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Adolescents with Attention-Deficit/Hyperactivity Disorder: An Overview of Empirically Based Treatments

BARKLEY, RUSSELL A. PhD

Journal of Psychiatric Practice: January 2004 - Volume 10 - Issue 1 - p 39-56
ARTICLES

The author first presents an overview of attention-deficit/hyperactivity disorder (ADHD) as it presents in adolescents. He reviews what is known about the predominantly inattentive subtype in adolescents, the persistence of symptoms into this developmental phase, and comorbid disorders in adolescent patients with ADHD. The author then reviews treatments for adolescents with ADHD for which there is some empirical support in the scientific literature. He first discusses common assumptions concerning the treatment of ADHD and evidence for or against these assumptions. Information on therapies that have been shown to be ineffective or the benefit of which is unproven are then described. These include cognitive-behavioral therapy and social skills training. The author then presents an overview of what is known about the medication treatment of ADHD and discusses how this information is applicable to adolescents with the disorder. Four main classes of drugs are discussed: stimulants, noradrenergic reuptake inhibitors, tricyclic antidepressants, and antihypertensive agents. The author then reviews the use of several psychosocial interventions, including contingency management strategies, parent training in behavior management methods, and teacher training in classroom management, and discusses how these strategies can best be used for adolescents with ADHD. The author then discusses the use of combined treatment with psychosocial interventions and medication. Finally, information on the use of physical exercise as therapy for adolescents with ADHD is discussed.

BARKLEY: Medical University of South Carolina.

Please send correspondence and reprint requests to: Russell A. Barkley, PhD, Department of Psychiatry, Medical University of South Carolina, 19 Hagood Ave., Room 910, Charleston, SC 29425.

Author support: While preparing this paper, the author was supported by the Office of Research, College of Health Professions, Medical University of South Carolina and by a grant from the National Institute of Child Health and Human Development. The author serves occasionally as a consultant to Shire Pharmaceuticals, Eli Lilly Co., and Pfizer and also receives book and newsletter royalties from Guilford Publications.

© 2004 Lippincott Williams & Wilkins, Inc.