While behavioral and environmental interventions can help individuals better cope with ADHD, medical therapy remains the treatment of choice for controlling ADHD symptoms. This can be a point of concern for many, especially parents who are uncomfortable with the prospect of “medicating” their child. While any medication has its share of side effects and other risks, working closely with your doctor to create an individualized treatment plan will ensure the best possible outcome. Below is a general overview of the drugs most commonly used to treat ADHD along with their common side effects and other information. Remember to ask your doctor which medication is right for you or your child.
Stimulants are the most widely used medications for ADHD. They are the first-line treatment in most cases of ADHD, and up to 90% of patients treated with stimulants will improve without significant side effects. The stimulants work by increasing the levels of certain neurotransmitters in areas of the brain important for concentration and attention. As a result, concentration and directed attention are increased, and the urge for impulsive and hyperactive behavior is lessened.
The commonly used stimulant medications are listed in the table below:
|Generic Drug Name||Available Brand Names|
|methylphenidate||Concerta, Metadate CD, Metadate ER, Methylin, Methylin ER, Ritalin, Ritalin LA, Ritalin SR|
|dexmethylphenidate||Focalin, Focalin XR|
|dextroamphetamine + amphetamine||Adderall, Adderall XR|
The various stimulants are considered to be equally effective over all, though in specific cases different drugs may work better for different people. Additionally, most are available in both short-acting and long-acting forms, offering the advantage of different dosing schedules based on when during the day symptoms are most severe.
The side effects of the stimulants are usually mild. Many patients will experience no significant side effects, and most who do can be treated simply by switching to another stimulant drug. In very few cases are the side effects so severe that stimulants cannot be used. Common side effects include decreased appetite (in fact, some of these drugs have been used as appetite suppressants), weight loss, and insomnia (difficulty sleeping). Other less common side effects include increased heart rate and blood pressure, temporary slowing of growth (no long-term effect), headaches, irritability, anxiety, and worsening of tics (spastic, involuntary movements) in patients with tic disorders (such as Tourette syndrome). Once again, an individual may experience side effects with one stimulant and not another.
Other ADHD Drugs
Other drugs are also used in the treatment of ADHD. These drugs may be less effective or have more side effects in some people when compared with stimulants, but they are quite useful in patients who cannot take stimulants due to inadequate response, unacceptable side effects, underlying disorders that might be worsened by stimulants (such as anxiety disorders, tic disorders), or other reasons.
Atomoxetine (brand name Strattera) is not a direct nervous system stimulant but has a similar effect in increasing neurotransmitter levels in parts of the brain. Thus, many of its side effects are similar to those of the stimulants. These include decreased appetite, weight loss, insomnia, abdominal pain, nausea / vomiting, and possible worsening of tic disorders. Other rare but serious side effects include liver damage and suicidal ideation (spontaneous thoughts about suicide or suicide attempts).
Some medications commonly used to treat depression are also effective in treating ADHD. These may be especially useful in individuals suffering from anxiety or tic disorders who cannot take other ADHD drugs. These medications also have a variety of common, uncommon, and potentially serious side effects.
Other medications currently in use or coming soon to the market may offer additional options for the treatment of ADHD. If you or your child has been diagnosed with ADHD, talk to your doctor to figure out which medication has the best chance for success in your individual case. Also remember that close follow-up with your doctor to assess the effectiveness of treatment and to address any side effects is vital to the successful treatment of ADHD. Armed with the proper treatment, a supportive environment, and dedicated medical care, most people with ADHD can maximize their potential for happiness, success and all of the wonderful things in life!