Response and Side Effects Using Stimulant Medication in Older Adults With ADHD: An Observational Archive Study.

Objective: To examine the naturalistic response to and cardiovascular side effects of stimulant medication in older adults with ADHD. Methods: Electronic Health Record (EHR) data of adult patients with ADHD (≥55 years) at the specialized PsyQ outpatient clinic for adult ADHD (n = 113, 55-79 years) were collected. Response, cardiovascular status, side effects, and provided medical care before and after the first ADHD medication dose have been recorded. Results: A total of 65% of the patients reported positive response to the medication, and 42% of the patients quit their medication due to side effects or nonresponse. There was a small but significant decrease in weight and increase in heart rate before and after methylphenidate use. Conclusion: Our results indicate that the use of stimulants may be a relatively safe and effective treatment for older adults with ADHD, under the condition that the cardiovascular parameters are monitored before and during pharmacological treatment. Randomized controlled trials (RCTs) are needed to confirm these findings.

"Moments of Failure": Coping With Attention Deficit Hyperactivity Disorder, Sleep Deprivation, and Being Overweight: A Qualitative Hermeneutic-Phenomenological Investigation Into Participant Perspectives.

BACKGROUND: People living with attention deficit hyperactivity disorder (ADHD) often have to cope with additional comorbid disorders. In daily practice, practitioners observe that ADHD not only causes a decline in participants' quality of life, but the presence of sleep and eating disorders also has an impact on daily functioning. The aims of this study are to give meaning to the experiences of participants who are living with ADHD and sleep deprivation and are overweight and to provide additional knowledge and data that will inform integrated treatment in the long term. The following research questions were formulated: METHOD: A qualitative design based on a Parse research method provided the best research framework to answer our questions. The method aims for data saturation, employing six steps in which data collection alternates with data analysis. This iterative process with double hermeneutics enlarges participants' perspectives on their experiences. RESULTS: Participants' daily life is continuously influenced by their experiences with (binge) eating, irregular sleeping patterns, and loss of emotional control. These complex phenomena are often caused by their ADHD, because of underdeveloped coping skills. An everyday struggle with life and difficulty making choices are the leading themes in participant narratives. Continuous feelings of failure, referred to in this report as everyday "failure moments," cause negative self-esteem and negative body image. According to participants, standardized care should include opportunities for participants to tell their life stories as well as an individualized analysis of how ADHD core symptoms affect daily decision making, taking into account sleeping and eating patterns. CONCLUSION: The experience of failure moments, the struggle with making choices, and negative self-esteem and body image all develop in a different way for each participant. When professionals treat participants by solely focusing on the core symptoms using a one-dimensional cognitive behavioral approach, they may overlook underlying (biological) interactions.