Complex presentations of adult ADHD and its management challenges: A case series

Adult ADHD is increasingly recognized in clinical practice, especially in private healthcare, leading to more patient presentations. However, accurate diagnosis remains challenging due to overlapping symptoms with other mental health issues. Thorough assessments beyond self-reports are crucial to avoid both over- and underdiagnosis, which can impact patient safety and treatment outcomes.A major challenge is the rising number of patients requesting stimulant medications, sometimes with fixed expectations. Clinicians must carefully weigh the benefits against risks such as side effects, misuse, and dependence, balancing patient autonomy with ethical prescribing.This case series from Australia and Sri Lanka highlights the complexities in diagnosing and managing adult ADHD, emphasizing diagnostic uncertainty, prescribing pressures, treatment risks, and the vital role of psychological support. It advocates for a multidisciplinary approach combining clinical judgment, structured assessments, and psychological input for responsible, effective care.