Adult ADHD treatment is usually a combination, not a single fix. It starts with understanding ADHD and changing what you can around you. Many people then choose medication, and some add structured psychological support such as ADHD-focused CBT.
The HSE's model of care draws on the UK guideline body NICE. NICE's ADHD guideline (NG87) recommends offering medication if symptoms still cause significant impairment after changes to your environment. The first-line medicines are lisdexamfetamine or methylphenidate. Psychological treatment is an option instead of medication or alongside it.
The HSE's adult ADHD model of care plans for clinics to provide psychoeducation, medication, group CBT and occupational therapy. Not every area has a clinic yet. ADHD coaching is popular, but has not yet been tested in randomised trials. Not everyone needs or wants medication.
NICE's ADHD guideline sets out a clear sequence for adults. In summary:
NICE also says decisions can be revisited. You can change your mind about a treatment later.
The HSE's Model of Care for adult ADHD was approved in November 2019 and published in January 2021. Under it, people are referred to an adult ADHD clinic through their local adult mental health team. The clinic then provides:
The model of care also says people should be advised about college supports, coaching, ADHD Ireland's services and employment supports. It describes medication as "still considered the first line of treatment", used alongside non-drug approaches.
Two caveats matter. First, this is the HSE's plan; the model says each clinic depends on funding. Second, adult ADHD teams do not yet cover every area. For how this looks in practice, read adult ADHD in Ireland: what the wait actually looks like.
NICE's order of choice for adults is:
NICE says guanfacine should not be offered to adults without advice from a tertiary ADHD service.
What is licensed and available in Ireland is not the same as in the UK. Our practical guide to ADHD medication for adults in Ireland covers which products are licensed here, titration, shared care, cost and pharmacy rules. For atomoxetine and guanfacine, see our guide to non-stimulant ADHD medication.
NICE says ADHD medication should only be started by a professional with training and expertise in ADHD. The HSE model of care says drug treatment for adults should be started by a psychiatrist with that training.
Before starting, NICE recommends a review of your mental and physical health. This includes height, weight, pulse, blood pressure and a heart check. NICE says an ECG is not needed routinely, unless specific heart-related features are present.
Once the dose is stable, NICE recommends a shared care arrangement with primary care. In Ireland, continuing a prescription is your GP's own clinical decision. We explain why in is a private ADHD diagnosis accepted in Ireland?
The largest recent analysis, a 2025 network meta-analysis in The Lancet Psychiatry, pooled 113 randomised trials with 14,887 adults. Its main findings were:
For how stimulants work, their effect on blood pressure and the misuse question, see what ADHD stimulants actually do.
When non-drug treatment is used, NICE says to offer at least "a structured supportive psychological intervention focused on ADHD" with regular follow-up. It "may involve elements of or a full course of CBT".
ADHD-focused CBT is not designed to remove the core symptoms. A 2025 review in World Psychiatry describes its goal as reducing their impact on everyday life. In practice that means skills for planning, organisation, time management and problem-solving. It also tackles unhelpful thoughts built up over years of difficulty.
Modest, and it needs careful reading.
So CBT is a reasonable option, recommended by NICE and the HSE. It is not as well evidenced for core symptoms as medication.
The model of care recommends the Young-Bramham CBT programme, delivered in groups to reach more people. It covers psychoeducation, attention strategies, time management and problem-solving, with homework between sessions. It also recommends individual occupational therapy, aimed at sensory strategies and organising everyday tasks.
The model of care says counselling soon after diagnosis is "an important component of the treatment plan". It should cover information about ADHD, your reaction to the diagnosis, and treatment options.
One Irish option you can join without a referral is UMAAP, the Understanding and Managing Adult ADHD Programme. It is run by ADHD Ireland with UCD's School of Psychology and the HSE's National Clinical Programme for ADHD in Adults.
A 2024 study of 257 participants found quality of life, self-acceptance and knowledge of ADHD improved. The gains held at three months. Psychological flexibility improved only by three months. The study had no comparison group. It shows the programme is workable and well received, but cannot show how much of the change it caused.
An ADHD coach works with you on practical goals such as routines, planning, time management and procrastination. The HSE model of care describes coaching as providing "support, structure and accountability". It says coaching "is not advice, therapy or counselling". It suggests a minimum of about six sessions or three months, and lists coaching as an option within wider care.
The evidence is thin. The 2025 World Psychiatry review said ADHD coaching is "yet to be tested by RCTs". The published studies so far are mostly before-and-after studies without a control group:
Without a control group, these studies cannot separate the effect of coaching from time, expectation or other help people were getting. Coaching may suit you, especially for practical goals. If you are considering it, ask about the coach's training and ADHD experience, the total cost, and how they work alongside any medical care.
NICE's guidance on the post-diagnosis conversation explicitly includes rights to reasonable adjustments at work and college. In Ireland, the Irish Human Rights and Equality Commission explains that employers must provide reasonable accommodation unless it would be a disproportionate burden. The Department of Social Protection's Reasonable Accommodation Fund may help pay for workplace changes.
At college, DARE says students with a disability are offered supports such as learning support and exam accommodations. This applies whether or not they entered through DARE. For the full picture, including disclosure and what evidence each route asks for, see ADHD at work and college in Ireland: your rights.
ADHD Ireland is a charity for people with ADHD and their families. The HSE model of care calls it the largest ADHD organisation in Ireland. It recommends telling every adult diagnosed about its support groups and webinars. As listed on its website on 3 November 2026, it offers:
NICE says professionals should stress the value of a balanced diet, good nutrition and regular exercise for adults with ADHD. The NHS adds that regular sleep helps, and that exercise can ease anxiety and low mood, which can make ADHD harder.
NICE does not recommend any supplement as a treatment for ADHD in adults. For children, it specifically advises against fatty acid supplements. If you want to try something, talk to your GP or prescriber first, especially if you take ADHD medication.
The NHS says ADHD medicines must be started and monitored by an ADHD specialist. A GP may take over prescribing only under a shared care agreement. The NHS also says talking therapies such as CBT or mindfulness may be recommended. You can ask for reasonable adjustments at work or college. The same NICE guideline applies.
The NHS notes that people with ADHD are more likely to have anxiety and depression. They are also at higher risk of suicide. If you are in crisis, call 112 or 999, or go to your nearest emergency department. Call Samaritans free on 116 123 at any time, or text 50808 for free 24/7 support.
No. NICE recommends offering medication when symptoms still cause significant impairment, but the choice is yours. It recommends psychological support for people who choose not to take medication. You can revisit the decision later.
It can help, mainly with the impact of ADHD on daily life. A 2018 Cochrane review found low-quality evidence of short-term benefit. A 2025 analysis found benefit on clinician ratings but not on people's own ratings.
It might be, especially for practical goals like routines and planning. But it has not yet been tested in randomised trials, so its benefit is uncertain. Ask about training, cost and how it fits with your other care.
In Ireland, medication is usually started by a psychiatrist. Once the dose is stable, your GP may take over prescribing, but that is the GP's clinical decision. The specialist should still review you at least once a year.
This article is general information, not medical advice. It cannot tell you which treatment is right for you. Talk to your GP or prescriber before starting, changing or stopping any treatment.
Reviewed by: Proco Team
Last updated: November 2026