Palm Beach ADHD Center
Adult ADHD evaluation and medication management — in-office and via telehealth throughout Florida
Adult ADHD Is Underdiagnosed and Undertreated
Most adults with ADHD weren't diagnosed as children. They were told they were "smart but lazy," "not living up to their potential," or "just need to try harder." With the right evaluation and treatment, the frustration of a lifetime finally makes sense — and symptoms that felt permanent often respond dramatically to medication.
Dr. Agresti provides comprehensive adult ADHD evaluation, medication management, and monitoring. His concierge model means you can text questions about your medication, get same-day dose adjustments, and never wait weeks to address a problem that arose today.
ADHD Presentations in Adults
Predominantly Inattentive
- Difficulty sustaining attention
- Easily distracted
- Forgetfulness
- Losing things
- Difficulty with follow-through
- Avoidance of mental effort
Most common in adults; often missed because hyperactivity is absent
Predominantly Hyperactive-Impulsive
- Restlessness (internal in adults)
- Interrupting conversations
- Acting without thinking
- Difficulty waiting
- Excessive talking
- Emotional impulsivity
Less common; often presents as urgency, irritability, and impulsive decisions
Combined Presentation
- Both inattentive and hyperactive-impulsive symptoms
- Most impairing presentation
- Most common in clinical settings
Most patients referred for treatment have the combined type
The Evaluation Process
Clinical Interview
60–90 minute comprehensive evaluation covering developmental history, school records, work history, and current symptom presentation across multiple domains of functioning.
Rating Scales
Validated ADHD rating instruments (CAARS, ADHD-RS) quantify symptom severity and compare to normative data. Collateral information from a partner or family member is valuable when available.
Differential Diagnosis
Ruling out conditions that mimic ADHD: anxiety, depression, bipolar disorder, sleep disorders, thyroid dysfunction. Many co-occurring conditions are also present and require integrated treatment.
Individualized Treatment Plan
Medication selection based on your specific profile: symptom subtype, co-occurring conditions, substance use history, cardiac history, and lifestyle factors.
ADHD Medications We Manage
Adderall
StimulantAmphetamine/Dextroamphetamine
Mixed amphetamine salts for ADHD. Available in immediate-release and XR formulations.
Vyvanse
StimulantLisdexamfetamine
Long-acting prodrug with smooth onset and reduced abuse potential.
Ritalin / Methylphenidate
StimulantMethylphenidate
Classic ADHD medication available in multiple formulations and generic options.
Non-Stimulant Options
Non-StimulantStrattera / Wellbutrin / Intuniv
Atomoxetine, bupropion, and guanfacine for patients who cannot tolerate or prefer to avoid stimulants.
ADHD Telehealth — Statewide in Florida
Dr. Agresti provides ADHD evaluation and medication management via telehealth for patients throughout Florida. Stimulant prescriptions can be issued via telehealth. No need to travel to Palm Beach for initial or follow-up appointments.
Learn About TelehealthADHD Questions Answered
Yes — ADHD is often undiagnosed until adulthood. Many adults with ADHD struggled through school without a diagnosis, relying on intelligence and effort to compensate until demands exceeded their ability to cope. Adult ADHD presentations often emphasize inattention and disorganization over hyperactivity.
Dr. Agresti conducts a comprehensive clinical interview covering developmental history, school and work history, current symptoms across settings, and symptom impact on functioning. Validated rating scales (CAARS, ADHD-RS) supplement the clinical interview. A thorough evaluation typically takes 60–90 minutes.
Not always. A clinical psychiatric evaluation by a board-certified psychiatrist is sufficient for diagnosis in most cases. Neuropsychological testing adds cost and time without always changing the clinical picture. If learning disabilities or cognitive issues are suspected, neuropsych testing may be recommended.
Yes — since the 2023 DEA telehealth rule update and subsequent extensions, controlled substances including stimulants can be prescribed via telehealth. Dr. Agresti can evaluate and prescribe for ADHD patients throughout Florida.
Approximately 20–30% of patients don't respond well to stimulants, or have contraindications. Non-stimulant options including atomoxetine (Strattera), guanfacine (Intuniv), and bupropion (Wellbutrin) are effective alternatives. Dr. Agresti is experienced in optimizing non-stimulant regimens.