ADHD Management

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By Yolanda Smith, B.Pharm.Reviewed by Afsaneh Khetrapal, BSc

For patients with Attention Deficit Hyperactivity Disorder (ADHD), it is important to manage the condition appropriately to ensure they maintain a high quality of life. Management techniques typically include several different approaches simultaneously, such as behavior therapy, lifestyle interventions and education about the condition.

Pharmacotherapy is usually indicated to manage the symptoms of the condition. Most drugs used in the treatment of ADHD target neurotransmitters such as dopamine and noradrenaline and are administered in conjunction with other management techniques, as outlined below.

Behavioral Therapy

Behavioral interventions, led by the parents or teachers of patients with ADHD, can help to manage the disruptive behavior and habits displayed by the individual in the home or school environment. For example, removing distractions and increasing organization of the environment is often helpful.

Cognitive behavioral therapy (CBT) involves direct patient contact to help the individual understand their own patterns of behavior and how they can manage their actions. This is most beneficial in improving symptoms of anxiety and depression in adolescents or adults, rather than children. CBT may be conducted in an individual or group setting.

Neurofeedback is a type of behavior therapy that utilizes computer-based exercises to provide feedback on attention levels. This can be very useful to allow patients to self-regulate their behaviors and initiate change.

Lifestyle and Diet Interventions

Simple interventions in diet and lifestyle can have a significant impact in the management of ADHD - this can include increasing the level of physical activity each day and making sure they get enough sleep.

There is limited evidence to suggest that some dietary changes can have a positive impact on the quality of life of a patient living with ADHD. For example, removing certain food components (e.g. preservatives, processed sugar and food coloring) from the diet has been found to have a positive impact in some cases, although the data is conflicting.

Education and Support

It is also essential that patients with ADHD, and their friends and community, are given adequate education and support to deal with the condition. This may include parents and teachers who are involved in the care of children with ADHD.

This education usually begins in the medical practice when a child is diagnosed with ADHD. Initially, there can be a vast amount of information to process so it is important that the education and support continues as the patient and their family have time to adjust to the changes that come with the diagnosis. Teachers also require more support and specialized teaching techniques to optimize the learning experience for a student with the condition.

Group education sessions are often beneficial and allow people to learn more about ADHD and how they can adapt daily situations to better suit affected individuals. Alternatively, psychoeducation may be given individually to parents and teachers.

Many parents find it challenging to accept and manage their child’s ADHD. Support from a health profession to devise a behavior management plan is beneficial and can help to guide actions. This may include behavioral strategies and guidelines for home, school, diet, physical activity and sleep, in addition to education about difficulties that may affect the child. The plan should be individualized for each patient to provide specific and relevant information.