ADHD Management (NICE)

Question 1

First line management of ADHD in children under 5

Answer 1

ADHD-focused group parent-training programme

Question 2

Second line management of ADHD in children under 5

Answer 2

Obtain further specialist input
Need second specialist opinion before meds

Question 3

First line management of ADHD in children over 5

Answer 3

Parental support and education sessions also involving school
Implement environmental modifications

Question 4

Second line management of ADHD in children over 5

Answer 4

Medication if still significant impairment after environmental modifications

Question 5

Management of ADHD in children over 5 if meds not fully helping

Answer 5

CBT

Question 6

First line management of ADHD in adults

Answer 6

Environmental modifications

Question 7

Management of ADHD in adults if environmental modifications don’t help

Answer 7

Medication

Question 8

Management of ADHD in adults if meds not fully effective/don’t want them

Answer 8

Psychological treatment
Regular follow up

Question 9

First line medication in children and young people over 5

Answer 9

Methylphenidate (short or long acting)

Question 10

Second line medication in children and young people over 5

Answer 10

Lisdexamphetamine

Question 11

What to prescribe if children over 5 either can’t tolerate stimulants or they don’t have adequate response?

Answer 11

Atomoxetine or guanfacine

Question 12

First line medication in adults?

Answer 12

Either methylphenidate or lisdexamphetamine
If one doesn’t work try the other

Question 13

What to prescribe if stimulants don’t work in adults?

Answer 13

Atomoxetine