Stimulant Medications for ADHD

Stimulant drugs are the treatment most often used for ADHD. They can help you manage symptoms, such as:

  • Short attention span
  • Impulsive behavior
  • Hyperactivity

They may be the only treatment you use, or you can try them along with behavior therapy.

These drugs ease ADHD symptoms in about 70% of adults and 70% to 80% of children. They tend to cut down on hyperactivity, interrupting, and fidgeting. They can also help a person finish tasks and improve relationships.

As long as the medication is taken, people have a better attention span and better behavior. Even though there is some debate about whether social skills or performance at school gets better, there are many people who benefit from them.

What Do Stimulant Drugs Do?

For someone with ADHD, these medications boost the levels of certain brain chemicals, like dopamine and norepinephrine. They help nerves in your brain talk to one another. They’re also created in response to pleasant activities. If you take them for ADHD, you’ll get slow and steady doses, just like your brain would create them naturally. That helps boost your energy, helps you pay better attention, and keeps you alert.

Common Stimulants for ADHD

There are many stimulants available to treat ADHD: short-acting, intermediate-acting, and long-acting forms.

The short-acting forms are usually taken two or three times a day, and the long-acting ones just once a day. The benefit of short-acting is that you have more control over when you have medication in your system. The downside is you have to remember to take them often.

A positive of the long-acting type is that you don’t have to remember to take them as often, usually just first thing in the morning. They may also cut down on some side effects. But it may be harder to wind down at night until you get your medication dose and timing right.

Short-acting stimulants include:

Intermediate-acting stimulants include:

  • Amphetamine sulfate (Evekeo)
  • Methylphenidate (Ritalin SR, Metadate ER, Methylin ER)

Long-acting stimulants include:

  • Amphetamine (Adzenys XR-ODT, Dyanavel XR)
  • Dexmethylphenidate (Focalin XR)
  • Dextroamphetamine (Adderall XR)
  • Lisdexamfetamine (Vyvanse)
  • Methylphenidate (Concerta, Daytrana, Jornay PM, Metadate CD, Quillivant XR, Quillichew ER, Ritalin LA)
  • Mixed salts of a single-entity amphetamine product (Mydayis)

Most are pills, but sometimes medication can be in a patch that is put on the skin or in a liquid.

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Who Should Not Take a Stimulant Drug?

You should not take stimulants if you have:

  • Glaucoma (a buildup of pressure in your eyes)
  • Severe anxiety, tension, agitation, or nervousness
  • Tics (body movements you can’t control that happen over and over)
  • Tourette's syndrome, or someone in your family has it
  • A history of psychosis or are psychotic
  • Taken a type of medication called a monoamine oxidase inhibitor within 14 days of when you start taking the stimulant. Examples of this type of medication include phenelzine (Nardil) and tranylcypromine (Parnate).

What Are the Side Effects of Stimulants?

Common side effects include:

These often go away after a few weeks of taking these medicines. That’s because your body can adjust to the medication. But if they don’t get better, let your doctor know.

Other side effects include:

  • Less of an appetite
  • Weight loss (Sometimes taking your medication after meals can help avoid this. Or you can add high-calorie snacks or shakes to what you eat.)
  • Nervousness
  • Insomnia (you have a hard time sleeping)
  • Tics

The side effects may go away if your doctor changes your dose or if you try a different type of stimulant.

Some kids and teens who take stimulants grow slower than those who don’t. But it doesn’t affect their final height. If your child is taking stimulants, their doctor should keep an eye on their weight and height.

Sometimes stimulants can cause allergic reactions. In the case of patches such as Daytrana, permanent loss of skin pigmentation can happen where the patch is put on. A skin rash can be one of the signs. In general, it’s best to call your doctor if have any new or unusual symptoms.

Are Stimulants Addictive?

Stimulants aren’t habit-forming in the doses used to treat ADHD in children and teens. And there is no evidence that taking them leads to drug abuse. In fact, studies have shown that people with ADHD who are treated with medication have lower rates of substance abuse than people with ADHD who are not treated.

Still, there is a potential for abuse and addiction with any stimulant medication. This is especially true if the person taking them has a history of substance abuse and addiction. It’s something you may want to take into consideration.

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Before You Take a Stimulant

When you talk to your doctor, be sure to tell him if you:

Tips for Parents

The following are useful guidelines to keep in mind if your child is going to take stimulants for ADHD:

  • Always give the medication exactly as prescribed. If there are any problems or questions, call your doctor.
  • When starting a stimulant, do it on a weekend. Then you will have a chance to see how the child does on it.
  • Your doctor will probably want to start your child on a low dose of medication. Then they can up the amount slowly until symptoms are controlled.
  • Try to stick to a regular schedule. To make sure they take the medicine at the same times every day, children may need teachers, nurses, or other caregivers to give the medicine.
  • If a dose is missed, take the next dose at the regular time. Don't try to catch up by taking additional doses.

What About ‘Medication Vacations’?

Some children do better if they take medication regularly. But if you want your child to take a "vacation" from the medication, plan to do it on a day when they may not need concentration, like a weekend in the summer.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on March 25, 2019

Sources

SOURCES: 

National Institutes of Health. 

News release, Pfizer.

National Institute on Drug Abuse: “Stimulant ADHD Medications: Methylphenidate and Amphetamines,” “What are prescription stimulants?”

CHADD: “Medication Management.”

Child Mind Institute: “Understanding ADHD Medications.”

FDA: “Highlights of Prescribing Information.” (Jornay PM)

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