ADHD medicationsare primarily stimulants designed to improve attention, focus, and impulse control in individuals withAttention-Deficit/Hyperactivity Disorder.
They come in immediate-release and extended-release formulations, allowing for different durations of effect. Non-stimulant medications like atomoxetine (Strattera) are also used, especially when stimulants are ineffective or cause adverse effects.
The goal of ADHD medication is to reduce core symptoms and improve daily functioning in academic, social, and occupational settings.
Key Points
Rationale
The paper addresses the lack of authoritative guidance on whether patients should take their prescribed ADHD medication during psychological evaluations.
This question is crucial as many patients undergoing evaluation are already taking stimulant medication, either as part of an initial trial or ongoing treatment.
The authors note that different clinics and clinicians have varying policies on this issue, highlighting the need for evidence-based recommendations.
Previous research has shown that stimulants can improve cognitive performance in both ADHD and non-ADHD individuals (Bagot & Kaminer, 2014; Coghill et al., 2014). However, the effects vary depending on the complexity of cognitive tasks and the individual’s baseline performance (Fosco et al., 2021; Pievsky & McGrath, 2018).
The next step in addressing this issue is to review relevant research literature and synthesize findings to develop practical recommendations for clinical use.
Method
The study employs a literature review methodology, drawing from a wide range of sources, including clinical handbooks, research studies, and meta-analyses.
The review focuses on studies related to:
Results
Stimulant Effects on Clinical Assessment Data:
Stimulants and Observable Behavior During Evaluation Sessions:
Time Course of Stimulant Effects:
Tolerance and Withdrawal Concerns:
Importance of Test Session Data:
Insight
This study provides a comprehensive review of the complex issues surrounding ADHD evaluation for patients already taking stimulant medication.
The key findings highlight the need for a nuanced approach to medication decisions during evaluations, considering factors such as the purpose of the evaluation, the specific cognitive tasks being used, and the potential for withdrawal effects.
Further research could focus on:
Strengths
The review had several strengths, including:
Limitations
This review also had some limitations, including:
These limitations suggest that while the review provides valuable insights, further research is needed to fully understand the complexities of ADHD evaluation in medicated patients across diverse populations and age groups.
Implications
The results of this study have significant implications for clinical psychology practice and ADHD assessment:
These implications highlight the complex interplay between medication effects, assessment practices, and clinical decision-making in ADHD evaluation. They underscore the need for ongoing research and professional development to ensure best practices in this area of clinical psychology.
References
Primary reference
Lovett, B. J., Nelson, J. M., & Jordan, A. H. (2024). Should patients be evaluated for ADHD while using ADHD medication?Professional Psychology: Research and Practice, 55(2), 160–168.https://doi.org/10.1037/pro0000555
Other references
Bagot, K. S., & Kaminer, Y. (2014). Efficacy of stimulants for cognitive enhancement in non‐attention deficit hyperactivity disorder youth: A systematic review.Addiction,109(4), 547-557.https://doi.org/10.1111/add.12460
Coghill, D. R., Seth, S., Pedroso, S., Usala, T., Currie, J., & Gagliano, A. (2014). Effects of methylphenidate on cognitive functions in children and adolescents with attention-deficit/hyperactivity disorder: evidence from a systematic review and a meta-analysis.Biological psychiatry,76(8), 603-615.https://doi.org/10.1016/j.biopsych.2013.10.005
Fosco, W. D., Rosch, K. S., Waxmonsky, J. G., Pelham Jr, W. E., & Hawk Jr, L. W. (2021). Baseline performance moderates stimulant effects on cognition in youth with ADHD.Experimental and clinical psychopharmacology,29(4), 302.
Pievsky, M. A., & McGrath, R. E. (2018). Neurocognitive effects of methylphenidate in adults with attention-deficit/hyperactivity disorder: A meta-analysis.Neuroscience & Biobehavioral Reviews,90, 447-455.https://doi.org/10.1016/j.neubiorev.2018.05.012
Keep Learning
Below are some Socratic questions for a college class to discuss this paper:
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
