From the Guidelines
The Adult Self-Report Scale (ASRS) is scored by evaluating responses to 18 questions about ADHD symptoms, with the first 6 questions serving as a screening tool, and a screen is positive when a patient checks often or very often for 4 or more of the 6 questions, as indicated in the study by Scoten 1.
Scoring the ASRS
The ASRS is a widely used tool for assessing ADHD symptoms in adults. The scale consists of 18 questions, with the first 6 questions serving as a screening tool. Each question is rated on a 5-point scale from "never" to "very often". A positive screen is indicated when a patient checks often or very often for 4 or more of the 6 questions.
Treatment Options for ADHD
For treatment of ADHD, options include both medication and non-medication approaches.
- First-line medications are stimulants like methylphenidate (Ritalin, Concerta) at 18-72 mg daily or amphetamine-based medications (Adderall, Vyvanse) at 5-70 mg daily, which work by increasing dopamine and norepinephrine in the brain, as discussed in the study by Wolraich et al. 1.
- Non-stimulant options include atomoxetine (Strattera) at 40-100 mg daily, and certain antidepressants like bupropion.
- Behavioral therapy, cognitive behavioral therapy, and organizational skills training are effective non-medication treatments that should ideally be used alongside medication, as noted in the study by Mechler and Häge 1. Treatment should be individualized, with regular monitoring for effectiveness and side effects. Lifestyle modifications such as regular exercise, adequate sleep, and minimizing distractions in work environments can also help manage symptoms. ADHD is a neurodevelopmental disorder affecting executive functioning, and proper treatment can significantly improve quality of life and daily functioning.
Key Considerations
- The ASRS is a useful tool for assessing ADHD symptoms in adults, but it should be used in conjunction with a comprehensive diagnostic evaluation, as recommended by the American Psychiatric Association 1.
- Treatment of ADHD should be individualized and may involve a combination of medication and non-medication approaches.
- Regular monitoring and follow-up are essential to ensure effective treatment and minimize side effects.
From the Research
Scoring the Adult Self-Report Scale (ASRS)
- The ASRS is a self-report questionnaire used to assess symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in adults.
- The scale consists of 18 questions, each rated on a 5-point scale (0-4) based on the frequency of symptoms over the past 6 months.
- To score the ASRS, add up the ratings for each question, with higher scores indicating more severe symptoms 2.
Treatment Options for ADHD
- Medications such as methylphenidate and atomoxetine are commonly used to treat ADHD.
- Methylphenidate is a stimulant medication, while atomoxetine is a non-stimulant medication.
- Studies have shown that both methylphenidate and atomoxetine are effective in reducing symptoms of ADHD, with some studies suggesting that methylphenidate may be more effective in certain cases 3, 4.
- Combination therapy with both methylphenidate and atomoxetine may also be effective in some cases 5.
Efficacy of Methylphenidate and Atomoxetine
- A meta-analysis of nine randomized trials found no significant difference in efficacy between methylphenidate and atomoxetine in children and adolescents with ADHD 3.
- However, a subgroup analysis found that osmotic-release oral system (OROS) methylphenidate was more effective than atomoxetine in some cases.
- Another study found that methylphenidate was associated with greater improvements in aggressive behavior, somatic complaints, and conduct problems in youths with ADHD compared to atomoxetine 4.
- In adults with ADHD, both methylphenidate and atomoxetine were found to be effective in reducing symptoms and improving quality of life, with no significant difference in efficacy between the two medications 6.