This guide shows you how ADHD treatment usually works in Germany. It’s based on my own experience, and updated with feedback from readers.
Health insurance coverage
The ADHD diagnosis, therapy and medication are fully covered by your health insurance. There is only a 5€ deductible on each prescription.1
If you have public health insurance, you must find a psychiatrist that accepts public health insurance. They are harder to find.
If you have private health insurance, it’s easier to find a psychiatrist and get an appointment.
Getting diagnosed for ADHD
To get diagnosed for ADHD, you must:
- Find a psychiatrist
If you can, choose a psychiatrist that specialises in ADHD. They are harder to find. – English-speaking psychiatrists in Berlin
- Book an appointment
This can be hard. Many psychiatrists don’t accept new patients. Your appointment might be in a few weeks.
- Take an ADHD diagnosis test
In most cases, the test is a simple interview. They just ask you a few questions about your life. Some psychiatrists will ask for more tests.
The hardest part is to find a psychiatrist and book an appointment. This is not easy for people with ADHD.
Finding a psychiatrist
These Berlin psychiatrists speak English and diagnose people with ADHD:
- Dr. Yrsa Werzinger2
- Dr. Nikolaos Riga3
- Charité Outpatient Center for Adult ADHD – very hard to get an appointment
- Dr. Susanne Finke – no public health insurance
- Dr. Arne Kuhlmei6
Try this list of ADHD doctors. This is an unofficial list. It might not get updated.
The ADHD treatment process
This is the process that I followed. Your experience could be different.
During your first appointment, your psychiatrist will see if you have ADHD, and how it affects your life. They will decide if you need therapy or medication for it.
Your psychiatrist will only prescribe ADHD medication if it’s necessary. German doctors are very careful about prescribing medication. They might want to try therapy and other methods first. Medication has side effects, so they try softer approaches first. You might find this frustrating, but you must be patient.
They might measure your brain activity with an Electroencephalogram (EEG). Not all psychiatrists do it.
They might measure your blood pressure, and take a blood sample. This is to see how the medication affects you.
First week of medication
During your first or second visit, you will get a prescription (Rezept). Bring it to a pharmacy (Apotheke) to get your medication. If they don’t have your medication, they will order it and contact you in 1 to 3 days. The medication costs you 5€.1 Your health insurance pays the rest.
You will probably get a low dose of Medikinet (Ritalin); usually 5 to 10 mg. Your psychiatrist will teach you how to take the medicine and explain its side effects to you.
You should not feel a big difference yet. 5 to 10 mg is a very small dose of Medikinet or Ritalin. You might experience nausea and and upset stomach while your body adjusts to the medication. It felt like a mild hangover that lasted until lunch. I felt a bit of euphoria, like if I had a really strong coffee. If you don’t feel any big improvements yet, it’s normal. If you feel big improvements, don’t get too excited. Your body is adjusting to the drug.
Keep a journal of how you feel. It helps your psychiatrist adjust your medication.
Every few weeks, you will see your psychiatrist to adjust your medication. They will listen to your feedback, and titrate your medication. Give clear, specific feedback. A journal really helps for that.
Usually, if you don’t have any bad side effects, they will increase the dose, and schedule another appointment. A nurse might take your blood pressure again.
You might start to feel a slight improvement at this point. It might become easier to pay attention in lectures or meetings, and boring tasks might become less difficult once you get started. But medication does not work like magic. For example, it can help you focus really hard on the wrong task.
If Medikinet does not work for you, tell your psychiatrist. You are not alone. They might suggest a different drug. It’s also covered by your health insurance.
Long term treatment
After you adjust your medication dosage, you can get prescriptions from your family doctor (Hausarzt).4 It’s easier to see a family doctor than a psychiatrist, because they have more free appointments.
ADHD medication used in Germany
Medikinet (Ritalin) is the most commonly prescribed ADHD medication. You can also get Elvanse (Vyvanse), Atomoxetine (Strattera) and other similar drugs, but you must usually start with Medikinet.5