Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard

Adverse events should also be reported to Takeda UK Ltd. at: AE.GBR-IRL@takeda.com.

Initiated, developed and funded by Takeda
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Prescribing information and adverse event reporting
Management of Adult ADHD Pack - ADHDeForum
If adult with ADHD has made informed choice not to have F i r s t li n e m ed i ca t i on Adult (aged ≥18 years) P re- t re at me n t O ff er If ADHD symptoms are still Lisdexamfetamine 4 If adult with ADHD has made informed choice Consider I f a d e q u a t e r e s po ns e I f a d e q u a t e r e s po ns e I f a d e q u a t e r e s po ns e M a i n ta i n treatment Alternative first line medication If 6-week trial of chosen stimulant at Second line medication If symptoms are responding to Second line medication If adult cannot tolerate lisdexamfetamine Ti t r at e d o se a cc o r d i ng Ti t r at e d o se a cc o r d i ng Consider non- Consider common If adult with ADHD has LDX Methylphenidate † Methylphenidate † Lisdexamfetamine 4 LDX Dexamfetamine* 4 Atomoxetine 4 OR I f a d e q u a t e r e s po ns e I f a d e q u a t e r e s po ns e Maintain treatment Third line medication Maintain treatment Maintain treatment Atomoxetine 4 Titrate dose according Maintain treatment Consider non- If adult with ADHD has made Obtain a second If adult with ADHD is If adult with ADHD has Consider non- Depression Anxiety Bipolar Borderline Substance Autism Antisocial OR Consider non- These resources on comorbid ADHD in adults with selected common co-existing conditions disorders disorder personality disorder use disorders spectrum disorder personality disorder have been produced by Takeda in collaboration with a clinical Steering Group diagnosed with ADHD co-existing conditions b a seli n e a ssessme n t 4 me d i c at i o n 4 pharmacological treatment 4 causing a significant impairment in ≥1 domain after environmental modifications have been implemented and reviewed made an informed choice not to have medication OR has difficulty adhering to medication non-pharmacological treatment 4 not to have medication OR has difficulty adhering to medication OR found medication to be ineffective or cannot tolerate it at o p t im a l d o se a nd monitor 4 as second line medication adequate dose  has not derived enough benefit in terms of reduced ADHD symptoms and associated impairment lisdexamfetamine  but patient cannot tolerate the longer effect profile or methylphenidate t o S m P C f o r d o se o p t imis at i o n 10-16 t o S m P C f o r d o se o p t imis at i o n 9 Ti t r at e d o se a cc o r d i ng t o S m P C f o r d o se o p t imis at i o n 17 Ti t r at e d o se a cc o r d i ng t o S m P C f o r d o se o p t imis at i o n 18 pharmacological treatment 4 medication OR has difficulty adhering to medication OR found medication to be ineffective or cannot tolerate it If symptoms have not responded to separate 6-week trials of both first line stimulants, having considered alternative preparations and adequate doses at optimal dose and monitor 4 at optimal dose and monitor 4 at optimal dose and monitor 4 to SmPC for dose optimisation 18 at optimal dose and monitor 4 pharmacological treatment 4 pharmacological treatment in combination with medication 4 opinion or refer to a tertiary service 4 unresponsive to ≥1 stimulant benefited from medication but symptoms are still causing a significant informed choice not to to be ineffective or and 1 non-stimulant impairment in ≥1 domain cannot tolerate it OR found medication OR has difficulty adhering to medication have medication Ti t r at e d o se a cc o r d i ng to SmPC f o r d o se o p t imis at i o n 9 Ti t r at e d o se a cc o r d i ng to SmPC f o r d o se o p t imis at i o n 10-16 Blurred picture of childrenBlurred picture of a boyBlurred picture of a girlBlurred picture of a people

Please scroll through the management optimisation algorithm from left to right, following the appropriate treatment pathway for your adult patient (aged ≥18 years) diagnosed with ADHD.

At each step in the pathway, supporting information is available by clicking on the orange 'Read more' icon and illustrative expert clinical case studies are accessible by clicking on the blue 'Case study' icons at the end of individual treatment pathways. References are viewable at any time by clicking on the pink 'References' icon.

ADHD in adults

ADHD is among the most common neurodevelopmental disorders of childhood that often persists into adulthood and old age. 1

Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment. 1

Recognition of ADHD in adults

Prevalence

In 2014, the prevalence of ADHD medication use in adults in the United Kingdom was estimated as 0.05%(95% confidence interval 0.05–0.05) 2 in relation to an estimated global total adult ADHD prevalence (2016) of ~ 2.8%(range 0.6–7.3%), 3 suggesting a considerable proportion of adults with ADHD remain untreated.

Key groups of individuals to be aware of

Certain groups may have an increased prevalence of ADHD compared with the general population: 4

  • people with a close family member diagnosed with ADHD;
  • people with epilepsy;
  • people with neurodevelopmental disorders;
  • adults with a mental health condition;
  • people with a history of substance misuse;
  • people known to the youth or adult criminal justice system; and
  • people with acquired brain injury.

ADHD is likely to be under-recognised in women. They are less likely to be referred for assessment for ADHD, may be more likely to have undiagnosed ADHD and may be more likely to receive an incorrect diagnosis of another mental health or neurodevelopmental health condition. 4

Adults who should be screened for ADHD include those with any chronic psychiatric disorder, including anxiety, depression, cyclothymia, personality disorder, bipolar disorder or substance abuse disorders, or those with multiple physical diseases. 1

Identification of ADHD in adults

What does adult ADHD look like?

Examples of ‘red flags’ for ADHD in adults include: 5

  • organisational skill problems;
  • erratic work/academic performance;
  • anger control problems;
  • family/marital problems;
  • difficulty maintaining organised household routines, sleeping patterns and other self-regulating activities;
  • difficulty managing finances;
  • addictions such as substance abuse, compulsive shopping, sexual addiction, overeating, compulsive exercise, video gaming or gambling;
  • frequent accidents either through recklessness or inattention;
  • problems with driving;
  • having a direct relative who has ADHD;
  • having to reduce course load or having difficulty completing assignments in education; and
  • low self-esteem or chronic under-achievement.

Screening for ADHD

The Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist is designed to help healthcare professionals screen their adult patients for signs and symptoms of adult ADHD. 6 Screening for adult ADHD can be achieved using six questions, which take about five minutes to complete. 6-8 This is not a diagnostic tool; however, this highly sensitive screener can help you in identifying adult patients who have a high likelihood of being subsequently diagnosed with adult ADHD. 6-8

World Health Organization Adult ASRS-v1.1 Symptom Checklist
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* Dexamfetamine is not licensed for the treatment
of ADHD in adults in the United Kingdom.
† Not all Methylphenidate preparations are licensed
for the treatment of ADHD in adults in the United Kingdom. ADHD, attention deficit hyperactivity disorder; CS, case study;
LDX, lisdexamfetamine; Pi, prescribing information;
SmPC, Summary of Product Characteristics.

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C-APROM/GB/NS/1205 March 2025