Abstract
Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is a contentious diagnostic issue, which has been increasing in prevalence in recent years, and is often comorbid with other psychiatric disorders. This report presents a detailed account of a clinical case involving a middle-aged man with a history of recurrent depressive episodes and an unsubstantiated diagnosis of ADHD, treated with stimulants. There is persistent debate around the use of psychostimulants both in adult ADHD and in the treatment of depression. Despite promising activating properties, psychostimulants carry significant risks of misuse and substance use disorder. In this report, we consider the potential benefits and adverse effects of stimulants in the treatment of adult ADHD and mood disorders and review the learning points of this complicated, but not uncommon, clinical case.
Highlights
There has been a considerable increase in diagnosing adults with Attention-Deficit/Hyperactivity Disorder (ADHD) and subsequent use of psychostimulants [1]
ADHD is characterised by persistent inattention and/or hyperactivity and impulsivity beginning before age of 12 and causing impairment in two or more settings [5]
Given the lack of support for a diagnosis of ADHD, risk of cardiac adverse effects, and the patient’s aggression, impulsivity, and mood variability over his admission, we suggested that he discontinue amphetamine
Summary
There has been a considerable increase in diagnosing adults with Attention-Deficit/Hyperactivity Disorder (ADHD) and subsequent use of psychostimulants [1]. Major depressive disorder (MDD) is characterised by depressed mood and fatigue, among other symptoms [5], and it is not unusual for effective treatment to necessitate trials of many different pharmaceutical agents [6]. Psychostimulants, such as methylphenidate and amphetamine, have activating properties. It is intuitively possible that these agents may have a role in the treatment of MDD In both cases, an examination of the evidence surrounding psychostimulants in clinical practice is important to address. Written informed consent to present this case was obtained from the patient prior to writing this report
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