【醫生信箱】Q33. Am my kid having Rejection Sensitive Dysphoria?

Q33. My kid has been diagnosed ADHD, on Vyvanse, i suspected that she had RSD, I would like to know if treatment e.g. clonidine and guanfacine is available in HK n worth to try? Does she need to stop Vyvanse? Besides medication, is psycho therapy useful? Thanks🙏

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Ans. Rejection Sensitive Dysphoria (RSD) is an extreme emotional sensitivity to perceived or real rejection, criticism, or failure. RSD is not a formal diagnosis in DSM-5. Some articles suggest that stimulant medications such as Vyvanse has been effective in lessening the symptoms of RSD. Apart from medication, RSD is usually managed by psychotherapy such as cognitive behavioral therapy.

Guanfacine (Intuniv) was not formally launched / registered in Hong Kong yet. It should be available, hopefully in 2026. But the medication can be imported under the "named patient program". You can approach your private psychiatrist and ask for that. Do bear in mind, the price of the medication under this program can be quite high. ✍🏻撰文：精神科專科醫生 張正平醫生