You've seen your doctor and made the decision: It's time to get your ADHD under control. But you may wonder, is the medicine you need safe for the long haul?
If you're an adult, most of the long-term worry about ADHD meds has to do with how they affect other conditions you have.
How ADHD Medications Affect You as an Adult
Your doctor will examine you, and together you can create a plan that keeps you healthy and helps your focus.
Side effects and risks associated with the long-term use of ADHD medication include:
- Heart disease
- High blood pressure
- Irregular heartbeat
- Abuse and addiction
- Skin discolorations
How ADHD Drugs May Affect Your Child
ADHD medication can be taken for months, years, or even a lifetime. Research shows that long-term use of ADHD meds is safe.
Short-term effects. Every kid reacts differently to ADHD medication. The effects from stimulants can kick in within an hour. Nonstimulants can take a couple of weeks to start working. Your child may have side effects while the drug is active in their body -- as little as 3 hours for some immediate-release stimulants and up to 24 hours for some extended-release non-stimulants.
The American Academy of Pediatrics recommends waiting until age 6 to start ADHD medications, and the FDA hasn’t approved Ritalin for children younger than that.
For stimulants, the most common reactions include:
- Low or no appetite
- Weight loss
- Sleep problems
- Social withdrawal
Less commonly, some kids have:
- More activity or bad mood as meds wear off (a “rebound” effect)
- Tics (involuntary muscle movements)
- Minor delay in growth
Very rarely, some kids have bizarre behaviors and higher blood pressure and heart rates.
For nonstimulants, side effects can include:
- Stomach pain
- Drop in blood pressure
ADHD medications should not change your child’s personality. If you find that they seem more dazed than usual, irritable, or nervous, their dose may be too high.
Long-term effects. Some children continue taking ADHD drugs as adults. Decades of research have found no major negative health effects from taking them for a long time. Some studies have suggested that children who keep taking stimulants into adulthood may grow up slightly shorter. But other studies have found no link between medication use and adult height.
Their doctor may from time to time check to see if the dose needs to be adjusted or can be stopped. Your child may be ready to come off ADHD medication if they:
- Had no symptoms for more than a year with treatment
- Got better over time on the same dose of medication
- Stay focused and well-behaved even when they skip a dose
- Find a new way to concentrate
- Had a major change in environment, like a change in schools
ADHD drugs fall into two camps: Stimulants and nonstimulants.
Stimulants: These are the most commonly prescribed ADHD drugs and the ones your doctor likely will recommend first. They help people with ADHD pay attention, control impulses, and avoid risky behaviors.
Stimulants boost the level of a chemical called dopamine in your brain to help you focus. Dopamine rises in response to pleasure. But ADHD drug doses are too low for anyone to feel a “high” or to become addicted.
Stimulants come in two classes: Amphetamines and methylphenidates. They can be long-acting pills, liquids, or patches that you take once a day, or quick-acting versions that require multiple doses daily.
- Mixed amphetamine salts (Adderall, Adderall XR)
- Mixed salts of a single entity amphetamine (Mydayis)
- Dextroamphetamine (Dexedrine, Dextrostat, ProCentra, Zenzedi)
- Lisdexamfetamine (Vyvanse)
- Dexmethylphenidate (Focalin)
- Methylphenidate (Ritalin, Concerta, Daytrana, Jornay PM, Metadate, Quillivant XR)
- Serdexmethylphenidate and dexmethylphenidate (Azstarys)
Nonstimulants: These usually don’t work as well as stimulants. They raise the amount of a brain chemical called norepinephrine to help you focus longer, be less impulsive, and stay calmer.
- Atomoxetine (Strattera)
- Clonidine (Kapvay)
- Guanfacine (Intuniv)
- Viloxazine (Qelbree)
Heart Disease or High Blood Pressure
Most ADHD drugs are stimulants. They can raise your blood pressure and speed up your heart rate. If you already have an issue with your heart, these medicines could be risky. Examples include:
- Amphetamine (50% levoamphetamine/50% dextroamphetamine) (Evekeo)
- Amphetamine/dextroamphetamine (25% levoamphetamine/75% dextroamphetamine) (Adderall, Adderall XR, Mydayis)
- Dextroamphetamine (Dexedrine, ProCentra, Zenzedi)
- Dexmethylphenidate (Focalin, Focalin XR)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (Concerta, Daytrana, Metadate, Methylin, Ritalin, Quillivant)
Seizure or Irregular Heartbeat
Another ADHD medication, atomoxetine (Strattera), isn't a stimulant, but it has been linked to seizures and irregular heartbeats. The FDA suggests people with a history of those problems stay away from it.
Abuse or Addiction
Some people misuse ADHD stimulant drugs. They might crush the pills and snort them to get high, which can lead to a dangerous overdose.
If you don't have a history of substance abuse, it's unlikely you'll go down that road. But if you do, you could be at risk for misusing your ADHD drugs.
Talk to your doctor honestly about your past or current drug abuse. They can help you decide if ADHD drugs are OK for you.
ADHD drugs may be tied to some mental health issues, but it's rare. For instance, some people have reported behavior problems like aggression and hostility. Others say they developed symptoms of bipolar disorder.
The FDA has also warned that there's a slight risk that stimulant ADHD drugs could lead to mood swings or symptoms of psychosis -- like hearing things and paranoia.
The methylphenidate skin patch (Daytrana) has been linked to a skin condition known as chemical leukoderma. This condition causes permanent loss of skin pigmentation at the place where the patch is applied.
How to Weigh the Risks
Work with your doctor. Together you can decide if ADHD meds are safe for you.
Your doctor may want to run a few tests to see if you have conditions that might not mix well with ADHD drugs. For instance, they can check to see if you have high blood pressure, an irregular heartbeat, or other kinds of heart disease.
Other conditions might bump up your risks from ADHD drugs. Tell your doctor if you have one of these:
- Allergy or sensitivity to stimulants
- Liver or kidney disease
- History of mental illness
- Motor tics or Tourette's syndrome
- Overactive thyroid
Let them know if you're taking other medicines or supplements. Some could react badly to ADHD drugs.
Once you start taking your ADHD medicine, see your doctor for regular checkups to make sure you aren't having any bad side effects.
Keep in mind, ADHD drugs are generally safe. The chance of serious problems is low. For lots of people, the benefits of treatment outweigh the risks.