Do you ever give stimulant medication to cover a longer continuous period when treating first responders or healthcare workers who work long shifts?
Traditional ADHD treatment usually covers a period of study or work for 8-12 hours each day. However, shift workers may have a period of work that lasts for 18-24 hours or longer. Should we treat the ADHD for a longer continuous period in these cases? Just to be clear, the purpose of the stimulant medication in this situation is to address focus, organization, and other executive functions, rather than alertness.
2 Answers
Mednet MemberInvited Expert
Psychiatry · Wake Forest University School of Medicine
Answered on
I think this has to be taken on a case-by-case basis. Some patients with ADHD are genuinely so impaired without their medication that I don't know if they'd be safe acting in emergency situations without something to help them focus on priorities. The other side of that coin is that first responders...
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Mednet Member
Psychiatry · Santa Cruz Health Center
Answered on
I would evaluate the patient to see if they meet criteria for Circadian Rhythm Sleep-Wake Disorder, Shift Work Type, and if they meet criteria, I would consider using modafinil as a monotherapy for both ADHD and Shift Work Disorder, as modafinil has outperformed nonstimulant meds for ADHD and is clo...
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