Adult ADHD evaluation and treatment for Boca Raton — structured diagnosis, careful prescribing.

For adults in Boca Raton, RECO Integrated Psychiatry offers structured DSM-5-TR ADHD evaluation — ASRS screening, DIVA-5 or CAADID diagnostic interview, and a documented developmental history rather than a two-question telehealth screener — 20 minutes up Federal Highway from Mizner Park. Stimulant and non-stimulant medication management is anchored to in-visit blood pressure, heart rate, and side-effect review, not portal-message prescribing. In-network with the major Florida commercial plans and built to handle the diagnostic complexity that low-friction telehealth misses.

From Mizner Park or Royal Palm Place, RECO Integrated Psychiatry’s Delray Beach office sits about 11 miles up Federal Highway — a 20-minute drive that keeps specialist psychiatric care inside a normal Boca Raton workday. For adults who suspect ADHD but have cycled through two-question telehealth screens or years of trial-and-error prescribing, that proximity matters. A structured DSM-5-TR evaluation, careful medication management, and cardiovascular follow-up all fit around a career and a family rather than requiring either to be rearranged.

The diagnostic protocol that actually confirms adult ADHD

Adult ADHD is not a self-report diagnosis. DSM-5-TR requires documented symptom onset before age 12, symptoms present in two or more settings — typically home and work or school — functional impairment across those settings, and active rule-out of alternative explanations. Depression, generalized anxiety, obstructive sleep apnea, chronic cannabis use, and thyroid dysfunction all produce inattention, working-memory failures, and executive dysfunction that a symptom checklist cannot distinguish from ADHD.

RECO’s intake uses the ASRS as a screening instrument and the DIVA-5 or CAADID as a structured diagnostic interview. Where adult recall of childhood symptoms is thin — a common problem after 20 or 30 years — the clinician requests childhood report cards, IEP or 504 documentation, or a family informant to establish the pre-12 onset criterion. A PHQ-9 and GAD-7 are administered at intake; a sleep history and a substance use inventory are standard. A TSH is ordered when the clinical picture warrants it.

Overdiagnosis of adult ADHD in the current care environment is a documented concern, driven largely by low-friction telehealth prescribing. The protocol above is what a defensible workup looks like, and it is what the practice runs on every ADHD treatment intake.

Stimulant options and how the choice gets made

Methylphenidate-class agents — Concerta, Focalin XR, Ritalin LA, Jornay PM — and amphetamine-class agents — Adderall XR, Vyvanse, Mydayis — are considered equally first-line for adult ADHD. Individual response is variable and largely unpredictable at baseline; a patient who fails one class often responds well to the other, and neither the ASRS score nor the presenting symptom profile reliably forecasts which will fit.

Long-acting formulations are strongly preferred over immediate-release. They flatten the diurnal effect curve, reduce dose-timing gaps that reintroduce inattention at critical hours, and lower diversion and misuse risk compared with short-acting tablets. Vyvanse (lisdexamfetamine) is a prodrug — the parent molecule is inactive until enzymatic cleavage in the bloodstream — which gives it reduced abuse liability and makes it a first-choice stimulant when there is any history of stimulant misuse, cocaine use disorder, or opioid use disorder.

Titration is anchored to scheduled follow-up visits rather than to portal messages. An initial dose is set, a two-to-four-week follow-up captures response, side effects, blood pressure, and heart rate, and adjustments are made in-visit. Controlled-substance prescribing without visit-anchored feedback is a pattern the practice deliberately does not run.

Non-stimulant options when stimulants aren’t the fit

Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor. Onset is slow — meaningful response typically requires 4 to 6 weeks at a therapeutic dose — but the abuse profile is negligible, and it is a reasonable first-line choice for patients with any active substance use history. Viloxazine (Qelbree) is a newer non-stimulant with a similar mechanism and a somewhat faster onset window.

Alpha-2 agonists — extended-release guanfacine and clonidine XR — are effective as monotherapy in some adults and as adjuncts to a stimulant in others, particularly when hyperactivity, impulsivity, or sleep-onset difficulty is prominent. Bupropion has modest evidence in adult ADHD and becomes a strong consideration when comorbid major depression is present, since it can address both conditions with a single agent rather than layered prescribing.

The non-stimulant pathway is well-mapped for patients with cardiovascular contraindications to stimulants, a substance use disorder history, or documented stimulant intolerance. It is not a second-tier option; for the right clinical profile it is the correct first choice, and framing it otherwise is a prescribing error.

Cardiovascular safety and the monitoring that goes with prescribing

Stimulant initiation in adults requires a documented cardiovascular history — personal and family — a resting blood pressure and heart rate, and an EKG in patients over 40 or with any personal cardiac history, family history of sudden cardiac death, or symptoms suggestive of arrhythmia. Uncontrolled hypertension, symptomatic coronary artery disease, and structural cardiac abnormalities are contraindications; the non-stimulant pathway exists in part for exactly these patients.

Follow-up visits include blood pressure and heart rate at every contact for as long as the patient is on a stimulant. Sustained blood pressure elevation or resting tachycardia prompts a dose reduction, a switch within class, or a transition to a non-stimulant. Weight is tracked; appetite suppression that produces meaningful weight loss is addressed with dose timing changes, formulation changes, or planned medication holidays where clinically appropriate.

The framework above is standard psychiatric practice and is documented in every major adult ADHD prescribing guideline. The relevant question is whether a given practice actually runs it. RECO does.

What the first visit looks like

The initial psychiatric evaluation runs 60 to 90 minutes. The clinician administers the ASRS, works through the DIVA-5 structured diagnostic interview, and collects a developmental history that reaches childhood behavior, academic performance, and any prior ADHD assessment. Where recall is thin, patients are asked in advance to bring report cards, IEPs, or a parent or older sibling for a portion of the visit.

Comorbidity screening is standard: PHQ-9 for depression, GAD-7 for anxiety, a sleep questionnaire, a substance use history, and a review of prior psychiatric medications and responses. A resting blood pressure and heart rate are taken. A prescribing decision may be made at the first visit or deferred to a short follow-up when collateral records are still pending; the practice does not prescribe stimulants on the same day as a first visit without a documented rationale.

Insurance and getting to Delray Beach from Boca Raton

RECO Integrated Psychiatry is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS. Benefits are verified before the first visit and a written estimate is provided; out-of-network and self-pay options are available for patients with high-deductible plans or narrow-network HMOs.

From Downtown Boca, Mizner Park, or Royal Palm Place, the drive to the Delray Beach office is 11 miles up Federal Highway (US-1) or I-95 north to Atlantic Avenue — roughly 20 minutes in typical traffic. Boca West adds five to ten minutes; Highland Beach is comparable to central Boca. Follow-up medication management visits are available via telepsychiatry after the initial in-person evaluation, which most patients use to keep the practice inside a normal workday.

Serving residents of: Mizner Park, Royal Palm Place, Downtown Boca, Boca West, Highland Beach.