Table 5.
Treating ADHD in girls and women: key consensus recommendations
| Pharmacological treatment | |
| • Medication recommendations do not differ by sex and differ only modestly by age. | |
| • Treatment monitoring may require deviation from conventional outcomes from rating scales and behaviour management. Individualised targets (e.g. emotional lability, academic attainment) may be more appropriate. | |
| • Prescribing needs to consider interactions between ADHD and other medications for comorbid conditions, where applicable. | |
| • Where mood problems are apparent but not pervasive it is advisable to treat ADHD symptoms and monitor for improvement first, prior to considering or initiating treatment for mood disorders. | |
| • Appetite suppression as a side effect of stimulant medication should be considered if eating disorders are a concern. | |
| • Risks of substance use whilst on ADHD medications should be considered and discussed with patients. | |
| • Treatment with ADHD medications is generally not advised during pregnancy or breastfeeding. | |
| • Review is advised during and after key periods of hormonal change (menopause, pregnancy). | |
| • Psychoeducation on pharmacological treatment options and treatment targets for parents and affected girls may help to improve adherence and engagement. | |
| • Regular review is required throughout development and may be especially important at times of key transitions. | |
| Non-pharmacological treatment | |
| • Whenever possible, provide psychoeducation taking a lifespan approach. | |
| • Parents and carers of teenage girls need psychoeducation to support detection of deliberate self-harming or risky behaviour. | |
| • Follow-up sessions are essential for support at key points of transition. | |
| • Interventions should be tailored to needs and address difficulties and challenges faced at home, school/work and in social activities. | |
| • Both group and individual assessments may be beneficial. | |
| • Direct parental input into interventions is required for children. Adolescents and adults are more likely to receive direct interventions without parental/carer input. | |
| • Programmes for all ages will benefit from focus on ADHD symptoms and associated problems, including executive functions, emotion regulation, conduct and social impairments, in an age-sensitive manner. | |
| • Programmes should differ depending on age with issues relating to transition, | |
| • As relevant, risk (sexual risk, substance misuse), and self-management should be addressed in adolescence, with adult interventions including employment problems, child-rearing and parenting. |