Adult ADHD evaluation and treatment for Boynton Beach — structured diagnosis, careful prescribing.

For adults in Boynton Beach, RECO Integrated Psychiatry sits roughly twelve minutes south along Federal Highway — closer than most Renaissance Commons or Ocean Ridge grocery runs. The adult ADHD workup uses the DIVA-5 or CAADID structured interview alongside ASRS, PHQ-9, and GAD-7 rather than a two-question telehealth screen, so the diagnosis actually holds up. Stimulant and non-stimulant options are both fully mapped, cardiovascular monitoring is standard practice at every follow-up, and controlled-substance titration is anchored to scheduled visits rather than message threads.

Boynton Beach residents heading south on Federal Highway reach RECO Integrated Psychiatry’s Delray Beach office in roughly twelve minutes — a shorter drive than the trip most Renaissance Commons or Ocean Ridge households already make to a full-service grocer. For adults working out whether their concentration failures, working-memory slips, and chronic follow-through problems represent attention-deficit/hyperactivity disorder or something else entirely, that geography matters. A defensible diagnostic workup takes more than one visit, and a manageable commute is often the difference between finishing an evaluation and abandoning it half-completed.

The diagnostic protocol that actually confirms ADHD

DSM-5-TR criteria for adult ADHD require symptom onset before age twelve, impairment across two or more settings — typically work and home, or work and social — functional consequences that are more than transient, and, critically, the exclusion of conditions that produce identical presentations. Untreated depression, generalized anxiety, obstructive sleep apnea, alcohol or cannabis use, and thyroid dysfunction all mimic attentional impairment. An honest workup rules those out before it confirms ADHD.

RECO’s adult ADHD evaluation uses the ASRS as an initial screen, followed by a structured diagnostic interview — the DIVA-5 or CAADID — that walks through each DSM criterion with anchoring examples. Where adult memory of childhood function is thin, we ask for school report cards, a parent or sibling informant, or documentation from prior evaluations. Comorbid conditions are screened with the PHQ-9 and GAD-7 at intake, sleep is queried directly, and when apnea is plausible we refer for a sleep study before initiating any stimulant.

Overdiagnosis by way of two-question telehealth intake is a documented problem in the current care environment. RECO’s protocol is deliberately built to catch presentations that don’t actually meet criteria — because a stimulant prescription that follows the wrong label is not a benign event.

Stimulant options and how we choose

Methylphenidate-class agents — Concerta, Focalin XR, Ritalin LA, Jornay PM — and amphetamine-class agents — Adderall XR, Vyvanse, Mydayis — are equally first-line for adult ADHD. Individual response varies substantially and cannot be predicted from history alone. The standard approach is a structured trial of one class with visit-anchored feedback, and a switch to the other class when response is inadequate or side effects are limiting.

Long-acting formulations are preferred over immediate-release. Steadier plasma levels reduce the afternoon crash, minimize rebound irritability, and — pragmatically — reduce diversion risk in households with children or roommates. Vyvanse (lisdexamfetamine) is a prodrug requiring gastrointestinal cleavage to release active dextroamphetamine, which lowers abuse liability and makes it the first-choice amphetamine for anyone with a personal or family history of substance use.

Dosing is titrated in scheduled visits with objective feedback — target symptoms, side-effect burden, blood pressure and heart rate — rather than through message threads. Between-visit adjustments to a controlled prescription are the exception, not the workflow.

Non-stimulant options for when stimulants aren’t the fit

Not every adult with confirmed ADHD is a stimulant candidate. Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor with a four-to-six-week onset and durable effect on attention and executive function; it carries no controlled-substance status and no meaningful abuse liability. Viloxazine (Qelbree) is a newer non-stimulant working on similar pathways with a somewhat faster onset.

Alpha-2 agonists — guanfacine extended-release and clonidine extended-release — are useful adjuncts for hyperactivity, impulsivity, and sleep-onset difficulty, and they meaningfully augment a partial stimulant response. Bupropion, while not FDA-approved for ADHD, has reasonable evidence in adults with comorbid depression and is often the pragmatic first choice when both conditions are present.

For clients with cardiovascular contraindications, prior stimulant misuse, active substance use disorder, or a considered preference to avoid controlled prescriptions, the non-stimulant pathway is fully mapped and well-tolerated. Choice of agent is driven by comorbidity, safety profile, and functional target rather than by prescribing habit.

Cardiovascular safety and the medications we monitor

Stimulant initiation begins with a documented cardiovascular history — personal and first-degree family — a resting blood pressure and heart rate, and, in adults over forty or with any cardiac history, a baseline EKG. Unexplained syncope, structural heart disease, uncontrolled hypertension, and arrhythmia change the calculus and frequently route treatment to a non-stimulant regimen.

Follow-up visits include blood pressure and heart rate at every contact. Sustained systolic elevation above 140, diastolic above 90, or resting heart rate above 100 prompts dose reduction, formulation change, or a switch to atomoxetine or an alpha-2 agonist. Height and weight are tracked because sustained appetite suppression has downstream metabolic consequences. Sleep is queried, since stimulant-induced insomnia is common, correctable, and clinically consequential.

None of this is exotic. It is the framework taught in every psychiatry residency. The difference at RECO is that it is actually run — vitals are actually taken, EKGs are actually reviewed, and prescriptions are not renewed on autopilot when parameters drift.

What to expect on your first visit

The intake is a ninety-minute evaluation covering presenting concerns, developmental history, prior psychiatric and medical treatment, medication trials and responses, family psychiatric history, and a substance use inventory. Rating scales including the ASRS, PHQ-9, and GAD-7 are completed before or during the visit; the AUDIT is added where relevant. A structured diagnostic interview using the DIVA-5 or CAADID walks through DSM-5-TR criteria with anchoring examples.

Where the diagnosis is clear and safety parameters are met, medication may be initiated at the intake. Where developmental history is thin, comorbidity is significant, or cardiovascular workup is incomplete, treatment begins at a rapid follow-up after the workup is finished. Follow-up cadence is weekly to biweekly during titration, monthly once stable, and quarterly for long-term maintenance.

Insurance and getting to Delray Beach from Boynton

RECO Integrated Psychiatry is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS plans typical of Palm Beach County employers. Coverage verification takes a single phone call before the intake. Self-pay rates are published for clients using out-of-network benefits or Health Savings Account funds.

The office sits directly off Federal Highway in Delray Beach, roughly seven miles and twelve minutes south of Boynton via US-1 or I-95. Residents of Renaissance Commons, Quantum Park, Hunters Run, Ocean Ridge, and Briny Breezes typically report door-to-door drives under twenty minutes. Telepsychiatry follow-ups are available once treatment is established, so ongoing medication management does not require every visit to be in person.

Serving residents of: Renaissance Commons, Ocean Ridge, Quantum Park, Hunters Run, Briny Breezes.