Managing adult attention-deficit/ hyperactivity disorder: To treat or not to treat?

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent and chronic neurodevelopmental disorder often with residual symptoms throughout the patient’s lifespan. Patients with ADHD have a significant disease burden that adversely affects interpersonal, psychosocial, and occupational domains of their life. Stimulants are usually the first-line treatment for all patient age groups. Familiarity with varying aspects of this disorder is important for clinicians, given the significant challenges in treating this chronic condition. Although risks of medication abuse and diversion pose significant challenges, not treating ADHD can gravely affect patients’ lives, potentially leading to school dropout, unemployment, legal problems, and more. This article reviews reasons to treat adult ADHD, versus reasons that support refraining from treating, and provides general treatment guidelines for practicing clinicians.