Andrew J. Cutler, MD

Videos

Experts in psychiatry discuss tips to differentiate between ADHD and other co-morbid psychiatric disorders.

Patient Case #1: Differentiating Between ADHD and Other Psychiatric Comorbidities

Stephen Faraone, PhD; Theresa Cerulli, MD; Craig Chepke, MD, FAPA; and Andrew J. Cutler, MD, discuss factors which prompt adults for an ADHD consultation.

Patient Case #1: Prompting an ADHD Consultation

Stephen Faraone, PhD, presents the case of a 19-year-old male with ADHD.

Patient Case #1: 19-Year-Old Male With ADHD

Experts in psychiatry discuss the future of ADHD management as well as challenges when approaching treatment of adult ADHD.

Future of Adult ADHD

Stephen Faraone, PhD; Theresa Cerulli, MD; Craig Chepke, MD, FAPA; and Andrew J. Cutler, MD, discuss efficacy and safety of treatment options in adults with ADHD.

Efficacy and Safety of Treatment Options Utilized in Adult ADHD

: Let's move on, Doctor Chepke, what are current unmet needs in adults with ADHD?

 There's quite a few of them, the first one that I would mention would be the under diagnosis or misdiagnosis of ADHD, but we've covered that very well already, so far here. But then, even once the ADHD is diagnosed in adults, then having it under treatment of it what I think is a significant problem, I mean, I practice in the southern part of the United States and sometimes I say that ADHD around here isn't treated with stimulants, it's treated with a hickory switch. And that tends to persist until adulthood too, that there's this stigma, is the biggest unmet need is combatting the stigma, because there's the belief that the person is just lazy, that they just need to work harder, they just need to pick themselves up by their bootstraps and do it, similar to what we hear in many different diagnosis in psychiatry, and having the acceptance of this diagnosis and the treatments for it is a significant unmet need. But then also, just the treatments that we have themselves. Although we have dozens, literally, of stimulants, and we have some non-stimulants as well, we still don't have enough treatment. One aspect is the small range of molecules that we have, we only have a few molecules despite the dozens of stimulants, and then of the non-stimulants as well, and each one of those has certain pharmacokinetic limitations, and we could get, we could have a very long discussion about that but, really, when it comes to the stimulants, you have to match the pharmacokinetics to the person, and I find that I need all the dozens of stimulants for each individual person, because everyone's day is a little bit different, and they have different needs.

 Yes, I would add, one of the unmet needs is, more effective non-stimulants, we only have 2, as of now, that are FDA approved, non-stimulants, that is, and there's a lot of adults that I'm concerned about abuse or diversion, or I don't want to use a stimulant because, as we talked about earlier, maybe they have hypertension or cardiovascular issues, and medications that help us address the comorbidities, because those comorbidities are so common, depression, anxiety, substance abuse, as we talked about, bipolar disorder as well.

Craig Chepke, MD, FAPA, and Andrew J. Cutler, MD, discuss unmet needs in adults with ADHD.