Attention-Deficit/Hyperactivity Disorder: Stimulant Therapy

Stimulant therapy is the most commonly used treatment for ADHD.

Stimulants are an effective way of managing ADHD symptoms such as short attention span, impulsive behavior, and hyperactivity. They may be used alone or in combination with behavior therapy.

These drugs improve ADHD symptoms in about 70% of adults and 70%-80% of children shortly after starting treatment. Improvements include reduced interrupting, fidgeting and other hyperactive symptoms as well as improved task completion and home relationships.

Improvements in behavior and attention span usually continue as long as the medication is taken, although benefits in social adjustment and school performance have not yet been shown to endure over the long term.

These medications are not considered to be habit-forming when used to treat ADHD in children and adolescents, and there is no evidence that their use leads to drug abuse. Nonetheless, there is a potential for abuse and addiction with any stimulant medication, especially if a person has a history of substance abuse.

Common Stimulants

There are many stimulants available: short acting (immediate-release), intermediate-acting, and long-acting forms. Common stimulants include:

• Adderall (intermediate-acting)
• Adderall XR (long-acting)
• Concerta (long-acting)
• Dexedrine (short-acting)
• Dexedrine spansule (intermediate-acting)
• Metadate CD (long-acting)
• Metadate ER (intermediate-acting)
• Methylin ER (intermediate-acting)
• Ritalin (short-acting)
• Ritalin LA (long-acting)
• Ritalin SR (intermediate-acting)
• Vyvanse

The short-acting forms of the drug are usually taken two or three times a day and the long-acting ones just once a day.

Newer forms of some stimulant drugs may reduce side effects and relieve symptoms for a longer period of time. They include Concerta (10-12 hour duration), Ritalin LA (6-8 hours), Metadate CD (6-8 hours), and Adderall XR (10-12 hours).

How Do They Work?

Stimulants regulate impulsive behavior and improve attention span and focus by increasing the levels of certain chemicals in the brain, such as epinephrine and norepinephrine, which help transmit signals between nerves.

Who Should Not Take a Stimulant Drug?

People with any of the following conditions should not take stimulants:

• Glaucoma (a condition that causes increased pressure in the eyes and can lead to blindness).
• Severe anxiety, tension, agitation, or nervousness.
• Treatment with a type of medication called monoamine oxidase inhibitors, such as Nardil or Parnate, within 14 days of starting stimulant therapy.
• People with motor tics or a personal or family history of Tourette's Syndrome.