Dose of methylphenidate during service transition for adults with ADHD

Objectives: We wanted to investigate how one element of the transitional process of adolescents to an adult ADHD service, namely the use of medication, fared when compared to the recommendations of national guidelines.

Methods: We did a chart review of the dose of stimulants in a cohort of transitional patients after they were transferred to an adult ADHD service, whilst investigating if other variables such as severity of ADHD, age, gender and comorbidity played any role in determining the dose of stimulants at transition.

Results: The dose of stimulants when calculated in mg/kg was almost half the recommended whist the patients were also severely symptomatic. Reported comorbidity with Autistic Spectrum Disorders was also very high.

Conclusions: A handover approach of adolescents with ADHD to an adult service, may hide gaps at least as far as prescribing is concerned. This gap may need considerable resources to address successfully. We suggest that establishing transitional processes may help minimise this problem.