Adolescents With ADHD Need Better Transitions to Adult Care
Search
AdvertisementAdvertisement
September 1, 2026/Pediatrics/Behavioral health
Why Adolescents With ADHD Need Better Transitions to Adult Care
Early planning can help prevent disruptions in treatment, medication access and support
Image content: This image is available to view online
View image online(https://assets.clevelandclinic.org/transform/73e39c07-7658-4128-952b-8a6b3d395cc5/adhd-transition)
Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental condition that does not end in childhood. Symptoms often persist into adulthood and, while they may become less overt, can remain significantly impairing
Advertisement
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy
This evolution in symptoms, along with the possibility of a missed diagnosis in childhood, can make early adulthood especially challenging. Estimates suggest that about 15% of individuals diagnosed in childhood continue to meet full diagnostic criteria in their mid-20s. Many others are not diagnosed until adulthood
Jasdeep Sohi, MD, a child and adolescent psychiatrist at Cleveland Clinic, is drawing attention to the particular vulnerability of early adulthood for patients with ADHD
“There is a misconception that ADHD is a childhood disorder that kids will simply outgrow,” says Dr. Sohi. “ADHD doesn’t just disappear at 18. There is a huge need for providers to understand, recognize and respond to an adult ADHD age group.”
Transitioning to young adulthood often means becoming untethered from support systems of childhood, like an individualized education program (IEP), established medication routines, or even a consistent pediatric healthcare provider. Young adults with ADHD may not have developed the coping skills needed to manage new demands, Dr. Sohi explains
“They might appear more depressed and anxious, even lazy and not adhering to the recommendations. Meanwhile, their providers may have missed the core symptoms of what is leading up to this,” she says
How ADHD symptoms change over time
In childhood, ADHD may present with hyperactivity, inattention, impulsivity and difficulty with emotional regulation. In adulthood, symptoms are often less obvious but no less disruptive, and may include impulsivity, impatience, oversharing, risk-taking and emotional reactivity
Advertisement
Many adults with ADHD compensate for inattention by working harder and longer, yet still struggle with chronic lateness, disorganization or difficulty completing tasks. Keeping up with societal expectations and responsibilities can contribute to anxiety, depression, lack of sleep and burnout.
Considerations for a highly treatable disorder
Medications can be highly effective Approximately 75% of patients will respond favorably to a first-line stimulant in the methylphenidate or amphetamine class. If one stimulant is ineffective despite dose optimization and adherence, she recommends trying the other class
Treatment decisions should take into account potential side effects, substance use history, cardiovascular risk and other coexisting conditions
Nonstimulant therapies such as atomoxetine may be appropriate for select patients, particularly those with anxiety, tics or misuse concerns. Guanfacine and clonidine are additional options, especially for patients with impulsivity, hyperactivity or sleep problems. Bupropion may be considered as an adjunctive therapy or off-label option, particularly when depression is present
Overall, she emphasizes that multimodal care involving medication, therapy, psychoeducation, accommodations, and sleep and routine support is the most effective approach for managing ADHD
Helping patients navigate ADHD care in early adulthood
Despite the advances in treatment, the transition to adult ADHD care remains a major challenge. A national shortage of specialists who treat adult ADHD, rising demand for evaluation and treatment, and concerns about prescribing controlled substances have all complicated access to care. Executive dysfunction may further interfere with scheduling, follow-up and medication adherence
Advertisement
Dr. Sohi makes the following recommendations to providers to help their patients maintain consistency:
- Start transition planning early.
- Involve families when appropriate.
- Identify adult providers before pediatric care ends.
- Connect students with campus resources.
- Help prevent interruptions in medication access.
The takeaway message
Dr. Sohi says the priority in transitioning from pediatric to adult care is ensuring that patients have ongoing support, a reliable pathway for medication access, and re
“We know ADHD is highly treatable, so early identification and intervention are key,” she says. “When facilitating these transitions, we must identify adult providers who understand that ADHD does not have an expiration date.”
Advertisement
Advertisement
Related Articles
March 16, 2026/Behavioral Health/Podcasts
ADHD Across the Lifespan: Managing a Common and Often Misunderstood Disorder (Podcast)
https://consultqd.clevelandclinic.org/adhd-across-the-lifespan-managing-a-common-and-often-misunderstood-disorder-podcast
Current diagnostic and treatment strategies can help improve focus, productivity and quality of life
October 31, 2023/Behavioral Health/Advancing Patient Care
Researchers Offer New Paradigm for Managing Adult ADHD
https://consultqd.clevelandclinic.org/researchers-offer-new-paradigm-for-managing-adult-adhd
Experts recommend task-focused strategy for monitoring treatment
February 3, 2026/Primary Care
ACE Inhibitors and ARBs Before Noncardiac Surgery: To Hold or Not to Hold?
https://consultqd.clevelandclinic.org/ace-inhibitors-and-arbs-before-noncardiac-surgery
Emerging evidence suggests a patient-specific approach
January 12, 2026/Pulmonary/News & Insight
Advances in COPD Treatment: The Role of Biologics
https://consultqd.clevelandclinic.org/advances-in-copd-treatment-the-role-of-biologics
Looking at the real-world impact and the future pipeline of targeted therapies
December 22, 2025/Heart, Vascular and Thoracic/Clinical Cardiology
Mavacamten’s Benefits Are Not Sex-Dependent and Include Sustained Cardiac Remodeling
https://consultqd.clevelandclinic.org/mavacamtens-benefits-are-not-sex-dependent
End-of-treatment VALOR-HCM analyses reassure on use in women, suggest disease-modifying potential
October 31, 2025/Digestive/Research
Sulfamethoxazole/Trimethoprim Outperforms Ciprofloxacin for Preventing SBP Recurrence in Cirrhosis
https://consultqd.clevelandclinic.org/sulfamethoxazoletrimethoprim-outperforms-ciprofloxacin-for-preventing-sbp-recurrence-in-cirrhosis
Study reveals key differences between antibiotics, but treatment decisions should still consider patient factors
October 27, 2025/Digestive/Research
Tirzepatide Linked to Better Heart Outcomes Than Semaglutide in MASLD, Obesity and Diabetes
https://consultqd.clevelandclinic.org/tirzepatide-linked-to-better-heart-outcomes-than-semaglutide-in-masld-obesity-and-diabetes
Findings could help clinicians make more informed decisions about medication recommendations
October 15, 2025/Neurosciences/Brain Health
Real-World Data Suggest Two Antidiabetic Drug Classes May Curb Alzheimer’s Risk
https://consultqd.clevelandclinic.org/two-antidiabetic-drug-classes-may-curb-alzheimers-risk
Observational evidence of neuroprotection with GLP-1 receptor agonists and SGLT-2 inhibitors
Ad
Rendered: Tue Sep 01 2026 05:34:43 GMT+0000 (Coordinated Universal Time)
