Treating ADHD in people with intellectual disabilities

Objectives Attention Deficit Hyperactivity Disorder (ADHD) is more prevalent in people with intellectual disabilities (ID). Drug therapy is the primary treatment for ADHD targeting the core signs of inattention, impulsivity, and hyperactivity (NICE 2013). Knowledge on ADHD has been gleaned from studies in children and children with ID. People with ID have comorbid disorders for example, autism and epilepsy that can complicate the management of ADHD. Knowledge of the effects of treatment is essential in managing ADHD in people with ID. The current evidence on the application of drug therapy for ADHD in ID is described. Method A literature review of publications in English language was undertaken. Results Using medication to treat ADHD is effective in treating the signs of ADHD in people with ID. The response rates in ID to drug therapy for ADHD approximates to 55% that is lower than in the general population. People with ID experience more side effects from medication that can lead to withdrawal from treatment. Guidelines exist internationally on the appropriate prescribing of medication. Methylphenidate, a psycho-stimulant drug is the drug of first choice. Atomxetine, a non-stimulant drug, is effective in people with ID. Conclusions ADHD in people with ID is treatable but clinicians need to be knowledgeable and skilled in managing the disorder in people with ID. Newer drugs could offer more because of their different profile of more tolerable side effects.