Safren and colleagues1 have demonstrated that CBT may be beneficial in adults with ADHD who have been stabilized on medications but still show clinically significant symptoms. Psychological testing would be indicated only if the diagnosis was uncertain. Referral to a neurologist would only be indicated in the case of an abnormal neurologic examination. Because the patient is experiencing breakthrough symptoms, medical management only is not appropriate. Breakthrough symptoms should be addressed, if possible.
- Continue current medication and refer for CBT.
1. Safren SA, Otto MW, Sprich S, et al. Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behav Res Ther 2005;43:831–42.
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