Attention Deficit Hyperactivity Disorder (ADHD) is a psychiatric condition that affects almost every aspect of daily life. Initially ADHD was understood as a childhood disorder. Over time psychiatrists noticed that adults also continue to experience symptoms.
They may have difficulties with organization, maintaining concentration, emotional regulation, and impulsivity. These neurocognitive deficits often interfere with people’s daily routine, work performance, and relationships.
ADHD is also frequently linked to other psychiatric conditions, especially substance misuse, mood disorders, anxiety, and personality disorders.
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Diagnosing Adult ADHD
Adults generally show fewer motor restlessness symptoms due to their ability to hide or control them. Even so, adults may remain overactive, inattentive, impulsive, poorly organized, and emotionally unstable.
Diagnosing ADHD starts with a detailed clinical history that includes symptoms, including those noticed in childhood. Different assessment tools are used, including self-report and observer-based questionnaires.
A diagnosis alone does not automatically mean that treatment is necessary. The decision depends on the severity of symptoms and the degree of psychological, social, or occupational impairment. When treatment is indicated, it may include medication, psychotherapy, and psychoeducation.
How Medication for Treatment of ADHD Works
ADHD is linked to an imbalance of neurotransmitters, especially dopamine and noradrenaline, in the prefrontal cortex, a brain region responsible for focus, attention, and impulse control. Stimulant medications counteract this imbalance by slowing the reuptake of dopamine and noradrenaline. This allows the neurotransmitters to remain active longer, increasing alertness, concentration, and mental performance.
Atomoxetine works differently. It selectively blocks the reuptake of noradrenaline, which helps improve attention and reduce impulsive behaviour. Guanfacine also affects noradrenaline signaling, although its exact mechanism in ADHD is not fully understood.
Available Medication for Treatment of ADHD
For the treatment of ADHD with medication, several groups of drugs are used. Stimulants such as methylphenidate (MPH) and amphetamine are considered first-line treatment. Atomoxetine (ATX), a noradrenaline reuptake inhibitor, also plays an important role and is not classified as a stimulant.
Some antidepressants, such as Bupropion or Venlafaxine, may also be used when other treatments are not suitable.
The main active substances used today for adult ADHD in Dubai include atomoxetine, methylphenidate, and lisdexamfetamine. Treatment usually begins with a low dose, which is gradually increased until symptoms improve.
Treatment of Adult ADHD with Methylphenidate
Methylphenidate is a psychostimulant used to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. It was first introduced to the market in 1954 under the brand name Ritalin.
Method of Use
Methylphenidate is available in several formulations that differ mainly in the way the active substance is released. These pharmaceutical differences determine whether the medication takes effect immediately or is released gradually over a longer period, which influences the duration of action. The choice of preparation depends on the patient’s individual needs. Immediate-release formulations allow flexible dosing but require more frequent intake, while extended-release formulations provide a steadier and longer effect, which can be especially useful in daily routines or school settings.
Immediate-Release Formulations
This form of methylphenidate is released quickly after ingestion and reaches its effective blood level within 30 to 60 minutes. The effect usually lasts three to four hours, which often makes multiple daily doses necessary. In Dubai, the immediate-release version is available under the brand name Ritalin. These tablets are often taken in the morning and afternoon to maintain consistent symptom control throughout the day, though they need to be taken at regular intervals.
Extended-Release Formulations
To achieve a longer-lasting effect and reduce the number of daily doses, extended-release methylphenidate was developed. These formulations release the active substance continuously over an extended period. This is achieved through specialized pharmaceutical technology that binds the medication in different layers or reservoirs. As a result, methylphenidate is released in several phases: an initial immediate release followed by a slow, continuous release over several hours. In Dubai, the extended-release form of methylphenidate is available under the brand name Concerta.
Atomoxetine for Adult ADHD
Atomoxetine is approved for adults when ADHD symptoms were present during childhood. It is often chosen when stimulants are not tolerated or not advisable.
Atomoxetine, marketed in Dubai under the brand name Strattera, is a selective norepinephrine reuptake inhibitor. It is the first ADHD medication classified as a non-stimulant and therefore not subject to narcotics regulations.
Clinical studies have shown that atomoxetine significantly reduces the core symptoms of ADHD: inattention, hyperactivity, and impulsivity. Improvements have also been observed in psychosocial areas such as self-esteem and family interactions. Its effectiveness is comparable to that of methylphenidate, and the response rate is similarly around 80 percent. Although many patients begin to notice an effect after about one week, it generally takes four to six weeks to reach full therapeutic benefit.
A major advantage of atomoxetine is that a single morning dose provides continuous symptom control until the next day. Atomoxetine is often considered when patients continue to experience symptoms at critical times—such as early in the morning—despite treatment with methylphenidate, or when methylphenidate is poorly tolerated. Some patients also prefer a non-stimulant option and welcome having an alternative. Atomoxetine can be particularly suitable for individuals with psychosis-like symptoms, such as reduced reality proof.
Atomoxetine is generally well tolerated and has no potential for misuse or dependence. The most common side effects include abdominal pain, headaches, and loss of appetite.
Lisdexamfetamine in Adult Therapy
Lisdexamfetamine is used in the treatment of attention-deficit/hyperactivity disorder (ADHD). It belongs to the group of synthetic amphetamines and is regulated under narcotics legislation. The substance is a prodrug that is converted in the body into its active form, dexamfetamine. In Dubai, lisdexamfetamine is marketed under the brand name Vyvanse.
Mechanism of Action
Lisdexamfetamine itself is pharmacologically inactive. After oral intake, it is rapidly absorbed in the gastrointestinal tract and converted primarily by red blood cells into dexamfetamine, the active metabolite.
The substance increases the availability of the neurotransmitters norepinephrine and dopamine in the synaptic cleft by inhibiting their reuptake. The exact way in which this process leads to improvement in ADHD symptoms is not yet fully understood.
Following oral administration, lisdexamfetamine dimesylate is quickly absorbed in the gastrointestinal tract. It is converted in the bloodstream into dexamfetamine through the hydrolytic activity of red blood cells. The drug is eliminated mainly through the kidneys.
The plasma half-life of lisdexamfetamine is generally less than one hour. Because the half-life of dexamfetamine is around 11 hours, a single dose of lisdexamfetamine provides symptom control throughout the day.
Side Effects
The most common side effects of lisdexamfetamine include gastrointestinal discomfort, dizziness, headaches, and increased restlessness, sometimes accompanied by sleep disturbances.
Limited Approval for Guanfacine and Dexamfetamine
Guanfacine and dexamphetamine have not been sufficiently studied in adults. Because evidence is limited, they are not approved in Dubai.
Possible Side Effects of ADHD Medication
Stimulant medications such as methylphenidate and lisdexamfetamine may cause sleep problems, reduced appetite, weight loss, gastrointestinal discomfort, high blood pressure, heart palpitations, headaches, inner restlessness, and irritability. Because of frequent sleep disturbances, these medications should not be taken late in the day.
Atomoxetine may also lead to decreased appetite, digestive symptoms, and elevated blood pressure.
Treatment of ADHD With Medication in Dubai. Summary
For many years ADHD was mistakenly regarded as a disorder that only affects children and adolescents. However, research has shown that symptoms often continue into adulthood.
ADHD is of major social and economic importance. It can cause significant psychological and social impairment. Proper treatment of ADHD can reduce symptoms and improve functioning. For many adults, medication for treatment of ADHD plays an essential role in daily functioning. When doses are adjusted carefully and monitored professionally, medications help reduce inattention, impulsivity, and emotional instability. They support better performance at work, more stable relationships, and improved overall quality of life.
Beginning the treatment of ADHD with medication early is highly relevant. Untreated ADHD has a negative impact on many areas of life; it carries a high risk of additional psychiatric disorders and contributes to significant societal costs.
The evidence shows that methylphenidate, lisdexamfetamine, and atomoxetine can effectively reduce symptoms in adults. Individual dose adjustments are crucial for achieving the best response.
