Would you consider starting a stimulant in an inpatient or crisis setting for patients whose severe behavioral issues are due to untreated ADHD?

For an adult without an established diagnosis, I don't believe initiating stimulant therapy during an acute inpatient stay is appropriate. ADHD is a legitimate neurodevelopmental condition, but it shouldn't be used as a catch-all explanation for behavioral disruptions in a hospital setting. Starting...

The decision to initiate a stimulant medication during an inpatient psychiatric admission is inherently complex. For the purposes of this discussion, I will assume the patient is a child or adolescent, recognizing that stimulants may be started for conditions other than ADHD. Even so, examining the ...

In an inpatient setting, if the medication seems like an appropriate fit (from a medical/cardiac and substance use) concern, I start them as part of our approach and to be able to monitor tolerance and benefit.

For a person in an inpatient, yes. But not in a crisis setting. I would require a follow-up that can't be guaranteed.

A crisis or inpatient setting can actually be an excellent time to consider initiating a stimulant when severe behavioral dysregulation appears to stem from untreated ADHD. In a contained, highly supervised environment, you can directly observe the patient’s behavior, rule out confounding factors su...