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

For adults in Hypoluxo Island, Manalapan, Ocean Ridge, and Old Town Lantana, RECO Integrated Psychiatry is 18 minutes south down Federal Highway — the closest office running a full DSM-5-TR ADHD workup with the DIVA-5 structured interview and a documented developmental history, rather than a five-minute telehealth screen. Prescribing is prescriber-led, cardiovascular monitoring is built in, and stimulant and non-stimulant options are chosen against comorbid depression, anxiety, sleep, and substance use rather than by default. In-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS.

Lantana sits on the Intracoastal between Delray Beach and West Palm Beach — a stretch of small marinas, barrier-island streets, and residential blocks in Hypoluxo Island, Old Town Lantana, Manalapan, and Ocean Ridge. Adults in these neighborhoods who suspect ADHD often face two poor options: a months-long wait for a university-based specialist, or a five-minute telehealth screen that ends with a Schedule II prescription and no follow-up. RECO Integrated Psychiatry, 18 minutes south down Federal Highway in Delray Beach, offers a third path: a structured DSM-5-TR diagnostic workup and prescriber-led follow-up for adult ADHD treatment.

The diagnostic protocol that actually confirms ADHD

DSM-5-TR requires symptom onset before age 12, symptoms present in two or more settings (work, home, driving, relationships), documented functional impairment, and rule-out of alternative explanations — major depressive disorder, generalized anxiety disorder, obstructive sleep apnea, thyroid dysfunction, active substance use, and the residual attentional effects of untreated PTSD or bipolar disorder. Meeting the checklist is the beginning of the workup, not the end.

RECO’s intake begins with the Adult ADHD Self-Report Scale (ASRS) as a screening instrument, then moves to the Diagnostic Interview for ADHD in Adults, fifth revision (DIVA-5), or the Conners Adult ADHD Diagnostic Interview (CAADID) where the clinical picture is more complicated. Both are structured interviews built directly around DSM criteria; neither is a checkbox exercise. Where adult memory of childhood symptoms is thin, we ask for report cards, IEP documentation, or a phone call with a parent or older sibling who can speak to grade-school function.

Screening scales including the PHQ-9 and GAD-7 are administered at intake to quantify comorbid depression and anxiety, which are present in roughly half of adults who ultimately meet criteria for ADHD. Sleep is assessed directly. If the presentation is dominated by insomnia, alcohol use, or an untreated mood disorder, ADHD treatment waits until those are addressed — a stimulant prescribed on top of an unrecognized bipolar disorder or a substance use problem is not neutral. Overdiagnosis is a real risk in the current care environment, and the protocol is designed to catch it before a controlled substance is written.

Stimulant options and how we choose

Methylphenidate-class medications (Concerta, Focalin XR, Ritalin LA, Jornay PM) and amphetamine-class medications (Adderall XR, Vyvanse, Mydayis) are considered equally first-line for adult ADHD. Individual response is idiosyncratic — roughly a third of patients respond better to one class than the other, and there is no biomarker or pharmacogenetic test that reliably predicts which. First-line choice is guided by comorbidities, sleep timing, prior response, cardiovascular profile, and history of substance use.

Long-acting formulations are preferred over immediate-release for adults. They produce smoother coverage across a workday, reduce end-of-dose rebound, and lower diversion risk. Jornay PM is a delayed-release methylphenidate taken the night before, useful for patients who need coverage from the moment they wake. Vyvanse (lisdexamfetamine) is a prodrug — pharmacologically inert until enzymatically activated after absorption — which produces a slower onset and a lower abuse profile, making it a reasonable first choice for anyone with a history of substance use.

Titration is driven by response and tolerability, not by messages between visits. Dose changes are made at scheduled follow-ups where blood pressure, heart rate, sleep, appetite, and functional response are all documented. Controlled substances are not adjusted by text; that boundary protects the patient and is consistent with DEA rules and current state prescribing guidance.

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

Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor with established efficacy in adult ADHD, no controlled-substance scheduling, and a slower onset — typically four to six weeks to full effect. It is a reasonable first-line option for patients with substance use histories, cardiovascular concerns, prominent comorbid anxiety, or a preference to avoid stimulants. Viloxazine (Qelbree) is a newer serotonin-norepinephrine modulator, FDA-approved for adult ADHD in 2022, with a similar risk profile.

Alpha-2 agonists — guanfacine extended-release (Intuniv) and clonidine extended-release (Kapvay) — are effective monotherapy or adjunct, particularly for hyperactivity, impulsivity, emotional dysregulation, and sleep-onset difficulty. They can be added to a stimulant to smooth evening symptoms without extending stimulant coverage into the night. Bupropion has published evidence in adult ADHD, particularly useful when a comorbid major depressive disorder or a smoking cessation goal is present.

For patients where stimulant medication is contraindicated — significant structural heart disease, active substance use disorder, certain arrhythmias — the non-stimulant pathway is well-mapped and is not a consolation prize. Where comorbid anxiety is prominent, adult-ADHD-adapted CBT, buspirone, and SSRIs such as sertraline or escitalopram are integrated with the ADHD regimen rather than treated in isolation.

Cardiovascular safety and the medications we monitor

Stimulant initiation in adults requires a documented cardiovascular history — personal history of syncope, chest pain, arrhythmia, cardiomyopathy, or structural heart disease, and family history of sudden cardiac death before age 40. Baseline resting blood pressure and heart rate are recorded. EKG is obtained in adults over 40, in anyone with a cardiac history, or when initial exam raises concern. American Heart Association guidance does not require routine screening EKG in healthy adults, and RECO follows the guideline rather than over- or under-testing.

Follow-up visits capture blood pressure and heart rate at every contact. Sustained systolic increases of more than 10 to 15 mmHg, resting heart rates above 100, or new palpitations prompt dose reduction, a switch to a non-stimulant, or cardiology referral before continuation. Height and weight are tracked; unintended weight loss is addressed with meal timing changes, dose reduction, or medication change — not ignored.

This is not a proprietary safety framework. It is what the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry have recommended for years. The difference in practice is who actually runs it — a five-minute telehealth visit does not include a blood pressure cuff.

What to expect on your first visit

The initial evaluation is a 60- to 90-minute appointment with a psychiatrist or psychiatric nurse practitioner. Intake paperwork completed before the visit includes the ASRS, PHQ-9, GAD-7, a full medical and medication history, and a release-of-information form for the primary care physician. Patients are asked to bring or upload any prior psychiatric records, report cards or IEP documentation where available, and a list of current medications and supplements with doses.

The visit itself covers a structured diagnostic interview (DIVA-5 or CAADID), developmental history, review of screening data, discussion of comorbid mood, anxiety, sleep, and substance use, cardiovascular history, and functional impact across work, driving, relationships, and executive function. If ADHD is confirmed and no rule-out issue is outstanding, an initial medication plan is discussed at the same visit. Where additional workup is needed — sleep study, thyroid panel, cardiology clearance — that is scheduled before controlled substances are prescribed.

Insurance and admissions from Lantana

RECO Integrated Psychiatry is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and Blue Cross Blue Shield plans. Benefits — deductible, copay, and coinsurance for psychiatric diagnostic evaluation and follow-up medication management — are verified before the first visit. Out-of-network and self-pay options are also available with published fees.

The Delray Beach office is a straight run down Federal Highway from Old Town Lantana and Hypoluxo Island, or I-95 south to exit 52 for patients coming from west of the tracks. Drive time from the Lantana Bridge is approximately 18 minutes off-peak and 25 to 30 minutes in afternoon rush. Telepsychiatry follow-up is available for established patients once the diagnostic phase is complete; initial evaluations are conducted in person.

Serving residents of: Hypoluxo Island, Manalapan, Ocean Ridge, Old Town Lantana.