ADHD Treatment Options Should Extend Beyond the Medications Alone

Clinicians should include dietary and behavioral training in treatment plans for patients with attention-deficit/hyperactivity disorder (ADHD), which impacts the “entire person,” said Napoleon Higgins, Jr, MD, CEO of Bay Pointe Behavior Health, South East Houston Research Group, and Global Health Psychiatry, Houston, Texas, in a session at this weekend’s Psych Congress Elevate virtual meeting. He discussed diagnosis and treatment options for ADHD patients across all life stages.

“You have a lot of different [medication] options of treating ADHD, and many times you have to explore them all depending on the individual you are working with,” Dr Higgins told virtual attendees, and “we have to also understand that there are treatment options beyond medications.”

All patients are different and treatment options for ADHD should extend beyond just medications alone, especially in cases where children may have issues tolerating medications. Dr Higgins stresses that “we have to look at dietary and behavioral interventions.”

In children especially, diet plays an important role in not only physical growth, but neurologic development as well because “whatever helps the body also helps the mind.” Ensuring children are receiving a regular, balanced diet will increase their neurofunction and further assist in managing ADHD.

In discussing behavior training, Dr Higgins elaborated that when looking at the hyperactive symptoms, “behavioral training is going to be very good at helping the child understand themselves, understand the setting, and trying to set in place the ability to sit still and not be disruptive.”

“Behavioral training has not shown to be as good for inattentive symptoms … it is hard to pay attention to paying attention,” he said. Therefore, parental and family support are also key in setting expectations and helping to guide children through their ADHD management.

In addition to dietary and behavioral training, Dr Higgins expressed the importance of physical exercise to increase dopamine production, decrease stress and anxiety, and improve executive function. Physical exercise activities that require practice on focus and form have been shown to assist in finding balance, working with a team, and creating positive relationships with mentors.

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“When it comes to treatment options, I don’t say it’s an either/or realizing that in practicing, it’s an and/and,” Dr Higgins stresses, regarding medication and life style therapies working in tandem.

When transitioning to discussing treatment options into adulthood, there is a lot of overlap with maintaining a healthy lifestyle as well as behavioral modifications, just on a larger scale.

“We have to look at the coaching that comes with adulthood, in that many adults were never treated as children, never took any medications, never identified until they became older,” Dr Higgins said.

Adult behavioral modifications will focus on time management, self-monitoring, goal setting, and creating a routine and schedules to avoid distractions. Adults also must pay more attention to their emotional responses and being able to handle their reactions, especially in highly charged situations. There is also an element of meditation that adults should incorporate into their routine to help them stay on track.

Dr Higgins concluded the session by stressing that “ADHD impacts the entire person throughout the entire journey of life.”

—Heather Flint

Reference

Higgins NB, Jr. Lost in translation: addressing the unmet needs of adult patients with ADHD. Presented at: Psych Congress Elevate; June 11–13, 2021; Virtual.