Results
ADHD is a heterogeneous disorder arising from complex genetic, neurobiological, and environmental influences. Diagnosis remains clinical and requires developmentally inappropriate symptoms, functional impairment, childhood onset, and manifestations in more than one setting, while excluding alternative explanations. Rating scales support but do not replace comprehensive clinical assessment. Comorbid learning, anxiety, depressive, oppositional, autism spectrum, tic, sleep, and substance-use disorders can substantially influence presentation and management. Behavioral parent training is recommended as first-line treatment for preschool-aged children. For most school-aged children and adolescents with clinically significant impairment, stimulants provide the strongest evidence for reducing core symptoms, whereas atomoxetine, extended-release guanfacine, extended-release clonidine, and extended-release viloxazine are appropriate alternatives for selected patients. Effective management integrates medication when indicated with psychoeducation, behavioral strategies, school-based interventions, and treatment of comorbidities. Monitoring should address symptoms, functioning, adherence, appetite, growth, sleep, blood pressure, heart rate, mood, and medication misuse or diversion. Digital interventions may offer adjunctive benefits, but current evidence does not support replacing established treatments.
