Question:  What exactly is an ADHD specialist?

Answer: Unfortunately there is no formal training or certification to reflect a certain minimal level of competence in the diagnosis and treatment of ADHD.  The most important factor in determining a clinician’s expertise in treating ADHD is experience.  What percentage of their current practice is ADHD?  How long have they been treating it?  Experience is especially important for doctors who realize that every patient is a teacher as well as a student. 

There are frequent seminars and short courses available.  Several good books are also available.  Any book written by Dr. Edward Hallowell is based on good scientific studies and his years of clinical experience.  His most recent book is Delivered from Distraction.  There is a lot of material available online through CHADD.org and ADD.org. 

Chances of getting an accurate diagnosis are better when seeing a specialist.  One particular problem is the need to identify any other medical and/or mental health problems before beginning treatment for ADHD.  Studies show up to 85% of ADHD adults have at least one other significant problem like anxiety, mood disorder, impulse control disorder, or substance abuse.  Specialists are generally more comfortable and experienced with the full range of medication options as well as the cognitive behavioral component of treatment.  They are usually more comfortable with higher doses required by some patients and combinations of 2 or more medications.

Question: Can my physician diagnose and treat ADHD in adults or is a specialist required?

Answer: In a recent survey the majority of primary care doctors felt comfortable diagnosing and treating anxiety disorders (85%) and depression (95%) in adults.  Only 15% were comfortable diagnosing and treating ADHD.  The main reason the majority of primary care doctors have not become comfortable with ADHD is that the best medications are stimulants that in many states require a special prescription and are more likely to cause problems with regulatory agencies or diversion of medication for non-medical purposes.  Unfortunately some doctors will prescribe non-controlled medications such as Strattera, Wellbutrin XL or other medications as the first line treatment.  Multiple studies have shown that stimulants are about twice as effective as other medications for ADHD.  Some people may wrongly assume that their suboptimal response to non-stimulants means they’re not really ADHD or that treatments are not particularly useful.