The most effective treatment remains stimulant medication (methylphenidate, dexamfetamine) or the non-stimulant atomoxetine. They appear to work by enhancing the action of the naturally occurring neurotransmitters, dopamine, and noradrenaline.

Hollis can’t understand why there is so much resistance to drug treatment when the drugs have been shown to be more effective and safer than many other commonly used drugs. “If your kid had diabetes, you wouldn’t hold back on starting insulin,” he says.

Kustom thinks online tests are useful but limited. “They are a snapshot and can be a useful aid, but will never replace clinical assessment. You need to find out how the person has functioned since childhood, and screen to see whether they have other physical and mental health problems.” But he acknowledges the tests can be particularly helpful in ruling out ADHD or adding weight to a diagnosis in complex cases.

ADHD usually presents in childhood, but the impairing symptoms persist into adulthood in up to 70% of cases. Undiagnosed and untreated adults often have problems holding down a job or staying in a relationship. “This disorganization and procrastination affects jobs and relationships, leads to anger management problems, mood swings, and high-stress levels. The stress may come out as depression and anxiety, alcohol and substance abuse and physical problems such as high blood pressure,” explains Kustom.

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