Medication initiation and optimisation in attention deficit hyperactivity disorder: A practical approach for general practice.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is increasingly managed within general practice in Australia, supported by evolving shared-care models and expanded general practitioner (GP) involvement. OBJECTIVE: Medication plays an important part in improving day-to-day functioning in patients significantly affected by ADHD. It should be used in conjunction with robust and evidence-based psychosocial supports and psychoeducation. This article aims to provide a practical guide for GPs in Australia seeking to initiate stimulant or non-stimulant medication. DISCUSSION: Medication initiation and adjustment should occur over multiple appointments and involve shared decision making with a focus on functional outcomes rather than symptom scores alone. Side effects should be monitored for carefully and timely escalation to non-GP specialists made as required. Response to medication varies from patient to patient, hence different medication management options are provided, both stimulant and non-stimulant, to be employed as a component of multi-modal patient care.