Psychiatr. praxi. 2025;26(2):108-115 | DOI: 10.36290/psy.2025.019

The diagnosis and pharmacotherapy of Adult ADHD - part 1

MUDr. Michal Vodička
Psychiatrická ambulance, České Budějovice

The introductory part of this review article on ADHD presents the prevalence, historical development, etiology, symptoms and diagnosis, including the importance of psychological assessment. It also discusses the pharmacotherapeutic options available in the Czech Republic, including their efficacy, side effects, interactions with other medications, potential health risks, and specific aspects of use in pregnancy and lactation. It also describes the differences between ADHD in childhood and adulthood.

Keywords: ADHD, medication, stimulants, emotional dysregulation.

Accepted: June 9, 2025; Published: July 4, 2025  Show citation

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Vodička M. The diagnosis and pharmacotherapy of Adult ADHD - part 1. Psychiatr. praxi. 2025;26(2):108-115. doi: 10.36290/psy.2025.019.
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References

  1. . Scoten O, Tabi K, Paquette, et al. Attention-deficit/hyperactivity disorder in pregnancy and the postpartum period. American journal of obstetrics and gynecology. 2024; 231(1):19-35. doi:https://doi.org/10.1016/j.ajog.2024. 02. 297. Go to original source...
  2. . Björk A, Rönngren Y, Selander J, et al. Health, lifestyle habits, and physical fitness among adults with ADHD compared with a random sample of a Swedish general population. Society, Health & Vulnerability. 2018;9(1):1553916. doi:https://doi.org/10.1080/20021518.2018.1553916. Go to original source...
  3. . Newcorn J, Weiss M, Biederman J, et al. Adult ADHD: Effective Treatment Strategies. 2006. Retrieved from Medscape Education: https://www.medscape.org/viewarticle/531493
  4. . Caddra. CADDRA - Canadian ADHD Resource Alliance: Canadian ADHD Practice Guidelines. (4.1 Edition). Toronto ON: CADDRA. 2020.
  5. . Ayano G, Tsegay L, Gizachew Y, et al. Prevalence of attention deficit hyperactivity disorder in adults: Umbrella review of evidence generated across the globe. Psychiatry research. 2023;328:115449. doi:https://doi.org/10.1016/j.psychres.2023.115449. Go to original source... Go to PubMed...
  6. . Mahone E, Denckla M. Attention-Deficit/Hyperactivity Disorder: A Historical Neuropsychological Perspective. Journal of the International Neuropsychological Society : JINS. 2017;23(9-10):916-929. doi:https://doi.org/10.1017/S1355617717000807. Go to original source... Go to PubMed...
  7. . Victor M, da Silva B, Kappel D, et al. Attention-deficit hyperactivity disorder in ancient Greece: The Obtuse Man of Theophrastus. Aust N Z J Psychiatry. 2018;52(6):509-513. doi:https://doi.org/10.1177/0004867418769743. Go to original source... Go to PubMed...
  8. . Albrecht B, Uebel-von Sandersleben H, Wiedmann K, et al. ADHD history of the concept: The case of the continuous performance test. Current Developmental Disorders Reports. 2015;2(1):10-22. doi:https://doi.org/10.1007/s40474-014-0035-1. Go to original source...
  9. . Lange KW, Reichl S, Lange KM, et al. The history of attention deficit hyperactivity disorder. Attention deficit and hyperactivity disorders. 2010;2(4):241-255. doi:https://doi.org/10.1007/s12402-010-0045-8. Go to original source... Go to PubMed...
  10. . Koťátková J. Lehká dětská encefalopatie - vývojové aspekty. Neurologie pro praxi. 1989;2(1):17-21.
  11. . Černá M, Strnad P, Šturma J, et al. Lehké mozkové dysfunkce. Praha: Karolinum. 1994.
  12. . Drtílková I, Šerý O, Balaštíková B, et al. Hyperkinetická porucha. Praha: Galén. 2007.
  13. . Grimm O, Kranz T, Reif A. Genetics of ADHD: What Should the Clinician Know? Current psychiatry reports. 2020; 22(4):18. doi:https://doi.org/10.1007/s11920-020-1141-x. Go to original source... Go to PubMed...
  14. . Faraone SV, Banaschewski T, Coghill D, et al. The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neuroscience and biobehavioral reviews. 2021;128: 789-818. doi:https://doi.org/10.1016/j.neubiorev.2021. 01. 022. Go to original source...
  15. . Kooij J, Bijlenga D, Salerno L, et al. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European psychiatry: the journal of the Association of European Psychiatrists. 2019;56:14-34. doi:https://doi.org/10.1016/j.eurpsy.2018. 11. 001. Go to original source...
  16. . Brown TE. ADD/ADHD and Impaired Executive Function in Clinical Practice. Current psychiatry reports. 2008;10(5):407-411. doi:https://doi.org/10.1007/s11920-008-0065-7. Go to original source... Go to PubMed...
  17. . Hupfeld KE, Abagis TR, Shah P. Living "in the zone": hyperfocus in adult ADHD. Attention deficit and hyperactivity disorders. 2019;11(2):191-208. doi:https://doi.org/10.1007/s12402-018-0272-y. Go to original source... Go to PubMed...
  18. . Perugi G, Pallucchini A, Rizzato S, et al. Current and emerging pharmacotherapy for the treatment of adult attention deficit hyperactivity disorder (ADHD). Expert Opin Pharmacother. 2019;20(12):1457-1470. doi:https://doi.org/10.1080/14656566.2019.1618270. Go to original source... Go to PubMed...
  19. . Shaw P, Stringaris A, Nigg J, et al. Emotion dysregulation in attention deficit hyperactivity disorder. The American journal of psychiatry. 2014;171(3):276-293. doi:https://doi.org/10.1176/appi.ajp.2013.13070966. Go to original source... Go to PubMed...
  20. . Soler-Gutiérrez A-M, Pérez-González J-C, Mayas J. Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. Plos one. 2023;18(1): e0280131. doi:https://doi.org/10.1371/journal.pone.0280131. Go to original source... Go to PubMed...
  21. . Grossman A, Avital A. Emotional and sensory dysregulation as a possible missing link in attention deficit hyperactivity disorder: A review. Front. Behav. Neurosci. 2023;17:1118937. doi:10.3389/fnbeh.2023.1118937. Go to original source... Go to PubMed...
  22. . Brandes-Aitken A, Powers R, Wren J, et al. Sensory processing subtypes relate to distinct emotional and behavioral phenotypes in a mixed neurodevelopmental cohort. Scientific Reports. 2024;14(1): 29326. doi:https://doi.org/10.1038/s41598-024-78573-2. Go to original source... Go to PubMed...
  23. . Barkley R. Neuropsychological Testing is Not Useful in the Diagnosis of ADHD: Stop It (or Prove It)! The ADHD Report. 2019;27(2):1-8. doi:https://doi.org/10.1521/adhd.2019. 27. 2. 1. Go to original source...
  24. . David AS, Fleminger S, Kopelman M, et al. Lishman's Organic Psychiatry: A Textbook of Neuropsychiatry (Revised 4th Ed) (4th ed.). John Wiley and Sons. 2009. Go to original source...
  25. . French B, Nalbant G, Wright H, et al. The impacts associated with having ADHD: an umbrella review. Front Psychiatry.2024;15:1343314.doi:https://doi.org/10.3389/fpsyt.2024.1343314. Go to original source... Go to PubMed...
  26. . Ohnishi T, Kobayashi H, Yajima T, et al. Psychiatric Comorbidities in Adult Attention-deficit/Hyperactivity Disorder: Prevalence and Patterns in the Routine Clinical Setting. Innovations in clinical neuroscience. 2019;16(9-10):11-16.
  27. . Katzman M, Bilkey T, Chokka P, et al. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017;17(1):302. Go to original source... Go to PubMed...
  28. . Salvi V, Migliarese G, Venturi V, et al. ADHD in adults: clinical subtypes and associated characteristics. Riv Psichiatr. 2019;54(2): 84-89. doi:https://doi.org/10.1708/3142.31249. Go to original source... Go to PubMed...
  29. . Instanes JT, Klungsøyr K, Halmøy A, et al. Adult ADHD and Comorbid Somatic Disease: A Systematic Literature Review. Journal of attention disorders. 2018;22(3):203-228. doi:https://doi.org/10.1177/1087054716669589. Go to original source... Go to PubMed...
  30. . Rogne A, Hassel B. Improvement of attention deficit/hyperactivity disorder (ADHD) in three adult men during testosterone treatment: a case series. Journal of medical case reports. 2022; 16(1):425. doi:https://doi.org/10.1186/s13256-022-03651-w. Go to original source... Go to PubMed...
  31. . Littman E, Dean JM, Wagenberg B, et al. ADHD in Females Across the Lifespan and the Role of Estrogen. The ADHD Report. 2021;29(5):1-8. doi:https://doi.org/10.1521/adhd.2021. 29. 5. 1. Go to original source...
  32. . Wilens T, Morrison N, Prince J. An update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adults. Expert Rev Neurother. 2011;11(10):1443-1465. doi:https://doi.org/10.1586/ern.11.137. Go to original source... Go to PubMed...
  33. . Li L, Zhu N, Zhang L, et al. ADHD Pharmacotherapy and Mortality in Individuals With ADHD. JAMA. 2024; 331(10):850-860. doi:https://doi.org/10.1001/jama.2024.0851. Go to original source... Go to PubMed...
  34. . Nanda A, Janga LSN, Sambe HG, et al. Adverse Effects of Stimulant Interventions for Attention Deficit Hyperactivity Disorder (ADHD): A Comprehensive Systematic Review. Cureus. 2023;15(9):e45995. https://doi.org/10.7759/cureus.45995. Go to original source... Go to PubMed...
  35. . Kolar D, Keller A, Golfinopoulos M, et al. Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatric disease and treatment. 2008;4(2):389-403. https://doi.org/10.2147/ndt.s6985. Go to original source... Go to PubMed...
  36. . Chang ZZ, Lichtenstein P, Halldner L, et al. Stimulant ADHD medication and risk for substance abuse. Child Psychol Psychiatry. 2014; 55(8):878-85. doi:https://doi.org/10.1111/jcpp.12164. Go to original source... Go to PubMed...
  37. . Cox D, Moore M, Burket R, et al. Rebound effects with long-acting amphetamine or methylphenidate stimulant medication preparations among adolescent male drivers with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2008;18(1):1-10. doi:https://doi.org/10.1089/cap.2006.0141. Go to original source... Go to PubMed...
  38. . Lensing M, Zeiner P, Sandvik L, et al. Psychopharmacological treatment of ADHD in adults aged 50+: an empirical study. Journal of attention disorders. 2015;19(5):380-389. doi:https://doi.org/10.1177/1087054714527342. Go to original source... Go to PubMed...
  39. . Nevels R, Weiss N, Killebrew A, et al. Methylphenidate and its under-recognized, under-explained, and serious drug interactions: a review of the literature with heightened concerns. Germ J Psychiatry. 2013;16:29-42.
  40. . Daniali S, Madjd Z, Shahbazi A, et al. Chronic Ritalin administration during adulthood increases serotonin pool in rat medial frontal cortex. Iran Biomed J. 2013;17(3):134-9. doi:https://doi.org/10.6091/ibj.1173.2013. Go to original source... Go to PubMed...
  41. . Verghese C, Abdijadid S. Methylphenidate. (StatPearls Publishing) (2024, October 29). Available from https://www.ncbi.nlm.nih.gov/books/NBK482451/.
  42. . Faraone S. The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neurosci Biobehav Rev. 2018;(87):255-270. doi:https://doi.org/10.1016/j.neubiorev.2018. 02. 001. Go to original source...
  43. . Stahl SM. Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press. 2013.
  44. . Moran LV, Skinner JP, Shinn, et al. Risk of Incident Psychosis and Mania With Prescription Amphetamines. The American journal of psychiatry. 2024;181(10):901-909. doi:https://doi.org/10.1176/appi.ajp.20230329. Go to original source... Go to PubMed...
  45. . Najib J, Wimer D, Zeng J, et al. Review of Lisdexamfetamine Dimesylate in Adults With Attention-Deficit/Hyperactivity Disorder. Journal of central nervous system disease. 2017;9:1179573517728090. doi:https://doi.org/10.1177/1179573517728090. Go to original source... Go to PubMed...
  46. . Fu D, Wu D, Guo H, et al. The Mechanism, Clinical Efficacy, Safety, and Dosage Regimen of Atomoxetine for ADHD Therapy in Children: A Narrative Review. Front Psychiatry. 2022;12: 780921. doi:https://doi.org/10.3389/fpsyt.2021.780921. Go to original source... Go to PubMed...
  47. . Ding YS, Naganawa M, Nabulsi N, et al. Clinical doses of atomoxetine significantly occupy both norepinephrine and serotonin transports: Implications on treatment of depression and ADHD. NeuroImage. 2014;86:164-171. doi:https://doi.org/10.1016/j.neuroimage.2013. 08. 001. Go to original source...
  48. . Buoli M, Serati M, Cahn W. Alternative pharmacological strategies for adult ADHD treatment: a systematic review. Expert review of neurotherapeutics. 2016;16(2):131-144. doi:https://doi.org/10.1586/14737175.2016.1135735. Go to original source... Go to PubMed...
  49. . Weiss M, Hechtman LT, Weiss G. ADHD in adulthood: A guide to current theory, diagnosis, and treatment. Taylor & Francis. 2001.
  50. . Safren SA, Otto MW, Sprich S, et al. Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behaviour research and therapy. 2025;43(7):831-842. doi:https://doi.org/10.1016/j.brat.2004. 07. 001. Go to original source...
  51. . Hirvikoski T, Waaler E, Alfredsson J, et al. Reduced ADHD symptoms in adults with ADHD after structured skills training group: results from a randomized controlled trial. Behaviour research and therapy. 2011;49(3):175-185. doi:https://doi.org/10.1016/j.brat.2011. 01. 001. Go to original source...




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