ADHD Medications: What Are They For? How Are They Used? What To Expect?

WHAT ARE ADHD MEDICATIONS TAKEN FOR? 

The most important outcome for an adult with ADHD is to improve functioning in activities of daily living by being self-sufficient, having a better quality of life and being able to cope with the demands of daily life. Adults with ADHD may benefit from education and psychotherapy (psychological counseling) in addition to drug therapy.

Stimulants and non-stimulants can be used to treat ADHD.1

Brand Name

Generic Name

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Stimulant Medications Used to Treat ADHD

Adderall®

Adderall XR®

amphetamine
(extended release)

Dexedrine®

Dextrostat®

dextroamphetamine

Focalin®

dexmethylphenidate

Metadate ER®

Metadate CD®

methylphenidate
(extended release)

Concerta®

methylphenidate
(long acting)

Daytrana® (patch)**

methylphenidate

Ritalin®

Ritalin SR®

Ritalin LA®

methylphenidate
(extended release)
(long acting)

Vyvanse®

Lisdexamfetamine 

Non-stimulant Medications Used to Treat ADHD

Strattera®

atomoxetine

Tenex®**

Intuniv®**

guanfacine hydrochloride

**Only approved by the Food and Drug Administration (FDA) for the treatment of ADHD in children/adolescents. 

How do stimulants work to increase attention span?

  • For someone with ADHD, stimulants directly activate parts of the brain by increasing levels of chemicals i.e. dopamine and norepinephrine. This action helps transmit signals that ultimately improve attention span and focus and regulate impulsive behavior.

How do non-stimulants work to increase attention span?

  • Non-stimulant prescription medications work in the brain to increase certain chemicals without stimulating the brain directly. They have been used in the following circumstances:3
    • Incomplete response or no response to stimulants
    • Inability to tolerate side effects of stimulants
    • Presence of certain co-existing psychiatric conditions (i.e. psychosis, depression, or tics)

 

HOW SHOULD ADHD MEDICATIONS BE USED?

Take your ADHD medication as prescribed at the same time every day.4,5

  • If you miss a dose skip the missed dose and go back to your normal dosing schedule.
  • Don't try to catch up by taking additional doses. Taking higher doses of prescription stimulants can lead to a heart attack, stroke, or even death.
  • Do NOT suddenly stop taking your ADHD medication. Stopping prescription stimulants can lead to a “crash” in which you may feel withdrawal symptoms characterized by sleep disturbances, anxiety, and fatigue. If you are considering stopping your ADHD medication, talk to your healthcare provider first.
  • Your medicines cannot work if you do not take them regularly as prescribed. There are many apps available to help you remember to take your medications. A free app you might like to try is available from mymedschedule.com

Avoid consuming caffeine with stimulants, as both caffeine and stimulants can be energizing leading to anxiety, worsened heart beat irregularities, and problems with sleep. Talk to your healthcare provider to discuss the safety of caffeine in your diet.6

 

WHAT SHOULD I EXPECT WHEN TAKING AN ADHD MEDICATION?

What are possible side effects of stimulants?

  • Upset stomach
  • Headache
  • Increased blood pressure and/or heart rate

These common side effects typically occur as the body adjusts to the medication. They tend to resolve a few weeks after starting therapy. If these side effects persist and/or are bothering you, talk to your healthcare provider. Also, report any underlying heart problems (i.e. high blood pressure) in yourself or your family members as this may increase heart risks.7,8,9

Other side effects include:

Possible side effect

Tips on how to manage

Nausea

  • Take your medication with food, unless directed otherwise

Decreased appetite and/or weight loss

  • Take your medication AFTER meals
  • Eat several small meals during the day as opposed to eating 3 or fewer larger meals

Insomnia

  • Take your medication earlier in the day
  • Limit or eliminate caffeine intake
  • Practice good sleep hygiene

Dry mouth

  • Stay hydrated by drinking plenty of fluids
  • Use lozenges to keep mouth moist

Nervousness

  • Talk to your healthcare provider

Mood changes

  • Talk to your healthcare provider 

What are possible side effects of the non-stimulant, atomoxetine (Strattera®)?10

  • Non-stimulants may produce similar side effects as stimulants.
  • Atomoxetine may cause liver injury that may manifest as jaundice. Report yellowing of the skin or eyes as these may be signs of jaundice. 

Can ADHD medications affect my other medications?

Stimulants and non-stimulants can interact with your other medications. Let your healthcare providers know all the medications you are taking (prescription and over-the-counter) and avoid starting new over-the-counter medications without first discussing with your healthcare provider.

 

DID YOU KNOW?

  • ADHD medication should NOT be shared
  • Peer pressure to share medication is highest for prescription stimulants (54%), but sharing medications is not just medically unwise, but also a crime.
  • The risks outweigh the benefits as symptoms of fast heart rate and increased blood pressure can result
  • Studies have shown that college students who use prescription stimulant medications for nonmedical purposes generally have lower grade point averages, are more likely to be heavy drinkers and users of other illicit drugs, are more likely to be dependent on alcohol and marijuana, miss class more frequently, and study less.
  • Furthermore, giving away or selling a prescription drug is a misdemeanor and possessing a controlled substance without a prescription can lead to prison sentence and/or a hefty fine.11

Is there a risk of developing substance abuse from stimulant use?

  • There is no evidence that stimulant use leads to substance abuse or dependence when used as prescribed for the treatment of ADHD.
  • Studies have actually indicated that successful treatment of ADHD with stimulants lowers the chances of substance use disorders, compared to adults with untreated ADHD.12

Diet and exercise tips: A healthy nutritious diet may improve symptoms of ADHD. Studies have shown that exercising regularly can improve thinking ability and may improve the symptoms of adult ADHD. Dietary supplementation to replete nutrients in the body may provide benefit, but studies are inconclusive.13

Before you leave the pharmacy make sure you understand what your medication is for, how to take your medication, what to expect from your medication, and if it is safe to drive while taking your medication (Roadwise RX is a tool to help you understand how medications may affect you and your driving). If you don’t know, ASK.14 

 

 

References:

  1. http://psychcentral.com/lib/treatment-for-attention-deficit-disorder-adhd/0001204
  2. http://www.webmd.com/add-adhd/guide/adhd-stimulant-therapy 
  3. http://www.mayoclinic.org/diseases-conditions/adult-adhd/basics/treatment/con-20034552
  4. http://www.webmd.com/add-adhd/guide/adhd-stimulant-therapy?page=2
  5. http://www.healthline.com/health/adhd/adderall-crash#TakeCaution5
  6. http://www.healthline.com/health-slideshow/caffeine-and-adhd - 1
  7. http://www.webmd.com/add-adhd/guide/adhd-stimulant-therapy?page=2
  8. http://www.webmd.com/add-adhd/guide/tips-reduce-adult-adhd-medication-side-effects
  9. http://psychcentral.com/lib/treatment-for-attention-deficit-disorder-adhd/0001204
  10. http://www.healthline.com/health-slideshow/adult-adhd-medication - 5
  11. http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/consequences_of_illicit_drug_use_-_fact_sheet_april_2014.pdf
  12. http://www.webmd.com/add-adhd/guide/tips-reduce-adult-adhd-medication-side-effects?page=2
  13. http://www.webmd.com/add-adhd/guide/adhd-home-remedies
  14. http://www.fda.gov/Drugs/ResourcesForYou/ucm163330.htm