Dear  ,

Welcome to the RANZCP ADHD Network Newsletter

I hope this edition of the newsletter finds you in good health and spirits. I apologise for the delay in sending the newsletter.

The aim of the ADHD Network Committee is to promote the recognition of ADHD amongst College Members and promote excellence in the assessment, diagnosis and management of ADHD throughout the lifecycle. Our network has a large membership of approximately 2,110 College members.

Education and Training

The ADHD Network Grand Round Case Presentation, which occurs on the first Wednesday of the month at 12 pm AEST/AEDT via Zoom, is now attracting about 90-100 attendees regularly. My thanks go out to our presenters and discussants for their ongoing support. Members who are interested in participating in the Grand Rounds can directly contact me or the jurisdictional members. For those unable to attend, the case presentation recordings are uploaded to the College website and accessible via the ADHD Network homepage.

February Grand Round:
Topic:  ADHD and Females – what we know about the role of sex hormones
Presenter:  A/Prof Caroline Gurvich

March Grand Round:
Topic:  ADHD and functional medicine perspective
Presenter:  Dr Sanjeev Sharma

Joint Conferences

The ADHD Network Committee will, once again, be joining with the Faculty of Adult Psychiatry and the Section of Private Practice for a joint conference to be held in 27-29 June 2025 at Novotel, In Barossa Valley, in Adelaide. Facilitated by RANZCP SA Branch, A pre-congress workshop on ADHD will be conducted by Prof David Coghill.

The Network Committee will also partner with the Faculty of Child and Adolescent Psychiatry this year for their Conference on 17-20 September 2025 at Crowne Plaza, Hobart. As part of this conference, the Network will facilitate a one-day workshop about ADHD on the 17 September 2025. Prof David Coghill, Prof Valsamma Eapen and A/Prof Soumya Basu will be the speakers for the workshop.

Medication shortage

There is shortage of Methylphenidate Concerta affecting all strengths and it is expected to last until December this year. TGA has approved an overseas alternative but it is unclear what will be the cost as Concerta is subsidized for younger patients.

Read for more information:
https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-shortage-methylphenidate-hydrochloride-modified-release-tablets

There is also shortage of Atomoxetine 40mg and 80mg capsules and it is expected to last from 20^th Feb to 15^th May 2025. Unfortunately, communication about the medication shortages from the respective agencies have not been great. It is important to periodically check for medication shortages through TGA Medication Shortage Database through the below link: https://apps.tga.gov.au/Prod/msi/search?shortagetype=All

Other matters

The Australian Government Response to the Senate Community Affairs References Committee Report has been released in December 2024. Of the 15 recommendations by the Senate Community Affairs References Committee, only one had the support, i.e., Recommendation 5 which is about development of uniform prescribing roles. Another 9 recommendations were supported-in-principle and the rest were noting. It appears that the Government Response has been narrow in scope.

There is increasing focus on ADHD by the political parties. WA Labour Party promises improving access for ADHD care through GPs. A call for education at a higher level which must involve not only a deep understanding of ADHD, but of mental health in general because of the issues of comorbidity. That is, GP's will not just be assessing for ADHD, they will be doing a full mental health assessment which is what happens when a patient sees a specialist.

The Network Committee is of view that appropriate clinical training and supports need to be in place for GP training. The Australian Greens have announced that ADHD and Autism assessments will be added to Medicare to reduce access related costs. An issue which is not acknowledged by the Government or Political Parties are about the cost of ADHD medications to Adults due to PBS criteria.

Resources

It is with great pleasure that I announce that Monash University Department of Psychiatry, under the leadership of Professor Suresh Sundram, has established an online Short Course.

ADHD in Adolescent and Adult Psychiatry – A Clinical Approach”, coordinated by Dr Petre Heffernan, Department of Psychiatry, Monash University. The course is based on the program Petre has been delivering privately over the past 3 years. Online details will soon be available. Petre hopes the Monash course sets the stage for the development of an ADHD Clinical Research Program in the Department of Psychiatry.

Email Peter for details- DrHeffernan@PeninsulaPsychologicalMedicine.com.au

Research articles of interest

A recent Lancet article by Ostinelli et al (2025), a well conducted systematic review and component network meta-analysis on pharmacological, non-pharmacological and neurostimulation interventions for ADHD in adults inclusive of 113 RCTs, concluded that both stimulants and Atomoxetine are effective in reducing ADHD core symptoms at 12 weeks in self-rating and clinician-rated scales. CBT, cognitive remediation, mindfulness, psychoeducation and transcranial direct stimulation were found by better than placebo only on clinician-rated scales. (Lancet Psychiatry; 2025 Jan;12(1):32-43. doi: 10.1016/S2215-0366(24)00360-2).

Exploring the risk of Raynaud Syndrome and ADHD medications, systematic review by Besag et al (2025) included 197 articles including a total of 61 cases from case reports, case series, a case control study and a retrospective cohort study. Methylphenidate and Dexamfetamine were commonly implicated but Atomoxetine was rarely associated. Reassuringly, the authors concluded that the symptoms were mild and resolved within weeks of discontinuation, dose reduction or change to an alternative medication in most cases. A small number of cases had series complications including the need for amputation or revascularisation (CNS Drugs. 2025 Mar;39(3):213-241. doi: 10.1007/s40263-024-01154-4).

In relation to the association between ADHD and psychotic disorders, the pooled lifetime prevalence of ADHD in psychotic disorders was 18.49% (95% CI: 11.78-27.83) as per the systematic review by Cheng et al (2025) in Schizophrenia Bulletin. ADHD rates were higher in child-onset psychotic disorders than adolescent- and adult-onset psychotic disorder. This study was affected by high heterogeneity and it included 36 studies and 30 726 individuals (Schizophr Bull. 2025 Jan 13:sbae228. doi: 10.1093/schbul/sbae228).

Membership

The ADHD Network has been growing steadily with a large membership base and the committee is thankful to the members’ participation the monthly Grand Rounds. The committee welcomes ideas and suggestions from the wider membership to promote the study, research and advancement of the science of practice of psychiatry in the field of ADHD. Should you wish to raise anything or participate in the Grand Rounds, please contact me or contact any of the committee members.

Dr Karuppiah Jagadheesan (Chair)
Dr David Chapman (NT Jurisdictional Member)
Dr Angelene Chester (SYMH Representative)
Dr Rosie Edwards (NZ Jurisdictional Member)
Dr Caroline Flynn (ACT Jurisdictional Member)
Dr Victoria Jackson (TAS Jurisdictional Member)
Dr Gordana Jovanova (NSW Jurisdictional Member)
Dr Ashar Khan (QLD Jurisdictional Member)
Dr Edward Ko Ko Aung (SA Jurisdictional Member)
Dr Elizabeth Lun (Trainee Representative)
Dr Teslin Mathew (VIC Jurisdictional Member)
Dr Roger Paterson (WA Jurisdictional Member)
Prof Sarah Romans (NZ Jurisdictional Member)
Dr Claire Gaskin (Co-opted Member)
Dr Peter Heffernan (Co-opted Member)

On behalf of the Committee, I would like to thank you for your continuing support of our vital work.

Best wishes,
Dr Karuppiah Jagadheesan
Chair, RANZCP ADHD Network Committee