Psychopharmacology and Psychiatry Updates Beyond Stimulants: Tailoring ADHD Treatment to Comorbidities
8 snips
Feb 20, 2026 Oscar G. Bukstein, a Harvard psychiatrist specializing in ADHD treatment, walks through a practical treatment algorithm. He discusses when to prefer nonstimulants for co-occurring substance use, strategies for ADHD with depression or anxiety, and when stimulants remain first-line. He also covers next steps after stimulant nonresponse and evidence on efficacy and tolerability.
AI Snips
Chapters
Transcript
Episode notes
Clinical Case Framing With SUD History
- A 32-year-old marketing professional with new adult ADHD also had a remitted alcohol use disorder complicating treatment decisions.
- The case frames whether to start stimulants or safer non-stimulant options given relapse risk.
Prioritize Non‑Stimulants With SUD
- For patients with substance use disorder, start with non-stimulants such as atomoxetine or bupropion before trying stimulants.
- This approach prioritizes relapse safety while addressing ADHD symptoms.
Treat Depression And ADHD Together
- For comorbid depression, consider bupropion monotherapy as it can treat both depression and ADHD symptoms.
- If inadequate, combine an SSRI or SNRI with a stimulant for added benefit.