Adult ADHD treatment: medication, CBT and follow-up explained

Treatment of adult ADHD usually combines understanding the diagnosis, practical adjustments, psychological treatment such as CBT and, when there is a diagnosis and a clinical need, medication, with regular follow-up. It is built around your goals, and the choices are made together with your doctor. This article explains each part in general terms. It does not promise any particular result.

Start with goals, not with a list of symptoms

A good plan starts from a concrete question: what would “better” look like in three months? Finishing the tasks that pile up at work? Fewer arguments about forgotten things at home? Getting a degree back on track? The UK assessment standard asks for measurable treatment goals to be considered before treatment starts [1].

The plan then turns the goals into specific next steps with a set time for review. Every session has an agenda, specific next steps and a defined interval for re-evaluation.

Understanding and practical adjustments

The first treatment is usually explanation: what ADHD is, how it shows up in your life and why it is not a character flaw. The NHS also lists lifestyle and workplace adjustments among the things that can help [2]. In practice this means looking at routines, environment and workload, and changing what you can change.

Not feeling well in an environment that does not suit you is not failure. It is an expected reaction. That is why the plan looks at the environment as well as at you.

Psychological treatment and CBT

Cognitive behavioural therapy (CBT) works on thoughts, behaviour and daily habits at the same time. For adults with ADHD, NICE recommends offering at least a structured, ADHD-focused supportive psychological intervention with regular follow-up, which may include elements of CBT or a full course. It should be considered when a person prefers not to take medication, has difficulty taking it, finds it ineffective or intolerable, or when medication helps only partly [3].

What does the research say? A 2023 meta-analysis of 28 randomised trials found that CBT reduced core ADHD symptoms and emotional symptoms such as depression and anxiety, and improved self-esteem and quality of life. The authors were “cautiously optimistic” [4]. A small earlier trial in 31 adults who still had symptoms on medication found that adding CBT did better than medication alone (56% versus 13% responders) [5]. The World Federation consensus adds a note of caution: in the two studies that used active control groups and blinded assessors, improvements were small [6]. So the honest summary is: CBT helps many people, but how much it helps varies and is not guaranteed.

What happens in CBT sessions? Typically a shared formulation of your difficulties, an agenda, practical problem-solving, planning, and homework between sessions. Dr Mylonas has specialist training in CBT.

Two ideas from the CBT toolbox matter a lot for ADHD-type difficulties.

• Avoidance keeps the problem going. When avoidance keeps the problem going, the aim is gradual exposure or a behavioural experiment, not waiting for the anxiety to go away. For the task you keep postponing, that means a small, timed first step, then a review of what actually happened.

• All-or-nothing thinking. “If I cannot do it perfectly, there is no point” is a conclusion, not a fact. A Socratic question tests it: if you do half of the task, is that the same as doing nothing?

CBT for ADHD is structured and short, and it works on skills you need now rather than on the distant past: planning a week, starting a task, saying something difficult in a calmer way. A new skill is learned a bit like driving: deliberately at first, step by step, and later it runs on its own.

Medication, in general terms

Medication is one option, not the default. It is considered when there is a diagnosis and a clinical need, and it should be started and monitored by a specialist [2]. International consensus reports that several medications are safe and effective in controlled trials [6]. A large 2018 network meta-analysis of 133 randomised trials (51 in adults) found that, in adults, several types of medicine reduced clinician-rated core symptoms more than placebo at around 12 weeks. Some were less well tolerated than placebo, and there was not enough data on 26 and 52 weeks [7]. Two things follow: short-term benefit is documented for several medicine types, and long-term evidence is thinner, which is why follow-up matters.

Before any medication is considered, a doctor needs your medical and family history, a screen for cardiovascular problems, and baseline blood pressure, pulse and weight. A routine ECG is not required for everybody [1].

The decision is shared. Alternatives are presented and the decision is made together; psychotherapy and medication are options discussed side by side, and side effects are discussed with a timeline and a trial period. Part of every review is also a simple adherence check: how are you actually taking it, and what gets in the way?

Whether you receive a prescription is decided by the doctor after the appointment. It is never promised in advance. As of October 2026 the range of ADHD medicines available in Greek pharmacies is limited. If your plan needs something that is not on the market, the doctor explains the options, including an individual import procedure through the Greek medicines agency (EOF).

Follow-up: where treatment is actually decided

Treatment is not a single prescription or a single session. NICE advises that, for adults taking medication, heart rate and blood pressure are checked before and after each dose change and every six months, and weight every six months. Routine blood tests or ECGs are not recommended unless clinically indicated [3].

A follow-up visit at this practice looks at how things work in daily life against your goals, sleep, appetite, weight, blood pressure and pulse, side effects and whether the plan still fits. If you do not respond, or the problems change, the plan changes too. More on this is on the Follow-Up & Long-Term Care page. Medication questions are covered on Medication Management, and psychological work on Psychotherapy. Follow-up can also take place by video. Everyday safety questions belong in the follow-up too, for example ADHD and driving.

If treatments you tried in the past did not help, that history is reviewed rather than taken as a final answer. We check whether earlier trials had an adequate dose and lasted long enough to be judged. And when part of the current plan is working, a targeted addition is preferred to changing everything at once.

Living in Greece or visiting without AMKA

If you do not have an AMKA, an e-prescription is still possible after an assessment. You need your passport and an email address. There is no EOPYY reimbursement, so you pay the full price at the pharmacy. The prescription code arrives by email and you give it to the pharmacist. This applies to controlled medicines too, and it is the same for tourists. The details are in this article.

What treatment cannot promise

No treatment can promise a particular outcome. The aim is to reduce the impact of ADHD on your daily life, and the plan is reviewed at set intervals. If you do not yet have a diagnosis, the first step is an assessment: see the Adult ADHD service page, or go straight to the booking calendar. The practice serves Trikala, Karditsa, Kalampaka and online across Greece (Anni Komninis 1-3, 3rd floor, 42131 Trikala).

This article is general information and does not replace a medical consultation.

Sources

1. Adamou M, Arif M, Asherson P, et al. The adult ADHD assessment quality assurance standard (UKAAN AQAS). Front Psychiatry 2024;15:1380410. https://doi.org/10.3389/fpsyt.2024.1380410

2. NHS. ADHD in adults (last reviewed 19 March 2025). https://www.nhs.uk/conditions/adhd-adults/

3. NICE. Attention deficit hyperactivity disorder: diagnosis and management (NG87), amended September 2019 (recommendations 1.5.16-1.5.18, 1.8.5-1.8.11). Copy on NCBI Bookshelf: https://www.ncbi.nlm.nih.gov/books/NBK493361/

4. Liu CI, Hua MH, Lu ML, Goh KK. Effectiveness of cognitive behavioural-based interventions for adults with attention-deficit/hyperactivity disorder extends beyond core symptoms: a meta-analysis of randomized controlled trials. Psychol Psychother 2023;96(3):543-559. https://doi.org/10.1111/papt.12455

5. Safren SA, Otto MW, Sprich S, et al. Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behav Res Ther 2005;43(7):831-842. https://doi.org/10.1016/j.brat.2004.07.001

6. Faraone SV, Banaschewski T, Coghill D, et al. The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neurosci Biobehav Rev 2021;128:789-818. https://doi.org/10.1016/j.neubiorev.2021.01.022

7. Cortese S, Adamo N, Del Giovane C, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry 2018;5(9):727-738. https://doi.org/10.1016/S2215-0366(18)30269-4