What Is ADHD?

What is ADHD

The following is the official diagnostic criteria from the American Psychiatric Association manual. American Psychiatric Association's Diagnostic and Statistics Manual (DSM-IV) criteria for Attention Deficit (ADHD). This file contains American Psychiatric Association's Diagnostic and Statistics Manual (DSM-IV) criteria for Attention Deficit (ADHD), which will now be broken into three distinct categories. This is provided for information purposes only. An accurate diagnosis is the important first step in addressing any needs; such a diagnosis can only be performed by a qualified professional who's familiar with the individual's history.
Attention-deficit/Hyperactivity Disorder A. Either (1) or (2):
1.       Inattention: at least *6* of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:  
a.       often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities;
b.      often has difficulty sustaining attention in tasks or play activities;
c.       often does not seem to listen to what is being said to him/her;
d.      often does not follow thru on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions);
e.      often has difficulties organizing tasks and activities;
f.        often avoids or strongly dislikes tasks (such as schoolwork or homework) that require sustained mental effort;
g.       often loses things necessary for tasks or activities (e.g., school assignments, pencils, books, tools, or toys);
h.      is often easily distracted by extraneous stimuli;
i.         often forgetful in daily activities;
Hyperactivity-Impulsivity: at least *4* of the following symptoms of hyperactivity-impulsivity have  persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
a.       often fidgets with hands or feet or squirms in seat;
b.      leaves seat in classroom or in other situations in which remaining seated is expected;
c.       often runs about or climbs excessively in situations where it is inappropriate (in adolescents or adults)
d.      may be limited to subjective feelings of
e.      restlessness);
f.        often has difficulty playing or engaging in leisure activities quietly.
g.       often blurts out answers to questions before the questions have been completed; often has difficulty waiting in lines or awaiting turn in games or group situations.
h.      Onset no later than age 7.
i.         Symptoms must be present in 2 or more situations (e.g., at school, work, and at home).
j.        The disturbance causes clinically significant distress or impairment in social, academic, or occupational functioning.
k.       Does not occur exclusively during the course of PDD, Schizophrenia or other Psychotic Disorder, and is not better accounted for by Mood, Anxiety, Dissociative, or Personality Disorder.
o    314.00 ADHD, Predominantly Inattentive Type if criterion A(1) is met but not criterion A(2) for the past 6 months.
o    314.01 ADHD, Predominantly Hyperactive-Impulsive Type: if criterion A(2) is met but not criterion A(1) for the past 6 months.
o    314.01 ADHD, Combined Type: if both criteria A(1) and (2) are met for past 6 months [note: should this be 314.02? It's not clear – RDF]
o    314.9 is ADHD NOS, for other disorders with prominent symptoms of attention-deficit or hyperactivity-impulsivity that do not meet criteria above. 


Adderall For ADHD

Currently, 4.4% of the adult population has ADHD (Attention Deficit Hyperactivity Disorder). This disorder is present from childhood, but many times it is not diagnosed until the person reaches adulthood and takes on more responsibility such as what is required when managing finances and jobs, and when interacting with spouses or significant others or their children. Under these additional demands, the attributes of ADHD (inattention, distractibility, and impulsivity) may become more prevalent.

Dr. Darvin Hege, an Atlanta psychiatrist, says it is important for people who have become depressed, overly anxious, or have turned to alcohol, drug, or medication abuse to help them deal with the stresses of life, be evaluated for ADHD. Many times if a patient seeks help for these concerns, " the overlying problem of depression, anxiety, or substance abuse may be diagnosed and treated. However, the foundational problem of ADHD may be missed. Unless the ADHD is successfully treated, the person may improve temporarily but still struggle unnecessarily and be more prone to relapsing to another bout of depression, anxiety, or substance abuse".

How could it be that the foundational problem of ADHD may be missed? Dr. Hege advises that the symptoms of ADHD can change from childhood to adulthood. Since the hyperactivity portion of ADHD tends to diminish in adults, the diagnosis of ADHD may be missed in an adult. Inattentiveness generally remains from childhood, however, and this is the predominant symptom of adult ADHD. The medications that are prescribed for ADHD help the inattentiveness of ADHD more than the hyperactivity of the disorder, so these medications can be very successful in helping with core symptoms. One of the medications he commonly prescribes for ADHD is Adderall.

Adderall has been around for about 20 years and was first marketed as a weight loss and diet control drug called Obetrol. In 1996, the FDA approved Adderall for ADHD treatment and it has since become one of the more widely prescribed medications for the treatment of the disorder. Doctors and patients who use the drug say it has less "peaks and valleys" than Ritalin, so it is more user-friendly.

Adderall is a psychostimulant. In other words, it is a central nervous system stimulant or an amphetamine. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control.

One reason Dr. Hege uses Adderall for ADHD is that it is a mixture of four drugs from the amphetamine family that provides a broad spectrum of coverage. He notes that there are several pros to this group of drugs:

  • they take effect quickly (in about one hour).
  • they leave the blood quickly (in about 4-12 hours). Because of this, you do not need to take the medication every day so you can take them on a day when you'll need the extra assistance.
  • 75-80% of people who have ADHD improve when takingAdderall for ADHD or something from the psychostimulant group of medications.

Anything with a "pro" has to have a "con" and there are some cons to consider when taking Adderall for ADHD:

  • Because the medicine only works for 4-12 hours, work or study in the afternoon or evening may require additional doses.
  • Because it takes about one hour for the medication to take effect, if you have trouble getting up for the alarm clock or getting organized in the morning, you will have to wait for the medication to take effect.
  • If you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam) within the past 14 days, you should not take Adderall. Serious, life-threatening side effects can occur if you take Adderall before the MAO inhibitor has cleared from your body.
  • It has a significant risk for abuse and/or addiction.

The most common side effects of Adderall are restlessness, dizziness, insomnia, headache, dryness of the mouth, and weight loss.

Dr. Hege recommends an ADHD evaluation if you or those around you have concerns about your inattention, impulsiveness, and distractibility. 

Dr. Darvin Hege has 25 years of experience dealing with patients who may fit the criteria for ADHD and may need a medication like Adderall for ADHD. He offers evening and weekend office hours at his Atlanta, GA practice. Call today at 770-458-0007 to discuss getting an ADHD evaluation and for help deciding the most effective and safest treatment.