Review of international clinical guidelines for adolescents on transition to Adult Mental Health Services and adults with attention-deficit hyperactivity disorder and their application to an irish context

Abstract

ADHD is a lifelong disorder, which if undiagnosed or untreated can lead to significant impairment resulting in a high economic cost for society. Stimulant medication is a first-line treatment option for adults with ADHD; however, some formulations are unlicensed in Ireland. Recent licensing of Atomoxetine, for both adolescents on transition and for adults with newly diagnosed ADHD is a welcome development. Third-line agents are rarely prescribed due to their side effect profiles and are prescribed off-label: It is important to establish clinical guidelines for an Irish context incorporating a biopsychosocial approach. Further discussion amongst clinicians and stakeholders is needed to plan service development.

Transitioning from child and adolescent mental health services with attention‐deficit hyperactivity disorder in Ireland: Case note review

“…However acceptance of the need to treat adults with ADHD and a relevant skill base may be growing in adult psychiatry with new adult treatment guidelines in the UK and Ireland [3,10,12]. Recently, of 91 adult psychiatrists surveyed in Ireland, three-quarters believed ADHD persists into adulthood and two-thirds said they would consider accepting childhood ADHD referrals and conducting new adult ADHD assessments [27].…”

“…NICE recommend stimulants as the first-line treatment, initiated by a psychiatrist or nurse-prescriber after a comprehensive assessment, and subsequently by primary care physicians in shared care with specialists [10]. Beyond the UK, treatment guidelines extending to adult ADHD have been developed in Ireland [12], Germany, Canada, as well as in a Europe-wide consensus statement from clinicians in the European Network of Adult ADHD [3].…”