1. Diagnosis — psychiatrist se, GP se nahi. Adult ADHD diagnosis ek structured clinical assessment hai — childhood history, current symptoms, functional impairment, rule-out of other conditions (anxiety, bipolar, thyroid, sleep apnea). General physician yeh nahi kar sakta. Aapko registered psychiatrist ya clinical psychologist (RCI-licensed) ke paas jaana hoga. Process mein 1-3 sessions lagte hain, aksar self-report scales (ASRS, CAARS) + collateral information (family se input).
2. Medication — Schedule X, psychiatrist mandatory. India mein ADHD ki two main medications hain:
- Methylphenidate (brand names: Inspiral, Addwize) — stimulant, sabse common. Schedule X drug hai — sirf registered psychiatrist prescribe kar sakta hai, special prescription form lagta hai, pharmacy 2 saal record rakhti hai. Fast-acting, 4-12 hours effect (formulation depending).
- Atomoxetine (brand names: Axepta, Tomoxetin) — non-stimulant. Schedule H (still prescription-only, less restricted). 4-6 weeks lete hain full effect dikhne ke liye. Anxiety comorbidity ho toh aksar prefer.
Doses individual hote hain. Side effects: appetite kam, neend disturbance, BP/heart rate increase (regular monitoring chahiye). Medication ek long-term decision hai — psychiatrist ke saath ongoing relationship important.
3. Behavioural therapy / ADHD coaching. Medication symptoms manage karti hai, lekin skills nahi sikhati. ADHD coaching practical strategies pe focus karta hai — calendar systems, task chunking, accountability structures, environmental design. India mein qualified ADHD coaches kam hain abhi, but online platforms availability grow kar rahi hai.
4. CBT for comorbid anxiety/depression. ADHD patients mein anxiety + depression 50%+ cases mein co-occur karte hain. CBT (Cognitive Behavioural Therapy) un comorbidities ke liye effective hai. Ideal: CBT + ADHD-specific psychoeducation combine ho.
Average cost India mein: Psychiatrist consultation private practice mein ₹1,500–₹4,000 per session metro cities mein. Medication monthly cost ₹500–₹2,500 (formulation depending). Government hospitals (NIMHANS, AIIMS) mein nominal fees (₹10-50 OPD) lekin waiting times long hote hain.