From: Adult ADHD and comorbid disorders: clinical implications of a dimensional approach
Psychiatric comorbidity | Treatment priority |
---|---|
Bipolar disorder | Treat bipolar disorder first Treat ADHD once bipolar disorder is stabilized Refer to specialist |
Depression Mild or dysthymia | Treat the most impairing condition first Consider treating ADHD first Consider cognitive behavioural therapy (CBT) |
Moderate or severe | Treat depression first and assess suicide risk Stimulants can be combined with most antidepressants with monitoring Consider CBT |
Anxiety disorders | Treat the most impairing disorder first “Start low, go slow” but titrate up to a therapeutic dose Consider adjunctive CBT Refer to specialist for augmentation with stimulants |
SUD | Treat SUD first using multimodal interventions including CBT and self-help groups Treat ADHD once SUD stabilized Some cases may require concurrent treatment of SUD and ADHD |
Personality disorders Borderline | Treating ADHD may facilitate psychological treatments for borderline personality disorder |
Antisocial | Complex, individualized and comprehensive intervention is recommended |