Adolescents with ADHD should be regularly screened for comorbid substance use disorder, and vice versa. This was one of 36 statements and recommendations regarding SUD and ADD recently published in the European Research Addiction Journal.
Long-acting stimulants should be the first-line treatment of ADHD in adolescents with comorbid SUD, and pharmacotherapy should be preferably combined with psychosocial treatment.
In adolescents with ADHD and SUD, no studies have been conducted that provide convincing evidence for a beneficial effect of dietary interventions, computerized cognitive training programs for ADHD,, mindful meditation, physical exercise, or “traditional and/or herbal medicine.” Therefore, these alternative treatments are not recommended.
The only point on which was consensus was not reached was regarding whether adolescent patients should abstain from all substance use for some period of time before starting any pharmacological treatment. Some were against the use ofin the treatment of these patients , while some were against the alternative use of bupropion.
Using a modified Delphi process, researchers reviewed existing literature to draft 37 statements, which were rated by 55 experts on a scale of 1-5 . Consensus was defined a priori as at least 95% of all the ratings being greater than or equal to 3 . Consensus was easily reached in the first round for 64% of the statements and – after adaptations of the original statements – this percentage mounted to 92% in the second and 97% in the third round, ending with consensus on 36 of 37 statements. The 37 statements can be viewed inClinicians, patients, and caregivers can use this set of consensus statements to aid the decision making process when choosing the most appropriate treatments for adolescents with ADHD and SUD.
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