Adult attention deficit hyperactivity disorder (ADHD) with comorbid addictive disorder. Therapeutic challenges using the example of a survey of clinical practice

Abstract

ADHD in childhood and adolescence is characterized by the symptoms hyperactivity, impulsivity, and inattentiveness; these symptoms may persist into adulthood or may manifest as restlessness, emotional instability, and disorganized behavior. In adults ADHD often occurs with increased substance use and is associated with an early onset of substance use, development of severe addiction, and decreased treatment effectiveness. This overview will present and critically discuss current study results and evidence-based and consensus-oriented recommendations that ensure the most adequate care for patients with ADHD and addictive disorder. For drug therapy, the current S3 guideline recommends methylphenidate, amphetamine salts, and atomoxetine, among others. Treatment of adult patients with ADHD and addiction with stimulants tends to be viewed critically; if required, long-acting medications should be used. Integrated treatment of ADHD and addiction, consisting of a combination of pharmacotherapy and psychotherapy, is recommended.