Recommendations for the screening, diagnosis and treatment of patients with comorbid attention deficit hyperactivity- and substance use disorder

ICASA consensus group, Máté Kapitány-Fövény, Csaba Barta, Cleo L Crunelle, Wim van den Brink, Franz Moggi, Maija Konstenius, Johan Franck, Frances R Levin, Geurt van de Glind, Corné Coetzee, Mathias Luderer, Arnt Schellekens, Frieda Matthys, Zsolt Demetrovics

Research output: Contribution to journalArticle

Abstract

Among patients with substance use disorders (SUD), adult attention deficit hyperactivity disorder (ADHD) is one of the most frequently co-occuring disorder. Those SUD patients with comorbid ADHD show earlier onset of substance use, more severe SUD and poor treatment outcomes. Therefore, early recognition of ADHD is highly rele - vant within this patient population. The results of available screening instruments may lay the foundation of timely ADHD diagnosis. Considering the integrated treatment of patients with a dual ADHD+SUD diagnosis, the applica tion of combined pharmaco- and psychotherapy is recommended. Based on the evidence-and consensus-based suggestions, prescription of long-acting methylphenidate, extended-release amphetamines and atomoxetine with up-titration might be the best choice in the treatment of patients who are either unresponsive to standard dose or characterized by therapy resistance. The main purpose of this manuscript is to establish a standing-ground for the effective screening, diagnosis and treatment of ADHD+SUD patients.

Original languageEnglish
Pages (from-to)435-447
Number of pages13
JournalPsychiatria Hungarica
Volume35
Issue number4
Publication statusPublished - 2020

Keywords

  • substance use disorders
  • adult attention deficit hyperactivity disorder
  • ADHD
  • comorbid ADHD
  • psychotherapy
  • pharmacotherapy

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