Doc: Treatment options for adults diagnosed with ADHD

Dear Dr. Roach: There is an extensive history of ADHD in my family. My son, who was formally diagnosed at 8 and is now 14, has just started taking meds. His transition to high school was difficult to manage. In looking at my own history, I can see the same patterns in my behaviorI have recently turned down promotions because I felt I could not handle the newer workload. I am 48 years old. Am I too old to start meds for this condition?

M.F.

Dear M.F.: Attention deficit hyperactivity disorder is a common condition, affecting about 4 percent of adults in the U.S. The condition certainly may have been undiagnosed when you were a child and teen. I have had many adult patients who, after being diagnosed, got treatment and saw improved function.

The first step is a correct diagnosis. The World Health Organization has created a self-administered screening test available at add.org/adhd-test/.

Dear Dr. Roach: I have been suffering from insomnia for years, but lately, after taking a magnesium supplement, I could see improvement. (I take half of a 600-mg capsule of powdered magnesium malate in a little water before going to bed.)

I also have angina and take diltiazem and sometimes nitroglycerine. Will the magnesium have a negative effect on my heart problem? If not, can I continue taking it forever?

M.F.

Dear M.F.: The amount of magnesium you are taking is about 50 mg of elemental magnesium. The U.S. recommended daily allowance for magnesium is 320 mg for women, 420 mg for men. The amount of magnesium you are taking is not dangerous. It’s a safe long-term dose.

Magnesium is safe for most people (except those with kidney disease).

I would stick with the low dose you have been taking.

Dear Dr. Roach: I am a 74-year-old female who has regular annual checkups with a family physician. My physicals last about 15 minutes and often seem perfunctory and incomplete. Besides the physical examination and annual labs, I am considering a mobile testing group that does preventive screening for several early-risk health issues. My physician does not support these screenings. What is your opinion?

J.L.M.

Dear J.L.M.: Without knowing what your physician is doing or the details of the screening you are considering, I can’t say directly. I suspect the optimum may be in between those two. It is possible your physician isn’t ordering appropriate tests for you. On the other hand, in low-risk people test results are more likely to be false-positive and can lead to unnecessary tests and procedures.

Email questions to ToYourGoodHealth@med.cornell.edu.