Treatment Monitoring
Best practice suggests that all adults with a new ADHD diagnosis, uncontrolled symptoms, or any change in medication should be seen within 30 days and monthly thereafter until the symptoms and function improve. When symptoms and function improve, visits every 3-6 months are recommended.
During the follow-up visit or appointment, consider the following:
- Review target symptoms and function
- Review medication use and effects, considering any dose or time of administration modifications (inquire about how long the effects last and any changes in symptoms or medications effects during a day)
- Monitor for treatment adherence and side effects
- Monitor vital signs
- Review information from patient (when available)
- Adjust therapy
- Provide patient education and advice
- Monitor for signs of substance abuse/dependence
Prognosis
About 60% of adults experience improvements in quality of life and symptom reduction in response to treatment. Comorbid conditions such as mood and anxiety disorders are also highly treatable.
Treatment Discontinuation
There is no evidence from controlled trials to indicate how long the patient with ADHD should be treated with medications. Trials without medications and “medication holidays” can be used to assess the patient's functioning without pharmacotherapy. Improvement may be sustained when the drug is either temporarily or permanently discontinued. However, the evidence of the effectiveness and safety of these methods is lacking in adults.
