Where Has All the Adderall Gone? Psychostimulants for the Non-Psychiatrist

Characterized by impulsivity, inattention, and hyperactivity, ADHD is thought to affect 8.4% of children and 2.5% of adults in the United States. Branded and generic formulations of stimulants such as boost levels of the neurotransmitters dopamine and norepinephrine in patients with ADHD, improving focus and motivation and reducing certain negative behavioral traits. The number of ADHD diagnoses grew by 31% from 2010 to 2017. Between 2019 and 2020, prescriptions for ADHD rose by 7.4% among adults aged 22 to 44 years, more than doubling the increase seen between 2020 and 2021. Today, practicing clinicians recognize the heritability of ADHD and the wide variability in clinical presentation of adult ADHD. As many as 80% of adults with ADHD have at least one coexisting psychiatric disorder, including mood and anxiety disorders, substance use disorders (SUD), and personality disorders. This can complicate the recognition and diagnosis of ADHD in adults, and despite ongoing clinical controversy, the bulk of evidence suggests that ADHD remains under-recognized and under-treated in the adult population.