Posted on: Saturday, February 5, 2005

PRESCRIPTIONS
Untreated adult ADHD could mess up your life

By Landis Lum

Q. I was always procrastinating and forgetful. My doctor diagnosed me with ADHD (attention deficit hyperactivity disorder). I'm doing much better on Bupropion. How did she know I had ADHD?

A. Adults with ADHD often had ADD (attention deficit disdisorder) with hyperactivy as a child, and then developed more inattention-type symptoms later, sometimes leading to car crashes, failure to renew licenses or get safety inspections, problems doing school or college assignments, and low self-esteem.

Separation and divorce rates are twice as high in adults with ADHD, who are also four times more likely to change jobs frequently.

If you answer yes to four of the following six questions, you may have ADHD:

1. Do you sometimes or often have trouble wrapping up the final details of a project once the challenging parts have been done?

2. Do you sometimes or often have difficulty getting things in order when you have to do a task that requires organization?

3. Do you sometimes or often have problems remembering appointments or obligations?

4. When you have a task that requires a lot of thought, do you often avoid or delay getting started?

5. Do you often fidget or squirm with your hands or feet when you have to sit down for a long time?

6. Do you often feel overly active and compelled to do things, like you were driven by a motor?

If you think you may have ADHD, check out more sample questions at www.med.nyu.edu/psych/assets/adhdscreen18.pdf.

If the problems mentioned above are present in two or more settings (work, home, school, etc.) and result in significant impairment in social, academic or occupational functioning, then it's ADHD.

Doctors, however, will also make sure another problem — such as a mood, psychotic or personality disorder — isn't the primary problem.

Up to 50 percent of ADHD patients also have anxiety disorders, while 30 percent also have depression or bipolar illness.

Those with ADHD have changes in those areas of the brain involving attention and ability to focus.

The heritability of ADHD is 70 percent — one of the highest for psychiatric disorders.

If you have ADHD, you can get counseling and join a support group. Check out www.chadd.org.

Also, if you have ADHD, drugs such as Bupropion, Strattera, Desipramine or methylphenidate are usually needed.

Amphetamines such as Adderall can elevate blood pressure — and because of the prospect of indefinite treatment and possible abuse — are inferior choices for adults.

A study published in January 2003 in the journal Pediatrics by Dr. Timothy Wilens and others from Massachusetts General Hospital concluded that children treated with stimulant drugs for their ADHD had reduced risk of later alcohol and drug abuse.

Don't procrastinate if you feel you have these symptoms. Proper treatment is crucial to improve social functioning, self-esteem and career development.

Dr. Landis Lum is a family-practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawai'i's John A. Burns School of Medicine. Send questions to: Prescriptions, Island Life, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; islandlife@honoluluadvertiser.com; or fax 535-8170. This column is not intended to provide medical advice.