ADHD in adults

How adult ADHD assessment works in Ireland

Diagnosis rests on a structured clinical assessment rather than a single test. A specialist takes a developmental history going back to childhood, because the condition begins in childhood even when it is recognised decades later, and looks for symptoms of inattention, hyperactivity and impulsivity that are present in more than one setting and that genuinely impair work, study or relationships. Rating scales are used to structure that conversation, not to make the diagnosis on their own.

A large part of the work is exclusion. Anxiety, depression, sleep disorders including obstructive sleep apnoea, thyroid disease, alcohol and substance use, iron deficiency, and the after-effects of trauma can all produce poor concentration, and treating ADHD that is not there does not help any of them. Collateral information from a parent, partner or old school reports is often requested, so it is worth gathering what you can beforehand. That level of assessment is why an online questionnaire cannot deliver a diagnosis, and why any service offering one should be treated with suspicion.

Which medicines are used

Stimulants are the first-line medicines: methylphenidate, and lisdexamfetamine, which is a prodrug of dexamfetamine. Both are controlled drugs. They are started at a low dose and titrated with regular review of blood pressure, pulse, weight, sleep and mood, and there are formulations with different durations of action, which is why choosing one is an iterative process rather than a single prescription.

Atomoxetine is the main non-stimulant, and it is not a controlled drug. It works differently, acts on noradrenaline reuptake, and takes weeks rather than hours to show benefit, which some people prefer and others find frustrating. Guanfacine is used mainly in children and adolescents. Bupropion is occasionally used off-label. Medication is only part of treatment: behavioural strategies, coaching, structure, treating co-existing anxiety, depression or sleep disorder, and workplace or college accommodations often do at least as much work as the tablet, and they are available while you are waiting for anything else.

Why stimulant medication is not prescribed remotely by us

Methylphenidate and lisdexamfetamine are controlled drugs, and MEDINOW does not prescribe controlled drugs under any circumstances. Article 11(6) of Directive 2011/24/EU allows member states to exclude medicines containing narcotic or psychotropic substances from the cross-border prescription route, and Irish rules keep controlled drugs out of it as well, so this is not a matter of internal policy that could be waived for a good case.

There is a clinical layer under the legal one. Stimulants require baseline cardiovascular assessment, dose titration with review, monitoring of blood pressure, pulse and weight, and attention to misuse and diversion, none of which a written assessment can support. The same reasoning excludes opioids, benzodiazepines, Z-drugs for sleep, gabapentinoids such as pregabalin and gabapentin, and medical cannabis. There is nothing to buy on this page. If you are already taking ADHD medication and are running low, the prescriber who titrated it, or the shared-care arrangement between that specialist and your GP, is the route, and it is worth contacting them before the supply runs out rather than after.

Atomoxetine and the non-stimulant route

Atomoxetine is a selective noradrenaline reuptake inhibitor and, unlike the stimulants, it is not a controlled drug and follows ordinary prescribing rules. It is used where stimulants are not tolerated, are not appropriate because of a cardiac or other issue, or where there is a history of substance misuse that makes a stimulant unwise. Some people simply prefer a medicine that provides an even effect through the day rather than one that wears off.

It is not a shortcut into treatment. Atomoxetine takes several weeks to show its effect, has its own side effects including nausea, reduced appetite, raised blood pressure and pulse, sleep disturbance and sexual side effects, and carries a warning about suicidal thinking that means the early weeks need monitoring. It is normally started by a specialist and then maintained under a shared-care arrangement with a GP who can carry out the monitoring, which is why even a non-controlled ADHD medicine is not something a remote renewal service takes on. MEDINOW does not initiate or renew ADHD medication of any kind.

The realistic routes to assessment

There are two, and both begin with the same conversation. The public route starts with a GP who refers to an adult mental health service or to an adult ADHD service where one exists locally; provision for adults has historically been patchy in Ireland and waiting times vary widely by area. The private route is a self-funded assessment with a psychiatrist or a specialist ADHD service, which is faster and costs a significant sum, usually with follow-up appointments for titration on top of the initial assessment fee.

Two practical points are worth knowing before you choose. Ask any private provider directly whether they can prescribe and titrate, and whether a GP will be asked to take over prescribing afterwards under a shared-care arrangement, because a diagnosis without a prescribing pathway leaves you no better off. And ask what the report contains, since a proper written report is what supports workplace or college accommodations. ADHD Ireland maintains information and peer support for people navigating this and is a reasonable first stop before spending anything.

What to bring to an assessment

Preparation shortens the process and improves the outcome. Bring anything documenting childhood: school reports, particularly comments about attention, restlessness or unfinished work, and the recollections of a parent or older sibling if that is possible. Write down concrete examples of the effect on your current life rather than adjectives, since specific instances of missed deadlines, lost jobs, unpaid bills, unfinished courses or damaged relationships carry far more weight than a general sense of struggling.

Also bring a full list of medicines and supplements, your alcohol and drug use answered honestly because it changes what is safe to prescribe, your sleep pattern, any history of anxiety or depression and how it was treated, and any cardiac history in yourself or your family, since that matters for stimulant safety. If you have completed rating scales online, bring them, but treat them as a starting point for the conversation rather than as evidence. Expect the assessment to consider alternative explanations seriously; that is a sign it is being done properly.

What MEDINOW does and does not offer here

We do not diagnose ADHD, do not carry out assessments for it, and do not prescribe or renew ADHD medication, whether stimulant or non-stimulant. There is no purchase route on this page and nothing here that leads to one. We say that plainly because ADHD is a field where people have often already paid for something that did not deliver what they needed.

What MEDINOW does run is a written repeat prescription assessment at 19.90 euro for unrelated long-term treatment that is stable and unchanged, and a weight management assessment at 29.90 euro. There is no video consultation, no phone appointment and no live chat. The fee covers the medical assessment itself, not the issuing of a document. If the doctor declines on medical or legal grounds, the fee is refunded. If the doctor asks you for documentation, you have at least 7 days to provide it and we will remind you before the deadline; if the consultation cannot be completed, we refund the full amount. None of that applies to ADHD medication, which stays with the specialist and GP who manage it.

Who wrote this page

This page was written by the MEDINOW editorial team and reviewed by lek. Damian Wojno, a doctor registered in Poland, PWZ no. 3211301. He is not on the Irish Medical Council register. Reviewed on 29 August 2026.

It is general information about how adult ADHD is assessed and treated in Ireland. It is not a diagnosis, not an assessment tool, and not a route to medication. Waiting times, service availability and private fees change, so check current details with a GP, with the HSE or with ADHD Ireland rather than relying on any figure quoted online.

How this page was put together: the medicines, categories and rules described here were checked against the sources listed below rather than written from memory, and any figure we could not verify at source was left out instead of estimated. Where Irish practice differs from the rules of another country, the Irish position is the one stated on this page, and the Irish regulators named here are the HPRA for medicines, the HSE for health services, the PSI for pharmacy and the Irish Medical Council for doctors practising in Ireland. Corrections are welcome by email and are made to the page rather than argued about.