Adult ADHD evaluation and treatment for Coral Springs — structured diagnosis, careful prescribing.

Coral Springs adults are 35 minutes down the Sawgrass Expressway from a practice that runs the full adult ADHD workup — ASRS screen, DIVA-5 or CAADID structured interview, developmental history, and PHQ-9/GAD-7 comorbidity screening — before writing a stimulant prescription. RECO prescribes across both methylphenidate and amphetamine classes and the full non-stimulant pathway (atomoxetine, viloxazine, guanfacine XR, bupropion), with BP and HR monitored at every visit. For patients with any substance use history, the Vyvanse-first approach is already in the standard playbook.

Coral Springs sits 25 miles inland from RECO Integrated Psychiatry’s Delray Beach office — a 35-minute drive via the Sawgrass Expressway to I-95 south. For adults in Eagle Trace, Hidden Hammocks, Cypress Run, Parkland Isles, and Heron Bay who suspect adult ADHD, or who have inherited a diagnosis from a two-question telehealth screen and want a defensible workup, a coastal outpatient psychiatric practice offers a longer, more careful evaluation than the rapid-prescribing channels that have proliferated across Broward County. What follows is how RECO conducts adult ADHD assessment, and why the protocol matters more than the prescription.

The diagnostic protocol that actually confirms adult ADHD

DSM-5-TR requires four things for an adult ADHD diagnosis: symptom onset before age 12, symptoms present in two or more settings, documented functional impairment, and reasonable exclusion of alternate explanations. Depression, generalized anxiety, obstructive sleep apnea, active substance use, thyroid dysfunction, and iron deficiency all produce inattention that mimics ADHD. Treating any of them as ADHD wastes months and exposes patients to Schedule II medication for a condition they do not have.

RECO’s intake for adult ADHD evaluation opens with the Adult ADHD Self-Report Scale (ASRS) as a screen, followed by the DIVA-5 or CAADID as a structured diagnostic interview. Developmental history is anchored to childhood report cards, standardized test data, or a parent or older sibling informant when adult recall alone does not establish the pre-12 timeline. Depression and anxiety are screened concurrently with the PHQ-9 and GAD-7; a positive PHQ-9 does not disqualify an ADHD diagnosis, but it changes the treatment sequence.

Overdiagnosis is a real problem in the current adult ADHD care environment — several telehealth-only prescribing services have been investigated or sanctioned for exactly this pattern. The workup above is standard adult psychiatric practice. The difference is that RECO runs it in full before a stimulant prescription is written, not after.

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 and side-effect profile vary and cannot be predicted from history alone; a trial of one class does not predict response to the other. If the first agent fails on efficacy or tolerability at an adequate dose and duration, switching classes is the standard next step.

Long-acting formulations are strongly preferred over short-acting immediate-release. Long-acting agents reduce mid-day dose gaps, protect against the rebound irritability that undermines evening function, and lower the diversion and misuse risk that immediate-release stimulants carry. Jornay PM is a bedtime-dosed methylphenidate with a delayed-onset core, useful for patients who struggle to function within the first hour of waking.

Vyvanse (lisdexamfetamine) is a prodrug — inactive until cleaved by red-blood-cell enzymes — and carries a lower abuse liability than immediate-release amphetamines. It is the preferred first stimulant for any patient with a personal or family substance use history. Dose titration happens at scheduled visits with documented response, blood pressure, and side-effect review, not through message-based escalations between contacts.

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

A meaningful fraction of adult ADHD patients cannot use stimulants — cardiovascular contraindications, active or historical substance use, prior stimulant intolerance, or personal preference against controlled-substance therapy all route treatment to the non-stimulant pathway. That pathway is well-mapped, though onset is slower.

Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor with an onset of action of 4-6 weeks and no controlled-substance scheduling. Viloxazine (Qelbree) is a newer non-stimulant with a similar mechanism and a modestly faster onset. Alpha-2 adrenergic agonists — guanfacine XR and clonidine XR — are effective as monotherapy or as adjuncts to stimulants, and are particularly useful when hyperactivity, impulsivity, emotional dysregulation, or sleep-onset insomnia dominate the presentation.

Bupropion has evidence in adult ADHD when comorbid depression is present and can be a reasonable single-agent trial where the ADHD and depressive symptoms overlap heavily. For patients with comorbid anxiety, sequencing an SSRI such as sertraline — or adding buspirone — before or alongside ADHD medication is often cleaner than treating both blindly at once. Treating the anxiety first occasionally resolves what looked like inattention.

Cardiovascular safety and the medications we monitor

Stimulant initiation requires a documented cardiovascular history (personal and first-degree family), a resting blood pressure and heart rate, and an EKG for patients over 40 or with any personal history of arrhythmia, unexplained syncope, structural heart disease, or family history of sudden cardiac death under 40. Uncontrolled hypertension, certain arrhythmias, and known structural disease are contraindications that route the patient to the non-stimulant pathway.

Follow-up visits include blood pressure and heart rate at every contact. Sustained systolic pressure above 140, sustained heart rate above 100, or new palpitations prompt dose reduction or a switch. Height and weight are tracked; clinically significant weight loss on stimulants is addressed with meal-timing changes, formulation adjustment, or a medication switch rather than ignored.

This monitoring framework is not proprietary. It reflects FDA labeling and standard adult psychiatric practice. The difference between prescribers is not the framework but whether it is actually run.

What to expect on your first visit

The initial evaluation is a 60- to 90-minute appointment with an adult psychiatrist. Patients complete the ASRS, PHQ-9, and GAD-7 in advance. During the visit, the psychiatrist conducts the DIVA-5 or CAADID structured diagnostic interview, reviews developmental history including any available childhood records, and screens the differential — depression, anxiety, sleep disorder, substance use, and thyroid dysfunction — with lab work ordered where indicated.

If ADHD is confirmed and stimulant treatment is appropriate, a baseline BP, HR, and cardiovascular history are documented and a first prescription is written that day, with a follow-up in two to four weeks. Where the functional impairment justifies work beyond medication alone, referral to adult-ADHD-specific cognitive behavioral therapy (CBT) is made — the CBT protocols developed by Ramsay and by Safren have the strongest evidence base for adult executive-function skill building.

Insurance and admissions from Coral Springs

RECO Integrated Psychiatry is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and Blue Cross Blue Shield, which covers most employer-sponsored plans held by Broward County residents. Benefit verification is completed before the initial evaluation so the copay, deductible status, and any prior-authorization requirement for stimulant coverage are known in advance rather than discovered at the pharmacy counter.

Coral Springs patients typically drive 25 miles down the Sawgrass Expressway to the Delray Beach office — 35 minutes outside peak commuting hours. After the in-person intake, follow-up medication management visits are available by secure telepsychiatry for Florida residents, which reduces the total time cost of ongoing care for Eagle Trace, Heron Bay, and Parkland Isles patients whose treatment has stabilized. New-patient scheduling typically opens within one to two weeks.

Serving residents of: Eagle Trace, Hidden Hammocks, Parkland Isles, Cypress Run, Heron Bay.