Book excerpt: An estimated seven million American adults have attention deficit hyperactivity disorder. Understanding and Treating Adults With Attention Deficit Hyperactivity Disorder provides accurate, timely information about the nature and treatment of this disorder. Written in a collegial style, this resource combines evidence-based material with clinical experience to address problems in diagnosing and treating adults with ADHD. Dr. Doyle shows how diagnostic and treatment methods in children with ADHD also apply to affected adults. He examines the role of medications, including new agents that expand the range of therapeutic choices. Understanding the evolution of the concept and treatment of ADHD in children illuminates current thinking about the disorder in adults. Dr. Doyle presents guidelines for establishing a valid diagnosis, including clinical interviews and standardized rating scales. He covers genetic and biochemical bases of the disorder. He also addresses the special challenges of forming a therapeutic alliance -- working with "coach" caregivers; cultural, ethnic, and racial issues; legal considerations; and countertransference issues. He explores a range of options for treating adult ADHD: Detailed facts about using medication, with specific information on both CNS stimulants and nonstimulant medications. He also discusses highly touted medications that are actually ineffective. Full coverage of comprehensive treatment approaches beyond medication -- focusing on cognitive behavioral therapies, among others. He uses a detailed clinical example drawn from several patients to illustrate issues involved in treating ADHD adults over time. Complete review of conditions that may require treatment before ADHD can be addressed. Many ADHD adults struggle with comorbid anxiety, affective disorders, and substance abuse. Dr. Doyle explains how overlooked ADHD can complicate the treatment of other disorders. He provides strategies for the patient with medication-resistant or treatment-refractory ADHD. The book provides in-depth discussion of such issues as the impact of ADHD in the workplace, including steps for maximizing job satisfaction; special considerations related to women; and the effect of ADHD on families. A useful appendix helps readers and patients find reliable information about ADHD on the Internet, allowing clinicians to develop an "e-prescription" to supplement medication and other interventions. Dr. Doyle advocates the promise of enhanced life prospects for adults with ADHD that effective treatment provides. Besides addressing the special challenges of ADHD adults, Dr. Doyle conveys the rewards of working with patients who prove resourceful, creative, and persistent.