If you’re searching for an experienced psychiatrist in Palm Beach who can evaluate, diagnose, and manage Adderall treatment for adult ADHD, you’ve found the right practice. Dr. Mark G. Agresti is a board-certified psychiatrist with more than 30 years of experience helping adults across Palm Beach and throughout Florida manage attention deficit hyperactivity disorder with evidence-based medication management — including Adderall and its extended-release counterpart, Adderall XR.
This practice is built around your schedule and your needs. You won’t wait weeks to reach Dr. Agresti when you need a dosage adjustment or have a question about a side effect. You get his direct cell number. That’s what concierge psychiatric care means.
Understanding Adderall
Adderall is a prescription stimulant that combines amphetamine and dextroamphetamine — two active amphetamine salts with decades of clinical evidence behind them. It belongs to the central nervous system stimulant class and works by increasing dopamine and norepinephrine availability in the prefrontal cortex, the brain region responsible for attention, planning, impulse control, and working memory. In individuals with ADHD, these neurotransmitter systems function differently; stimulant medications help normalize that activity.
Immediate Release (Adderall IR) takes effect within 30–60 minutes and lasts 4–6 hours, offering flexibility for patients who need targeted coverage — for example, just during work hours.
Extended Release (Adderall XR) uses a beaded delivery system to release roughly half the dose immediately and the rest over several hours, providing 10–12 hours of coverage from a single morning dose. Many adults prefer XR because it eliminates the mid-day dosing requirement and avoids a noticeable mid-afternoon drop.
Adderall is FDA-approved for ADHD in both children and adults and remains one of the first-line choices for adult ADHD pharmacotherapy.
Who Is Adderall Right For?
Adderall is appropriate for adults with a confirmed ADHD diagnosis for whom stimulant medication is medically indicated. Not every focus problem is ADHD, and not every person with ADHD needs a stimulant — which is exactly why a thorough psychiatric evaluation is essential before starting any Schedule II medication.
Adderall tends to be well-suited for adults who:
- Have a confirmed ADHD diagnosis (inattentive, hyperactive-impulsive, or combined presentation)
- Have not responded adequately to non-stimulant alternatives
- Have no significant untreated cardiovascular risk factors
- Have no active or recent history of stimulant misuse
- Need reliable, consistent symptom control throughout the day
Adults with co-occurring anxiety may still be Adderall candidates, but the interaction between stimulants and anxiety requires careful, individualized management. Dr. Agresti evaluates each patient thoroughly — not through a one-size-fits-all lens.
What to Expect — Starting Adderall
Before prescribing any controlled substance, Dr. Agresti conducts a comprehensive psychiatric evaluation. This is not a brief checklist appointment. It includes a detailed clinical interview covering your symptom history, functional impacts at work and in relationships, family history, co-occurring conditions (anxiety, depression, sleep disorders), your full medication history, and any prior evaluations or testing.
If Adderall is the right starting point, you’ll typically begin at a low dose — often 5–10 mg IR or 10 mg XR — and titrate upward every one to two weeks until you find an effective dose with manageable side effects. Effective doses vary considerably; some adults do well on 10 mg daily while others require 40 mg or more.
During titration, Dr. Agresti is directly accessible for questions and adjustments. If a side effect is bothering you or the dose isn’t adequate, you reach him directly — not a voicemail tree, not a patient portal with a 72-hour response window.
Side Effects and Management
Like all medications, Adderall can cause side effects. The most common include:
- Appetite suppression: Most common during peak medication hours. Eating a substantial breakfast before the medication takes effect and a full dinner after it wears off helps most patients maintain nutrition.
- Sleep disturbance: Taking doses too late in the day delays sleep onset. Adjusting timing — ensuring the last dose is taken by mid-afternoon — usually resolves this.
- Elevated heart rate or blood pressure: Stimulants produce a modest cardiovascular effect in some patients. Dr. Agresti monitors these parameters and will adjust dosing accordingly.
- Dry mouth: Staying well hydrated helps; sugar-free gum provides relief.
- Emotional rebound: Irritability or emotional sensitivity as the medication wears off often improves with dose or timing adjustments.
- Headache: Often related to dehydration or caffeine interaction; typically transient.
Most side effects are dose-dependent and manageable. Serious adverse events are rare when medications are properly prescribed and monitored, but Dr. Agresti takes cardiovascular safety seriously and will not simply continue a dose that’s causing significant side effects.
Adderall Shortage — Alternatives Available
Since 2022, patients across the country have experienced significant Adderall supply disruptions due to manufacturing constraints, DEA quota limitations, and dramatically increased demand. If you’ve been unable to fill your prescription consistently, you’re not alone — and there are clinically appropriate alternatives.
- Vyvanse (lisdexamfetamine): A prodrug amphetamine with more consistent supply and a smoother, longer-acting profile. Many patients actually prefer it to Adderall once they try it.
- Mydayis: An extended-release amphetamine formulation designed for 16+ hours of coverage.
- Methylphenidate (Ritalin, Concerta, Focalin): A different stimulant class with generally better supply availability that works well for many patients.
- Non-stimulant alternatives: Strattera, Wellbutrin, Qelbree, or Intuniv for patients who cannot wait for supply to stabilize.
If you’re managing an ongoing shortage, contact the office — Dr. Agresti can work quickly to find an alternative that maintains your symptom control.
Concierge ADHD Care
Managing ADHD with stimulant medication requires a level of responsiveness that traditional psychiatric practices struggle to provide. The difference between 20 mg and 25 mg of Adderall XR can be the difference between a productive workday and a frustrating one. If reaching your psychiatrist for a minor adjustment takes two weeks, you’re left struggling when you didn’t have to be.
Dr. Agresti practices concierge psychiatry, which means:
- Direct cell phone access: You have Dr. Agresti’s personal cell number. Dosage questions, prescription needs, and side effect concerns are addressed directly — typically the same day.
- Same-day refills: Refills are sent electronically the same day you request them, without requiring an in-person visit for routine prescription needs.
- No annual membership fee: Unlike many concierge practices, Dr. Agresti’s access level does not require a separate retainer.
- Unhurried appointments: Evaluations and follow-ups are thorough. You are not rushed through in 10 minutes.
For ADHD patients — where medication management is a dynamic, ongoing process — this kind of access is genuinely valuable.
Telehealth ADHD Treatment Across Florida
You do not need to be in Palm Beach to receive care from Dr. Agresti. He provides telehealth psychiatric services to patients anywhere in Florida through a secure, HIPAA-compliant video platform.
The DEA’s telemedicine flexibilities permitting Schedule II stimulant prescribing (Adderall, Vyvanse, Ritalin) via telehealth without a prior in-person visit have been extended through 2026. If you’re a Florida resident in Miami, Orlando, Tampa, Jacksonville, or anywhere else in the state, you can complete your evaluation and begin treatment entirely via telehealth. Dr. Agresti conducts the same comprehensive evaluation over video that he would in his Palm Beach office.
Schedule Your ADHD Evaluation
If you’re ready for a proper ADHD evaluation with a psychiatrist who responds when you call, contact Dr. Agresti’s office today.
Dr. Mark G. Agresti, M.D.
Board-Certified Psychiatrist | 30+ Years Experience
44 Cocoanut Row, Suite M-202, Palm Beach, FL 33480
Call or text to schedule: 561-760-4107
After-hours / emergency: 561-386-7743
Telehealth available for all Florida residents. Most evaluations scheduled within one week.
Related: ADHD Treatment in Palm Beach | ADHD & ADD Treatment | Telehealth Psychiatry Florida | Concierge Psychiatry