ADHD can be a bit of a roller coaster- something you likely already know if you or someone you know has ADHD! Maintaining focus can be an uphill battle on the best of days, making “Adulting” feel nearly impossible. Medications are a powerful tool to lessen those challenges and help level the playing field. Generally, medications are part of a treatment plan that includes therapy and lifestyle changes. Understanding the various options available may seem confusing and intimidating, but it does not need to be! So, let’s simplify it:
Stimulant vs. Non-stimulant:
Stimulants:
Stimulant medications, such as Ritalin, were the first treatment available for ADHD and are still frequently used today. They increase certain chemicals naturally produced in our brains, called neurotransmitters. These chemicals play many key roles in our body, including helping with focus, motivation, and impulse control. We can further break down this group of medications into two groups: Methylphenidate-based medications and Amphetamine-based medications.
Methylphenidate-based
This group includes common medications such as Ritalin and Concerta. They block the absorption of both norepinephrine and dopamine, two of those neurotransmitters that we mentioned earlier. They only take about 30-60 minutes to start working, and are available in a short-acting form (lasts for about 3-4 hours) or an extended release form (lasts 8-10 hours).
Amphetamine-based
Our second group of stimulant medications includes Adderall and Vyvanse. Similar to the Methylphenidate-based stimulants, these medications start working fairly quickly. They are also available in both short and extended release forms. However, they do tend to last longer. The short-acting form lasting for about 6 hours and the extended-release form lasting for about 8-12 hours.
Side effects:
Generally, stimulants very well-tolerated but do some potential side effects like all medications. These include:
- Decreased appetite and subsequent weight loss)
- Increased heart rate
- Dry mouth
- Insomnia (especially if taken in the evening/late in the day)
- Irritability
- Potential for misuse due to euphoric side effects
Stimulants: The Fine Print
Since stimulants are controlled substances, they come with a few extra hoops to jump through. It is likely that you will need to get a new prescription every month in addition to hurdles specific to your insurance. However, don’t let this deter you- if the medications work for you, they tend to be highly effective and worth the extra effort.
Non-stimulants:
There are two groups of non-stimulant medications that are used to treat ADHD as well: Norepinephrine reuptake inhibitors (NRIs) and certain antidepressant medications. Whereas stimulants tend to work quickly after one dose, non-stimulants must be taken daily for several weeks to achieve therapeutic effects. This means that these medications tend to provide stable, all-day therapeutic effects.
NRIs:
The most commonly used medication in this group is Atomoxetine, and it works by increasing the amount of norepinephrine available in the brain. Remember those neurotransmitters that we talked about earlier? Norepinephrine is one of them and plays an important role in our ability to concentrate and perform executive functions.
Antidepressants:
Some common antidepressants can be used to treat ADHD as well, such as Bupropion and Nortriptyline. These medications are particularly beneficial for people who also struggle with depression, which commonly co-occurs with ADHD.
Side effects:
Just like stimulants, non-stimulants medications also have the potential for side effects, such as:
- Dry mouth
- Insomnia
- Decreased appetite
- Nausea
- Decreased libido and erectile dysfunction
While these lists of side effects may seem intimidating, it is important to remember that no everyone experiences these side effects. Each person tolerates medication differently, and what works for one person may not work for the next. These side effects can also disappear over time of taking a medication, no longer being an issue once the body is accustomed to it.
Finding the Right Fit:
The right treatment plan is different for each person and can take a bit of time and patience to find. Some people benefit from one medication while others may need a combination of medicine, therapy, and lifestyle changes. Each person and their situation is unique, which means that their needs are different from anyone else. A few factors that may influence your choice include:
- Age and lifestyle: People of all ages respond to medications differently in addition to having different needs at different stages throughout life.
- Health history: Your current health and health history can play a big role in deciding which medications are the best fit for you.
- Side effects: Some side effects may be more tolerable than others, and some people may experience more or less side effects than other people. It is important to work closely with your provider to find the best medication for you.
- Insurance coverage and medication availability: Some medications may be more widely available than others and some insurance companies may cover certain medicines and not others.
Our highly trained and caring counselors here at The Traini Counseling Group would love to answer your questions and help guide you through the process of finding the correct treatment for you. We offer medication management services in addition to counseling. Please feel free to reach out to us via the Appointment Request Form or phone at (810)-379-9251.