%

ADHD in old age: a review of the literature and proposal for assessment and treatment

Kooij

Michielsen

Kruithof

et al. 2016

Expert Review of Neurotherapeutics

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ADHD is an often heritable, neurodevelopmental disorder with a prevalence of 4-5% in children and adults and about 3% in older adults. The disorder in older adults (> 55 years) is accompanied by similar comorbidities such as anxiety and depression, and social impairment as in younger age groups. Areas covered: An overview of the literature on diagnostic assessment, differential diagnosis, and treatment of older adults with ADHD is described. Case studies show that stimulant treatment is beneficial for ADHD in old age, but randomized controlled trials are lacking. Stimulant treatment has been studied in depression and even dementia in older adults, and seems safe with active cardiovascular risk management. In this paper, a proposal for diagnostic assessment and treatment is described for ADHD in older adults, including differential diagnosis with other psychiatric and neurocognitive disorders. Expert commentary: Regarding the organization of mental health, professionals in geriatric psychiatry need to be trained in assessment and treatment of ADHD in older age. Lifespan ADHD clinics may help patients of all ages to receive better specialized care.

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Section: Methylphenidatesupporting

confidence: 66%

ADHD in old age: a review of the literature and proposal for assessment and treatment

Kooij

Michielsen

Kruithof

et al. 2016

Expert Review of Neurotherapeutics

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“…As the dose of methylpenidate exceeds 0.5 mg/kg, the rates of insomnia and appetite suppression increase. Within the recommended therapeutic range, this is not generally a problem in adults [2], but at higher doses this could be a major limiting factor. The cardiovascular effects of stimulants (e.g.…”

Section: Side‐effectsmentioning

confidence: 92%

“…In Australia, the total number of prescriptions issued for stimulants across all age groups increased more than 10‐fold in the years 1990–1998 McManus P: personal communication, 1999]. Many patients have benefited from this trend, with an increased ability to perform at work or study and an improvement in the quality of their lives [2]. Most psychiatrists, however, approach the prescription of stimulants with some trepidation.…”

mentioning

confidence: 99%

How high a dose of stimulant medication in adult attention deficit hyperactivity disorder?

Sachdev

Trollor

2000

Aust N Z J Psychiatry

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The clinical and experimental data justify the use of chronic low-dose stimulant treatment of ADHD in adults, with the recommended upper limit of dose being 1 mg/kg for methylphenidate and 0.5 mg/kg for dexamphetamine. There is no empirical evidence of greater improvement with higher doses and any beneficial effect is likely to be compromised by the adverse effects, some of which can be very serious. The recommended doses should be exceeded only after careful consideration and objective documentation of beneficial and adverse consequences. Monitoring of drug levels in blood may be of some value for compliance or pharmacokinetic considerations, as there is a direct relationship between blood and brain levels as well as dopamine transporter occupancy. These recommendations are tentative and further clinical research is warranted.

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“…19 Second, being poor and from a lower socioeconomic class is associated with a worse pregnancy outcome. 20 Furthermore, men with ADHD are poorer than their peers, 21 although studies on women are limited. Gender differences are poorly understood and generalizations are not always accurate.…”

Section: Adhd and Pregnancy Outcome-are They Linked?mentioning

confidence: 99%

Possible Link Between Attention-Deficit/Hyperactivity Disorder and Reproductive Complications

Lyman

2002

Prim. Care Companion CNS Disord.

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ABackground: Initially conceptualized as a disorder of childhood, attention-deficit/ hyperactivity disorder (ADHD) is now emerging as a chronic disorder that may present in adolescence and persist into adulthood. Failure to recognize this common disorder in childhood may lead to disabling comorbid symptoms and a poor longterm prognosis in adulthood. Young adults with undiagnosed ADHD experience significant psychiatric comorbidity, including high rates of drug dependency and lower levels of global functioning. The public health consequences of poor impulse control (e.g., delinquency, criminal activity, drug use, risky sexual behaviors, high-risk pregnancies) are emerging, and a link between ADHD and poverty seems highly probable.Case Report: I explore the sexual behaviors, and their consequences, of a young adolescent female. Her reproductive complications led me to consider undiagnosed ADHD.Conclusion: The long-term prognosis when ADHD is unrecognized and untreated in the adolescent is discouraging: maternal and perinatal morbidity may be anticipated and are biologically plausible. The actual assessment of risk in the setting of pregnancy and unrecognized ADHD remains largely unknown, and the benefits of timely diagnosis and appropriate treatment of ADHD during pregnancy have yet to be addressed. The following case presentation suggests an association between undiagnosed ADHD and reproductive complications.

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A 55-Year-Old Man With Attention-Deficit/Hyperactivity Disorder

Cited by 17 publications

References 40 publications

ADHD in old age: a review of the literature and proposal for assessment and treatment

ADHD in old age: a review of the literature and proposal for assessment and treatment

How high a dose of stimulant medication in adult attention deficit hyperactivity disorder?

Possible Link Between Attention-Deficit/Hyperactivity Disorder and Reproductive Complications

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