What Happens After an ADHD Diagnosis: The Family Doctor's Role in Ongoing Care

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You have an ADHD assessment report recommending medication, but no doctor has agreed to prescribe it. The assessment service expects your family doctor to take over. Your family doctor hasn’t received the report, or you don’t have a family doctor.

CAMH, the Centre for Addiction and Mental Health, describes adult ADHD treatment as work that often happens in primary care, with specialist input when needed. [1] We’ve already written about what an Ontario family doctor can do during an ADHD assessment. Ongoing care needs a separate agreement about who will prescribe, review the treatment, and respond to problems between appointments.

A Diagnosis Doesn’t Automatically Come With Follow-Up

Before the assessing service closes your file, establish who has agreed to take over. A recommendation to see a family doctor doesn’t confirm that a particular practice has accepted responsibility for treatment. If you are still looking for a doctor, tell the assessing service and ask what follow-up it can provide while you search.

The same arrangements need attention when someone leaves a pediatric practice, moves for university, or changes doctors after years of treatment. For the handover:

Ask for the assessment and consultation reports to be sent to the receiving practice, and keep copies.
Bring a current medication list, including doses, and a record of previous treatments and side effects.
Confirm where the next appointment will happen and who will handle prescriptions until then.
Keep the contact details for the practice responsible for questions between visits.

What Does “Working” Mean?

“I think my concentration is better” is a start. Are you finishing the work you sit down to do? Getting bills paid before late notices arrive is another concrete measure. At home, you might notice whether you can follow a conversation without losing track halfway through.

CADDRA, the Canadian ADHD Resource Alliance, recommends assessing both symptoms and daily functioning. Its guidelines describe setting specific treatment goals and using follow-up questionnaires to measure change. [2] Agree with your doctor on what to track, then compare it at later appointments.

Being less overwhelmed by the morning routine may matter more to you than finishing more work. Tell the doctor what you wanted to change and what happened. If work is easier but home life is still difficult, describe the difference.

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The First Prescription Needs a Follow-Up Plan

Medication follow-up is where the prescriber reviews the benefit alongside unwanted effects. CAMH recommends monitoring every two weeks until the correct dose is reached, then every three months. It also recommends comparing effectiveness and side effects before and after changes, and checking for medication interactions. [3] Your doctor may set a different schedule based on your circumstances; agree on the next appointment when treatment starts.

You don’t need to arrive with a spreadsheet. A few notes about when you noticed improvement and what bothered you make the discussion more specific. For example, “I finished my work, but I’ve been lying awake until two” describes a benefit and a problem that need reviewing together. Bring your other medications into the discussion too, including anything prescribed by another clinician.

Who handles renewal requests? Ask the prescribing office how much notice it needs and whether a visit is required before the next prescription. Get instructions for contacting the practice if a problem appears between appointments. Discuss dose changes with the prescriber.

Why Your Doctor Is Checking Your Blood Pressure

ADHD medications can affect blood pressure and heart rate. CADDRA recommends measuring both before medication starts and during follow-up. Its guidance also covers sleep, nutrition, and side effects such as appetite suppression and weight loss. [2] Tell your doctor about changes in appetite or weight, even if your concentration has improved.

An electrocardiogram isn’t required for everyone before starting treatment. CAMH advises further assessment for certain cardiac histories, including unexplained fainting or unresolved structural heart problems. [3] Bring up your own heart history and any known heart conditions in your family before medication is prescribed.

Better Concentration Can Still Leave Other Problems to Work On

CAMH describes support that includes occupational therapy for daily organization and psychotherapy for emotional and interpersonal difficulties. It also recognizes that a late diagnosis can bring distress about earlier experiences alongside relief. [4] A family doctor can help you discuss what remains difficult and what additional support might fit. If therapy is recommended, ask whether the therapist works with adults with ADHD and what you would be working on together.

Some psychotherapy is available through publicly funded services, while private care may involve fees. CAMH advises asking about cost and the expected number of sessions. [5] If the recommended service is beyond your budget, tell your doctor before booking.

When a Psychiatrist Still Has a Role

CAMH advises considering specialist referral when treatment response is inadequate, side effects need additional management, or other psychiatric and medical conditions complicate care. [1] Your family doctor can explain the reason for referral and what care they will provide while you wait.

If you are seeing several professionals, tell each prescriber about medication changes made elsewhere. Ask for consultation reports to be shared with your family practice, and check at the next follow-up that the recommendations arrived.

The Appointment and the Prescription Have Different Coverage

Having an Ontario health card does not automatically mean your ADHD medication is paid for. Prescription coverage depends on the drug and your eligibility for a public program or private plan. OHIP+ covers eligible prescriptions for people aged 24 and under who have OHIP coverage and no private plan. Other Ontario Drug Benefit eligibility routes include age 65 or older, Ontario Works, the Ontario Disability Support Program, and enrolment in the Trillium Drug Program. [6,7]

Ask the pharmacist to check the prescribed medication against your coverage and explain any amount you will need to pay. If that cost makes the plan unmanageable, tell the prescriber while treatment is being planned.

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References

Centre for Addiction and Mental Health. camh.ca/en/professionals/treating-conditions-and-disorders/adult-adhd Adapted from Jain U, The adult patient with attention-deficit/hyperactivity disorder, in Psychiatry in Primary Care, 2019. Accessed October 6, 2026.
Canadian ADHD Resource Alliance. caddra.ca/wp-content/uploads/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf, edition 4.1. Toronto, ON: CADDRA; 2020. Cardiovascular Issues, p. 57; Titration and Monitoring, p. 69; Managing Side Effects, pp. 70-73. CADDRA’s caddra.ca/guideline-overview/ identifies this as the January 2020 edition and still lists it as the latest edition, checked October 6, 2026.
Centre for Addiction and Mental Health. camh.ca/en/professionals/treating-conditions-and-disorders/adult-adhd/adult-adhd—treatment/adult-adhd—pharmacotherapy Principles of Medication Management. Adapted from Jain U, The adult patient with attention-deficit/hyperactivity disorder, in Psychiatry in Primary Care, 2019. Accessed October 6, 2026.
Centre for Addiction and Mental Health. camh.ca/en/professionals/treating-conditions-and-disorders/adult-adhd/adult-adhd—treatment/adult-adhd—psychotherapy Adapted from Jain U, The adult patient with attention-deficit/hyperactivity disorder, in Psychiatry in Primary Care, 2019. Accessed October 6, 2026.
Centre for Addiction and Mental Health. camh.ca/en/health-info/mental-illness-and-addiction-index/psychotherapy Mental Illness and Addiction Index. Accessed October 6, 2026.
Ontario Ministry of Health. ontario.ca/page/learn-about-ohip-plus Updated February 11, 2026; accessed October 6, 2026.
Ontario Ministry of Health. ontario.ca/page/medication-coverage-results Ontario Drug Benefit eligibility and medication coverage information. Accessed October 6, 2026.