Therapy of ADS with antidepressants

Synonyms in a broader sense

Attention Deficit Syndrome, Fidgety Phil, Psychoorganic Syndrome (POS), Hyperkinetic Syndrome (HKS).


In order to be able to compensate for the problem of the messenger substance – imbalance of serotonin, dopamine and noradrenaline in the brain, which according to the current state of research is the cause of the problem, and thus to regulate the transmission of information between the nerve cells of individual brain areas, drug therapy is justified within the framework of ADHD therapy. In this context, drug therapies with drugs of the psychotropic drug division are possible, for example: In general, psychotropic drugs aim to influence the activity and function of the central nervous system (= CNS) in order to affect emotionality, mood and affectivity (= emotional state). Thus, antidepressants can increase motivation and improve mood in the same way as they can dampen it.

This is possible because different groups have to be distinguished which have different effects on the messenger substances. A distinction is currently made between:

  • MAO inhibitors
  • RIMA (Reversible Monoaminooxidase Inhibitors)
  • Tri- and tetracyclic antidepressants
  • SSRI (Selective – Serotonin – Recovery – Inhibitors)
  • NARI (Noradrenalin – Recovery – Inhibitors)
  • SNRI (Serotonin – Noradrenalin – Recovery – Inhibitors)
  • Stimulants (methylphenidate preparations, stimulants)
  • Antidepressants

With regard to the drug treatment of ADHD and ADHD, the following can be noted:

  • Drug therapy only in clear cases. – Medicinal therapy not under the age of six!
  • Side effects can occur individually and are particularly dependent on the prescribed medication. – The dosage and the time of taking the medicine are individually different. Both must be “tested” in a certain way.

The treating doctor can approximate the correct dosage based on the underlying body weight and make dosage recommendations. Since attention deficit syndrome also exists in adults, medication can also be used to treat them. However, the choice of the appropriate medication is more difficult in adults.

This is partly due to the fact that the metabolism is faster in adults and the hormone balance is composed differently. Just as with children, stimulants are the drugs of first choice. Tricyclic antidepressants or a mixed combination are also frequently used.

Selective serotonin reuptake inhibitors are only rarely used at present. The fact that, as far as we know, no drug based on methylphenidate is currently approved for adults is problematic. It can be prescribed by a doctor within the framework of a so-called off-label prescription.

The costs are rarely covered by health insurance companies and are therefore usually not covered. Some experience reports from adults who have decided to undergo drug therapy report that the effect of the drugs does not occur immediately, but that it can take up to half a year before the expected effect is achieved. Since drug therapy is subject to certain conditions (see above), reports are quite rare.

Studies also usually refer to children and teenagers. Adult studies on this topic often show different and inconsistent results. As with children and adolescents, drug therapy should only be considered if a clear diagnosis can be made. This also includes the differential diagnosis of other personality disorders (borderline, depression, Tourette’s syndrome).