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Diagnosing ADHD

A brief overview, adapted from the DSM-5-TR, on the necessary criteria that must be met when diagnosing individuals with attention‑deficit/hyperactivity disorder (ADHD).1,2

Evaluating children vs adults

The ADHD rating scale 5 (ADHD-RS-5) is a rating scale specifically for children and adolescents with ADHD that has been updated to correspond with the DSM-5-TR. The ADHD‑RS‑5 has several versions, which correspond to different age groups (5‑10 years old and 11‑17 years old) as well as different settings (home and school).

The Adult ADHD Investigator Symptom Rating Scale (AISRS) measures aspects of ADHD in adults that are consistent with the 18 DSM-5-TR symptoms.2

Both scales measure how ADHD symptoms can affect behavior, such as hyperactivity/impulsivity, restlessness, and inattention.1-3

Teenage girl in a striped shirt putting a black jacket and bag into her backpack in a classroom.
Teenage girl in a striped shirt putting a black jacket and bag into her backpack in a classroom.

The diagnosis of ADHD in pediatrics

In order to be diagnosed with ADHD, 6 or more symptoms of inattention and/or hyperactivity/impulsivity must have persisted for at least 6 months to a degree that is inconsistent with developmental level and that has a negative, direct impact on social and academic/occupational activities.1

A freckled woman sands a wooden chair in a workshop.
A freckled woman sands a wooden chair in a workshop.

The diagnosis of ADHD in older adolescents and adults

In order for people age 17 and older to be diagnosed with ADHD, 5 or more symptoms of inattention and/or hyperactivity/impulsivity must be present and negatively impacting social and academic occupational activities directly. Symptoms must have started before age 12.1

Learn more about Qelbree efficacy:

In children 6-11 years  In teens 12-17 years  In adults 18-65 years 

Symptoms to look for when diagnosing ADHD

 

Symptoms of inattention1,2

  • Makes careless mistakes/lacks attention to detail
  • Lacks sustained attention in tasks or fun activities
  • Poor listener, even in the absence of obvious distraction
  • Fails to follow through on tasks and instructions
  • Difficulty with organization, time management, and deadlines
  • Avoids tasks requiring sustained mental effort
  • Loses things necessary for tasks or activities
  • Easily distracted (including unrelated thoughts)
  • Forgetful in daily activities
  • Procrastinates and puts off tasks until the last moment possible
 

Symptoms of hyperactivity/impulsivity1

  • Fidgets, taps hands, or squirms in seat
  • Leaves seat in situations when remaining seated is expected
  • Excessive running/climbing or feelings of restlessness
  • Often “on the go”; acting as if “driven by a motor”
  • Difficulty with quiet, leisure activities
  • Excessive talking
  • Blurts out answers before questions are even completed
  • Difficulty waiting their turn
  • Interrupts or intrudes on others
Teenage girl with headphones studying at a desk in a well-lit room.
Teenage girl with headphones studying at a desk in a well-lit room.

Several ADHD symptoms must be present in 1 or more settings1

In order to diagnose ADHD, symptoms must be persistent; confirmation of substantially impacting symptoms across settings typically cannot be accurately assessed without consulting observers who have seen the individual in the setting.

Symptoms may vary depending on setting/context. Below, you will find some examples of how ADHD may affect individuals at home, at school, at work, and in relationships and social settings.

At home1

  • Is forgetful doing chores
  • Has difficulty keeping materials and belongings in order
  • Reluctant to engage in tasks that require sustained mental effort, such as homework
  • Several inattentive or hyperactive/impulsive symptoms are present in one or more set­tings (eg, at home, school, or work; with friends or relatives; in other activities)

At school or work1

  • Does not follow through on instructions and fails to complete tasks
  • Overlooks or misses details
  • Is often restless and leaves seat inappropriately
  • There is clear evidence that the symptoms interfere with or reduce the quality of so­cial, academic, or occupational functioning

In relationships and social settings1

  • Does not seem to listen when spoken to directly
  • Cannot wait for their turn in conversation
  • May intrude into or take over what others are doing
  • Has a difficult time making or maintaining friendships or romantic relationships

These are not the complete diagnostic criteria. Please see DSM-5-TR for full diagnostic criteria. It is important to note that diagnosis should be based on a complete clinical history of the patient.

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; DSM-5-TR, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision.

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IMPORTANT SAFETY INFORMATION

INDICATION

Qelbree (viloxazine extended-release capsules) is indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in adults and pediatric patients 6 years and older.

IMPORTANT SAFETY INFORMATION

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

In clinical studies, higher rates of suicidal thoughts and behaviors were reported in [read more] patients with ADHD treated with Qelbree than in patients treated with placebo. Closely monitor all Qelbree-treated patients for clinical worsening and for emergence of suicidal thoughts and behaviors.

In clinical studies, higher rates of suicidal thoughts and behaviors were reported in patients with ADHD treated with Qelbree than in patients treated with placebo. Closely monitor all [read more] Qelbree-treated patients for clinical worsening and for emergence of suicidal thoughts and behaviors.

CONTRAINDICATIONS

  • Concomitant administration of a monoamine oxidase inhibitor (MAOI), or dosing within 14 days after discontinuing an MAOI, because of an increased risk of hypertensive crisis
  • Concomitant administration of sensitive CYP1A2 substrates or CYP1A2 substrates with a narrow therapeutic range

WARNINGS & PRECAUTIONS

  • Suicidal thoughts and behaviors: Closely monitor all Qelbree-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors, especially during the initial few months of drug therapy, and at times of dosage changes
  • Heart rate, blood pressure increases: Qelbree can cause an increase in diastolic blood pressure and heart rate. Assess these measures prior to starting therapy, following increases in dosage, and periodically during therapy
  • Activation of mania or hypomania: Noradrenergic drugs may induce a manic or mixed episode in patients with bipolar disorder. Prior to initiating treatment with Qelbree, screen patients to determine if they are at risk for bipolar disorder. Screening should include a detailed psychiatric history, including a personal or family history of suicide, bipolar disorder, and depression 
  • Somnolence and fatigue: Patients should not perform activities requiring mental alertness, such as operating a motor vehicle or hazardous machinery, due to potential somnolence (including sedation or lethargy) and fatigue, until they know how they will be affected by Qelbree 

ADVERSE REACTIONS

The most common adverse reactions (≥ 5% and at least twice the rate of placebo for any dose) in patients 6 to 17 years were somnolence, decreased appetite, fatigue, nausea, vomiting, insomnia, and irritability, and in adults, insomnia, headache, somnolence, fatigue, nausea, decreased appetite, dry mouth, and constipation. 

PREGNANCY

There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to Qelbree during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Psychiatric Medications at 1-866-961-2388 or by visiting www.womensmentalhealth.org/preg. 

Please see full Prescribing Information, including Boxed Warning.

References:

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text rev. American Psychiatric Association; 2022.
2. Spencer TJ, Adler LA, Qiao M, et al. Validation of the Adult ADHD Investigator Symptom Rating Scale (AISRS). J Atten Disord. 2010;14(1)57-68. doi:0.1177/1087054709347435
3. Ramsay J. Assessment and monitoring of treatment response in adult ADHD patients: current perspectives. Neuropsychiatr Dis Treat. 2017;13:221-232. doi:10.2147/NDT.S104706

IMPORTANT SAFETY INFORMATION

INDICATION

Qelbree (viloxazine extended-release capsules) is indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in adults and pediatric patients 6 years and older.

IMPORTANT SAFETY INFORMATION

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

In clinical studies, higher rates of suicidal thoughts and behaviors were reported in [read more] patients with ADHD treated with Qelbree than in patients treated with placebo. Closely monitor all Qelbree-treated patients for clinical worsening and for emergence of suicidal thoughts and behaviors.

In clinical studies, higher rates of suicidal thoughts and behaviors were reported in patients with ADHD treated with Qelbree than in patients treated with placebo. Closely monitor all [read more] Qelbree-treated patients for clinical worsening and for emergence of suicidal thoughts and behaviors.

CONTRAINDICATIONS

  • Concomitant administration of a monoamine oxidase inhibitor (MAOI), or dosing within 14 days after discontinuing an MAOI, because of an increased risk of hypertensive crisis
  • Concomitant administration of sensitive CYP1A2 substrates or CYP1A2 substrates with a narrow therapeutic range

WARNINGS & PRECAUTIONS

  • Suicidal thoughts and behaviors: Closely monitor all Qelbree-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors, especially during the initial few months of drug therapy, and at times of dosage changes
  • Heart rate, blood pressure increases: Qelbree can cause an increase in diastolic blood pressure and heart rate. Assess these measures prior to starting therapy, following increases in dosage, and periodically during therapy
  • Activation of mania or hypomania: Noradrenergic drugs may induce a manic or mixed episode in patients with bipolar disorder. Prior to initiating treatment with Qelbree, screen patients to determine if they are at risk for bipolar disorder. Screening should include a detailed psychiatric history, including a personal or family history of suicide, bipolar disorder, and depression 
  • Somnolence and fatigue: Patients should not perform activities requiring mental alertness, such as operating a motor vehicle or hazardous machinery, due to potential somnolence (including sedation or lethargy) and fatigue, until they know how they will be affected by Qelbree 

ADVERSE REACTIONS

The most common adverse reactions (≥ 5% and at least twice the rate of placebo for any dose) in patients 6 to 17 years were somnolence, decreased appetite, fatigue, nausea, vomiting, insomnia, and irritability, and in adults, insomnia, headache, somnolence, fatigue, nausea, decreased appetite, dry mouth, and constipation. 

PREGNANCY

There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to Qelbree during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Psychiatric Medications at 1-866-961-2388 or by visiting www.womensmentalhealth.org/preg. 

Please see full Prescribing Information, including Boxed Warning.