Medication treatment for ADHD
Medication for ADHD at our practice in Trier is an important component of a holistic therapy concept and is always based on a thorough ADHD diagnosis. The goal of medication therapy is to reduce key ADHD symptoms such as inattention, impulsivity, and restlessness, and to facilitate psychotherapy and daily life.
As a specialist in psychiatry and psychotherapy, I adhere to current medical guidelines and employ a structured three-stage treatment model. Medication selection and adjustment are carried out individually and in close consultation with the patients, and in the case of children and adolescents, also with their parents.
The 3-stage model of drug treatment for ADHD
Step 1: First-line medication
The first treatment stage involves medications considered first-line treatment. These have proven scientifically effective in the treatment of ADHD and are frequently used. The goal is a significant improvement in attention, concentration, and self-regulation with the best possible tolerability. Medications such as methylphenidate (e.g., Medikinet© or Ritalin©) or lisdexamfetamine (e.g., Elvanse©) are used for this purpose. If there are contraindications, concerns, or if the patient prefers a different approach, a different stage of therapy can be used as initial treatment.
The effectiveness and potential side effects are regularly monitored, and the treatment is individually adjusted. Before treatment begins, an individual risk profile is always created, and preliminary diagnostic tests are performed, including blood work and ECG examinations.
Stage 2: Alternatives in case of insufficient efficacy or tolerability
If first-line medication is not sufficiently effective or is not well tolerated, alternative medication options are used. These can be particularly useful if there are comorbidities or if certain symptoms are predominant. Medications such as atomoxetine (e.g., Strattera©) are used for this purpose.
Even at this stage, treatment is closely monitored and geared towards the personal needs of those affected.
Level 3: Individual combinations and specialized strategies
In the third stage, individualized treatment strategies are developed. These may include adapted medication regimens or combinations, particularly in complex cases or with additional psychological stressors. Some antidepressants, such as venlafaxine or bupropion, can also be effective in treating ADHD, although this is considered "off-label" use. This stage requires particularly careful specialist medical supervision.
Combination of medication and psychotherapy
Medication for ADHD is most effective when combined with cognitive behavioral therapy. Medication can help stabilize symptoms, while psychotherapy provides strategies for daily life and supports long-term changes.
The decision for or against drug treatment is always made jointly and reviewed regularly.