How does one go about receiving an ADD diagnosis and medical treatment these days?

September 17, 2009 1:12 PM

I'm a 28 year old male in Las Vegas, Nevada. When I was in my late pre-teens, I was diagnosed with Attention Deficit Disorder, and went through various treatments (Ritalin, Adderall, then eventually easing off medications entirely). Now, due to a promising promotion and other life changes, I need to be able to focus beyond what my self-regulation allows me. What can an adult expect to go through to convince a doctor that they have ADD, and to convince them to treat it medically?

Initially, I was diagnosed and treated by a Neurologist, through a referral from our family doctor. Later, I was treated by a Psychiatrist (for ADD as well as manic depression and obsessive/compulsive disorder). I haven't been treated medically for ADD since my mid-teens, so I don't know quite where to start.

As an added bonus, I'm currently uninsured and do not have a regular doctor. If I were insured, I'd just start at a general practice doctor and work my way up the chain from there. I'm hoping there are people here with experience regarding if a general practitioner will be willing to diagnose and medically treat ADD, or if it's still mostly in the realm of (more expensive) specialists.

What can one expect, going to a doctor with this sort of treatment request? At least when I was a kid, there was a great deal of concern regarding abuse of these medications, and they are controlled substances. I don't have medical records for my treatment as a child, and I'm not sure they'd satisfy any concerns a doctor may have anyway.

Any hints as to what uninsured pricing for these medications might be would be appreciated, but of less concern to me than going to the right person the first time, and getting things rolling.

(Please note: I am aware of, and respect the idea of non-prescription treatments for ADD. Unfortunately, they rarely work for me, and not to the degree I've experienced lately through other means. I'm at the point where I'm seeking professional medical treatment for the disorder.)

posted by Rendus to health & fitness (9 comments total)

ADD is quite often diagnosed and treated by general practitioners. In my experience, you can expect to pay about $120 for a prescription to name brand Adderall without insurance, though I believe the generic is significantly cheaper, possibly by as much as half.
posted by solipsophistocracy at 1:17 PM on September 17

Assuming you know (or can find out) the doctor from childhood, once you find a GP, you could see about having your records transferred (or get copies) - that shouldn't be particularly expensive. This will save the GP a lot of legwork, and back up your verbal medical history.
posted by canine epigram at 1:21 PM on September 17

What can an adult expect to go through to convince a doctor that they have ADD, and to convince them to treat it medically?

There is a standardized test for ADD. I am not sure if a GP will administer it.
posted by desjardins at 1:21 PM on September 17

I don't have ADD specific answers but could you maybe go a different route and find a new psychiatrist? I've been on anti-anxiety meds for a while and the first time I went to see my new shrink she just handed over an Rx for what I told her I had been on previously without checking with any previous doctors. I think my last GP did the same.

You might even be able to score free samples or be charged on a sliding scale. Or maybe you could find a low cost mental health clinic that could help you.
posted by mrsshotglass at 1:30 PM on September 17

First, if you haven't read it, check out Delivered from Distraction.

All the major ADHD meds have generic variants, so if and when you get a prescription, it shouldn't break the bank.

I've been to general practitioners who were happy to diagnose and treat psychiatric ailments—whether they knew WTF they were doing or not—and I've been to GPs who'd refer almost everything to specialists. I have no idea how you'd tell who's who without making an appointment and seeing for yourself.

If you're honest and forthcoming with the doctor, they'll be way less likely to suspect you of scamming them for drugs. "I was diagnosed with ADHD when I was younger, and it's still a problem for me. I've got this new job and these other life changes going on, and I don't want the ADHD to screw them up for me: I'd like to get it under control." Be very clear that you intend to make lifestyle changes coincident with the medication: the right diet and regular exercise may not be a complete solution, but they make a big difference.

Good luck.
posted by Zozo at 1:31 PM on September 17

Assuming you know (or can find out) the doctor from childhood, once you find a GP, you could see about having your records transferred (or get copies) - that shouldn't be particularly expensive. This will save the GP a lot of legwork, and back up your verbal medical history.

After posting this, I started thinking about that, and I do recall the neurologist's name, and I remember the hospital I visited for treatment. I'm digging up contact information for him now, thanks for the tip.


First, if you haven't read it, check out Delivered from Distraction.

I've actually read the precursor to that book, I believe. Until now, I've leveraged my ADD as an asset, and I've frightened others with my ability to focus on a single thing when I need to (between ADD and Obsessive/Compulsive Disorder... What a wonderful combination :P) I'm starting to work my way out of the world of dealing with customers and people, and into dealing with spreadsheets and numbers, so what was an asset to get me here is turning into a hindrance.

The posts here motivated me to call around, and I found a doctor that'll see me about it, and the receptionist couldn't talk too much about it but did state he's treated it before. I wasn't too worried about it, I just didn't want to start barking up the entirely wrong tree, or wind up on some blacklist somewhere for taking the wrong approach. Thanks for the advice and suggestions.
posted by Rendus at 1:43 PM on September 17

The "right approach" is to be extremely honest with your doctor about your symptoms. ADD is a real disorder. If you're not just trying to "score some speed", then you have nothing to be afraid or ashamed of.

Your doctor may refer you to a counselor for a one-time visit. They'll want to chat with you and screen for other illnesses that may have similar symptoms to ADD (like PTSD).

It may help to complete this questionnaire and bring it with you:

http://addictionpain.com/ADD%20questionnaire.pdf

Cheers!
posted by aMeta4 at 3:39 PM on September 17

Adult ADD is the new big thing. Ask your GP for a referral to a specialist in adult ADD, and they'll hook you up.

Warning: The specialist may pressure you into participating in drug trials. You're allowed to say no.
posted by Sys Rq at 7:29 PM on September 17

According to my pharmacist, the cash price for a month's worth of Vyvanse (which doesn't have an exact generic equivalent) is $175.

I don't think you're going to look like a drug seeker, since you've been diagnosed with ADD before. But you're going to have to get a regular doctor. In your shoes I would call a family doctor or GP and explain that you were treated for ADD before, and would like to start treating it again. I would start with a family doctor just because they're cheaper than psychiatrists.

Although ADD drugs can be WHEEEEE FUN for people without ADD, that shouldn't make you feel hesitant/guilty/criminal for seeking help.

(Is getting medical insurance an option? I think -- and this is just my guess -- that it'll be more difficult to get insurance after you've started treatment, unfortunately. And having insurance would give you the option of taking the brand new meds if they'd be better for you. But you know all this, and I suppose you're not going insuranceless for the fun of it.)
posted by The corpse in the library at 7:27 AM on September 18