Which Clinical Guidelines Cover Adult ADHD, and Where the First US Guideline Stands

A clinical practice guideline is a set of recommendations written by an expert group after a structured review of the evidence. It tells clinicians what good care usually looks like and gives patients and insurers a reference point. For adult ADHD, the United States has gone without one. That is expected to change, and this page records exactly where things stood on October 13, 2026.

Why the lack of a US guideline matters

American guidance on ADHD has long centered on children and adolescents. Adults have been evaluated and treated using the diagnostic criteria in the DSM-5-TR, FDA-approved labeling, review articles and guidelines written for other countries' health systems. That leaves room for wide variation in how thorough an evaluation is, what follow-up looks like, and what a telehealth company or a primary care office treats as adequate.

A national guideline does not have the force of law. It does shape training, insurer policies and what a reasonable clinician is expected to do, which is why its publication matters to patients as well as professionals.

The APSARD guideline: status on October 13, 2026

APSARD is the professional society producing the first US guideline for adult ADHD. Here is what its own guidelines page and a recent interview with its president confirm.

• Not published. APSARD's guidelines page links press releases, articles and an interview. It links no guideline document.
• Final review. The newest APSARD notice, dated August 27, 2026, is titled "APSARD Announces Launch of Final Review Stage for U.S. Adult ADHD Guidelines; Publication Anticipated This Fall".
• Timing. In a Psychiatric Times interview published September 15, 2026, APSARD president Brooke Molina, PhD, described the guidelines as being in stage 3, the final review before publication, with feedback due by the end of September and publication expected later in the fall.
• How it was written. About 30 volunteer experts worked in three subcommittees (screening and diagnosis; medication; psychosocial and non-medical interventions) and reached consensus through anonymous Delphi voting.
• Content. Dr. Molina declined to preview specific recommendations. Nobody outside the process can accurately say what the guideline recommends until it is released.

APSARD's page shows the project going back to a 2022 announcement, so the work has taken several years. "Anticipated this fall" is an expectation, not a date.

What clinicians use in the meantime

The American Family Physician review

The 2024 article by Olagunju and Ghoddusi is a clinical review with graded recommendations. It is often cited as if it were a guideline, and it is not one. Its main recommendations:

• Use validated tools and a clinical history to confirm the diagnostic criteria (evidence rating C).
• Stimulants are first-line drug therapy for adults (rating A).
• Non-stimulants are used when stimulants are contraindicated, not tolerated or ineffective (rating B). The review notes that one of the drugs it lists, bupropion, is not FDA-approved for ADHD.
• Cognitive behavioral therapy and mindfulness are recommended non-drug therapies (rating B).
• Clinicians should consider controlled-substance agreements and prescription monitoring program checks. In New York, checking the state registry is already a legal requirement for most controlled-substance prescriptions.

NICE and CADDRA

England's National Institute for Health and Care Excellence publishes guideline NG87. The dates in the table come from published descriptions of the NICE page, which could not be opened directly for this article, so treat them as reported. CADDRA, the Canadian ADHD Resource Alliance, identifies its current guidelines as edition 4.1 and describes them as guidance for healthcare professionals on screening, assessment and treatment. CADDRA's site dates the edition to January 2020.

Both were written for health systems that differ from New York's in how care is paid for, which medications are available and who is permitted to prescribe. They are useful references, and they do not set the standard of care in the United States.

What the sources agree on

The US sources opened for this guide (the American Family Physician review, CHADD, the National Institute of Mental Health, the CDC and the major pooled trial analyses) line up on three points.

1. Diagnosis is clinical. It rests on a history from childhood to the present, evidence of current impairment, rating scales, information from someone who knows the person, and screening for other conditions. There is no single test.
2. Stimulants are first-line medication for adults, with non-stimulants as the alternative. A 2018 network meta-analysis of randomized trials reached the same ordering for short-term treatment.
3. Psychological treatment, mainly CBT, belongs alongside medication. A Cochrane review found benefit, on evidence it rated low quality.

NICE and CADDRA are widely reported to take the same general positions. Neither document was opened in full for this guide, so that agreement is stated here as reported and unconfirmed.

What a patient can do with this

You do not need a published guideline to judge whether an evaluation was careful. The points of agreement above describe what to expect: questions about childhood, questions about how symptoms affect work and home, standardized rating scales, a request to hear from a partner or parent where possible, and screening for anxiety, depression, sleep and substance use.

When the APSARD guideline is published, the specifics may shift, and this page will be updated. Statements online about what "the new US guidelines say" should be treated with caution until the document itself is available.

For the standard that already exists, read the diagnostic criteria for adult ADHD, in plain language. For the trial data behind the treatment recommendations, see what the major studies found. The practice's pages on evaluation and treatment describe how care is organized there.

The next step in this guide is a comparison: clinical evaluation or neuropsychological testing, a choice on which the existing sources already give clear direction.