What You Don’t Know About ADHD Medication

As a preschooler, Jarrett was hyperactive, impulsive, and restless. He also talked incessantly, interrupted others, and had trouble with focus. His doctor diagnosed him with ADD/ADHD and put him on stimulant medications, a standard treatment option. But the medicine didn’t work. In fact, it made him worse.

The little boy’s mother took him to another doctor, who prescribed a different stimulant, but it didn’t improve his symptoms either. Eventually, Jarrett saw 5 doctors and tried 5 stimulant medications for ADHD. None of them helped.

Instead, they led to rollercoaster mood swings and intense rages. At home, the youngster punched holes in the walls and frightened his siblings. At school, he had trouble making friends. And his teachers warned his mother that Jarrett would never amount to much and urged her to lower her expectations.

In time, his behavior became so disruptive that his physician recommended antipsychotic medication. Why didn’t the standard ADD/ADHD treatment work for Jarrett? Years later, a brain scan revealed why.

In treating attention-deficit hyperactivity disorder (ADHD), also called attention-deficit disorder (ADD), medication is often a first line of defense. In some cases, it can be a lifesaver. For others, like Jarrett, the drugs can exacerbate symptoms. Why don’t stimulants work for everyone with ADD/ADHD? That’s just one of 9 questions about ADD/ADHD medications answered here.

9 QUESTIONS ABOUT ADD/ADHD MEDICATION

1. How do ADD medications work?

Current research shows that stimulant medications increase activity in areas of the brain such as the prefrontal cortex. Brain-imaging shows that people with ADD/ADHD typically have low activity in the prefrontal cortex, especially during concentration. This means the harder people with ADD/ADHD try to pay attention, the harder it gets.

Stimulant medications also increase levels of important neurotransmitters, such as dopamine.  People with ADD/ADHD tend to have low levels of dopamine, which is involved in motivation, mood, memory, and attention.

2. How can stimulant medication help people with ADD/ADHD?

Research shows that stimulant medications can improve ADD/ADHD symptoms in approximately 70% of adults and 70%-80% of children. Improvements in symptoms include:

• Increased concentration
• Increased impulse control
• Increased empathy
• Increased motivation
• Decreased hyperactivity and restlessness
• Decreased distractibility
• Decreased irritability
• Decreased conflict-seeking behavior

In general, these medications can improve performance at school, at work, at home, and in relationships.

3. What are some of the most common stimulant medications currently available?

Stimulants are the most common form of medication prescribed for ADD/ADHD. The majority of stimulants are either amphetamines or methylphenidates.

• Amphetamine and amphetamine salt combinations: These are available under the brand names Adderall, Adzenys, Dexedrine, Dynanavel, Evekeo, ProCentra, Vyvanse, and Zenzedi. 
• Methylphenidate-based products: These are sold under the brand names Ritalin, Concerta, Daytrana, Focalin, Jornay, Metadate, Methylin, Quillivant, and Quillichew.

4. Why don’t stimulant medications work for everyone with ADHD?

ADHD medication that works for one person may not work for another. In part, this is because the brain-imaging work at Amen Clinics clearly shows that the condition isn’t just one thing. Brain SPECT scans shows there are 7 types of ADD/ADHD, and medication needs to be targeted to your ADD type.

SPECT is a functional brain-imaging technology that measures blood flow and activity in the brain. It reveals areas of the brain with healthy activity, too much activity, and too little activity.

Stimulant medications tend to work better in people who have too little activity in certain brain regions. In people who have overactivity in the brain, they can make things worse.

Take Jarrett, for example. Jarrett’s brain SPECT scan showed dramatic overactivity in a pattern the physicians at Amen Clinics call the “Ring of Fire.”

Overall increased activity:

Ring of Fire ADHD

Using stimulants on an overactive brain is like pouring gasoline on a fire. Published brain-imaging research at Amen Clinics shows that stimulants make the Ring of Fire brain pattern worse in 80% of people.

5. How long does the medication last?

These drugs come in short-acting and long-acting formulas.

• Short-acting (immediate release): These medications typically last up to 4 hours. In some people, however, they may last only 2.5 hours or up to 6 hours. They are designed to be taken as needed throughout the day.

When short-acting products wear off, people may experience rebound effects. This can include a significant drop in energy levels and moods and a sharp increase in hunger. Based on the experiences of tens of thousands of ADD/ADHD patients at Amen Clinics, Adderall tends to last longer than Ritalin and is gentler as it wears off.

• Long-acting (extended release): Slow-release preparations are designed to take once a day. Some last approximately 8 hours while others may last up to 16 hours. In clinical practice, the slow-release form of Ritalin is known as being somewhat erratic. The slow-release forms of Dexedrine, Adderall and Vyvanse seem to be somewhat more reliable.

6. What is the usual dosage?

When it comes to these medications, everyone is different. Some people require only one dose per day, while others need to take it 5 times per day. Other individuals do best with larger doses of stimulants.

Take note that the proper dosage often has nothing to do with a person’s body weight or age. Finding the most effective dose can require some adjustments.

7. What side effects are associated with ADHD medication?

Common side effects of stimulant medications include:

• Lack of appetite
• Trouble falling asleep
• Headaches or stomachaches
• Irritability or crankiness
• Crying or emotional sensitivity
• Staring into space
• Loss of interest in friends

Be aware that some people may experience mood swings and subtle changes in personality. These side effects typically go away in about 1-2 weeks. If they persist, it means a change in medication may be necessary.

Less common side effects include:

• Tics (such as eye blinking, throat clearing, or head jerking)
• Rapid pulse or increased blood pressure
• Nervous habits (such as skin picking, stuttering, or hair pulling)

It’s important to note that early studies revealed concerns that stimulants might stunt growth. However, newer long-term studies have found that taking stimulants for ADHD does not result in changes in adult height.

In addition, the side effects of having untreated ADD/ADHD are generally more significant than those associated with medication. Untreated ADD/ADHD is associated with increased risk for depression, school dropout, substance abuse, financial problems, divorce, and incarceration.

8. How long do stimulant medications need to be taken?

Every individual is different. Some people benefit from taking ADD/ADHD medication for just a few years while others may need it for many years.

9. What are some alternatives to taking stimulant medications for ADHD?

There are many natural ways to help ADD/ADHD, including lifestyle changes and nutritional supplements. For Jarrett, this involved nutraceuticals to calm overactivity in the brain, regular exercise, adequate sleep, a higher-protein lower-carb diet, goal setting, and more.

Over time, Jarrett experienced significant improvement in his behavior. The temper outbursts subsided, he started making the honor roll at school, and he had an easier time making friends. His life completely turned around.

If Jarrett had never gotten that brain scan, no one would have known that his brain was overactive. If he had just kept trying different stimulant medications, his future likely would have been very different.

SEEKING TREATMENT FOR ADD/ADHD

If you or a loved one has ADD/ADHD, it’s critical to discover your type to find the most effective solutions. Make an appointment with a mental health professional who understands that this is a brain-based disorder that has multiple types.

Brain imaging with SPECT can be helpful in determining which treatments will work best. This means you can find the right solutions more efficiently, which means faster healing.

ADD/ADHD and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.