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Adolescences with ADHD, who suffer from social problems, are under risk of depression, anxiety, destructive conduct disorder, and drug addiction. If there are co-morbid disorders associated with ADHD, it makes the treatment difficult and causes some other complications.
The fundamental treatment principles of the psychiatric co-morbidities of ADHD are also effective for adolescence period. However, especially, we should be careful about the conditions that have high prevalence during adolescence period and the conditions which affect prognosis in a negative way. These situations need to be assessed in diagnosis and treatment plan.
Anxiety Disorders: Some researches indicate that a stimulant treatment has small effects on anxiety disorder. The treatment of ADHD without anxiety disorder gets more successful results. However, according to recent research, treatment is also effective on anxiety disorder.
In general, considering the effect of CBT on the anxiety disorder treatment, it is suggested that CBT beside medication treatment is effective on ADHD having co morbidity with anxiety disorder. If there is co morbidity, it is suggested that the priority needs to be given to ADHD and that if the anxiety symptoms continue, another medication treatment should be considered.
Mood Disorders: Depression is an important problem in adolescence period. The important point in treatment is to identify that if ADHD causes to depressive findings or major depression.
If ADHD cooccurs with major depression, both of them need to be treated. The treatment may be done either by stimulants or atomoxetine or only by SSRIs or tricyclic anti depressants. The last option is to use the two methods both.
When there is co-morbid depression and ADHD, the efficacy of antidepressants is lower than when it is depression alone. In clinical observation, depression findings in adolescence period should be assessed attentively. If there is major depression, the treatment should be carried out together with ADHD. Selective serotonin reuptake inhibitors (SSRI) may be used with stimulants.
Conduct Disorders: If ADHD is not treated, it may possibly turn to conduct disorder. In many studies, the use of stimulants for the treatment of co-morbid ADHD and conduct disorder is investigated. The results of these studies show that stimulants are effective when the morbidities are both separate or together.
However, if there are co-morbid ADHD and conduct disorder, the effectiveness of stimulants on aggression is lower. If there are co-morbid ADHD and aggression and if the typical ADHD treatment does not work, it may be useful to add atypical antipsychotics to the treatment. If ADHD is co-morbid with conduct disorder, working with adolescents, using behavioural approaches, supporting families and to providing them education about the problem may be helpful.
If ADHD co occurs with drug addiction, both disorders should be treated. Stimulants can be used in a controlled way. However, due to addiction, prescribing stimulants may be cause legal problems. Atomoxetine and bupropion could be other options. Eventhough, antidepressants are effective in ADHD, their effectiveness in addiction is limited.