ADHD treatments are moving to workplace

NEW YORK - Like dormitories and dining halls, Adderall was something Cory Clair figured he'd leave behind in college.

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But when he went off the medication and started a new job in January, his mind began wandering at work - just as it did in class before he was diagnosed with attention deficit disorder and prescribed the drug, a common treatment for a related problem, attention deficit and hyperactivity disorder.

"I thought I'd have it for school, and then I'd be out and wouldn't need it anymore," said Mr. Clair, who works in public relations in New York. "I was wrong."

After a few months of struggling to pay attention to co-workers and complete assignments on time, he finally made an appointment with a doctor and renewed his Adderall prescription, which his health insurance covers.

"The difference is remarkable," Mr. Clair said. "When you're on it, you stay focused on what you're doing."

The kids of the ADHD drug boom are growing up, and some finding that what they thought would be a school-age ailment might in fact last a lifetime. As they enter the workforce - and as older people are increasingly diagnosed - drugs for the disorder are becoming more common in the workplace.

ADHD is seen in 3 percent to 5 percent of children, according to the National Institute of Mental Health. About half continue to experience symptoms into adulthood, said Louis Kraus, the chief of child and adolescent psychiatry at Rush Medical Center in Chicago. Symptoms include distraction, forgetfulness, fidgeting, impulsivity and disorganization. Some patients, such as Mr. Clair, are diagnosed with attention deficit disorder only, not including hyperactivity.

ADHD drug sales have skyrocketed in recent years - U.S. retail sales of the total ADHD drug market more than tripled between 2000 and 2004, according to health care information company Verispan - and pharmaceutical companies are increasingly marketing their drugs to adults.

Experts disagree on whether the surge in sales is due to better recognition and publicity of the disorder, or doctors prescribing the drugs too leniently.

Also, many question the safety of prescription stimulants - in February, Adderall XR, sold by Shire Pharmaceuticals, was pulled from the Canadian market amid reports connecting it to deaths. The U.S. Food and Drug Administration said it would continue evaluating the drug, but has not taken regulatory action.

Some adult users adopt a pseudo-doctor role, illegally lending their medication to friends and colleagues that they believe need it, Mr. Kraus said.

The drugs are relatively inexpensive (a few dollars a pill) and easy to stock up on. Physicians write one-month prescriptions, but insurance companies allow people to order three-month supplies, he said. That's a system that some people manipulate.

ADHD drug abuse isn't as rampant in the workplace as it is on college campuses, where it's estimated that one in five students has abused prescription stimulants to study or get high. But it does exist, notably among bankers, stock brokers and others in high-pressure, long-hour positions, said Punyamurtula Kishore, the president and director of the National Library of Addictions in Brookline, Mass.

If you think you have adult ADHD, don't test out the drugs on your own - see a doctor first. Because most of the drugs are stimulants, they raise blood pressure and speed up the heart. Unmonitored, they can cause heart problems and psychosis, said pharmacologist Peter Anderson, a clinical instructor in psychiatry at Harvard Medical School.

To treat adult ADHD, most experts recommend relying on not only medication, but also therapy and lifestyle changes. These include maintaining a quiet work space, using personal digital assistants and task books to organize your duties, requesting one-on-one training instead of group training, and using tape recorders during meetings. Such non-medication techniques can, for some sufferers, be a substitute for drugs, Mr. Anderson said.