ADHD Medication & Its Side Effects
Attention disorders are one of the most common mental health issues in the United States. According to recent research, more than six million children (9.4%) in the United States have an attention deficit disorder (ADD) diagnosis. 1
While many people associate attention disorders with children, adults can also struggle with this condition. In fact, around 2.5% of U.S. adults have an attention disorder.
ADHD Medication & Its Side Effects
Attention disorders are one of the most common mental health issues in the United States. According to recent research, more than six million children (9.4%) in the United States have an attention deficit disorder (ADD) diagnosis. 1
While many people associate attention disorders with children, adults can also struggle with this condition. In fact, around 2.5% of U.S. adults have an attention disorder.
Table of Contents
People suffering from an attention disorder often struggle to sit still, concentrate, or complete tasks. Having ADHD can make working, playing, and interacting with others more challenging. Tasks that require calmness, focus, and sustained attention tend to be problematic for kids or adults with an attention disorder.
If ADHD is left untreated, it can impede a child’s social and educational growth and interfere with an adult’s capacity to pursue their life goals successfully.
The good news is that there are medications that can help people with ADHD effectively manage their symptoms. However, these medications may also cause side effects.
For people who are using (and abusing) ADHD medication—and for their loved ones—this page provides vital information about ADHD medications and their potential side effects.
The following sections answer vital questions such as: What is ADHD? What kind of medications are used to treat ADHD? How do these medications affect the brain? In other words, how exactly do they work to relieve ADHD symptoms? What are the potential side effects of ADHD medication? And how can these be reduced or avoided?
What is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopment disorder. This means that it is associated with the brain’s functioning and neurological system. 2
Psychiatrists and other mental health professionals use the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to officially diagnose ADHD. 3
According to the DSM-5, ADHD has three major symptoms, which are:
- Inattention
- Impulsivity
- Hyperactivity
Depending upon which of these three symptoms is most prevalent, one of three types of ADHD will be diagnosed. If a person experiences a mix of these primary symptoms (not fitting into any specific category), they may be diagnosed with more than one type of ADHD.
People struggling with ADHD may be overactive and have trouble with impulsive behaviors. They may find it challenging to pay attention, follow instructions, or organize and complete tasks.
ADHD symptoms can look different for adults than they do for children. The symptom of hyperactivity, for instance, may manifest in a child as squirming in their seat or getting up when they shouldn’t. The child may run around or climb on things or make excessive noise when they are playing.
In an adult, similar hyperactive impulses will typically be expressed differently, for instance as:
- Feelings of internal restlessness or impatience.
- Feeling uncomfortable sitting for a long time—perhaps standing up, pacing around the room, or walking away.
- Feeling uncomfortable or fidgety sitting through long meals, extended work meetings, or even leisure activities like movies or concerts.
- Avoiding activities or situations that require patience.
- In conversations, interrupting or finishing other people's sentences or talking excessively.
- Being prone to taking jobs that change a lot or are highly active.
- Being prone to reckless behavior, including substance abuse.
Do People Outgrow ADHD?
It was once commonly believed that children diagnosed with ADHD would likely outgrow the disease. More recent research, however, suggests something different.
When symptoms of ADHD first appear in childhood, they often continue into adulthood. Although there may be intermittent periods of remission, 90% of children with ADHD continue to experience residual symptoms of the disorder as adults. 4
It’s essential to keep in mind that having ADHD—and the brain differences that come with it—doesn’t mean that the person isn’t intelligent. But these differences in neurological function can make it more difficult for parts of their brain to communicate with each other. So, people with ADHD have unique challenges concerning cognitive functions such as impulse control, working memory, and reaction time.
ADHD medications are designed to help alleviate such symptoms by changing how the brain works and improving cognitive function.
ADHD Medication
ADHD medication treats the main symptoms of attention-deficit/hyperactivity disorder: hyperactivity, inattention, and impulsivity. While it may take some time to find the right kind of ADHD medication, once a person does, they will probably experience significant improvements in their symptoms.
In the same way that putting on a pair of eyeglasses helps to focus vision and wearing a hearing aid helps to focus sounds, taking ADHD medication helps to focus attention. While such medications don’t cure ADHD, they can allow a person to function comfortably and effectively.
Types of ADHD Medications
Most prescription ADHD medications come in tablet, capsule, or liquid form, which the person takes by mouth. These medicines fall into two main categories:
- Stimulants
- Non-Stimulants
These two types of ADHD medications affect the brain in slightly different ways. Some people respond better to one type than to the other, so people with ADHD will often switch if one kind of medicine isn’t working well.
Stimulants
Of the two types of ADHD medications, stimulants are the most widely prescribed and have been used for a much longer time (since the 1960s) than non-stimulants. Stimulant ADHD medications tend to be the most effective type for children. Studies have shown that 70%-80% of children with ADHD have fewer symptoms after finding the correct stimulant medication and dosage. 5
Stimulant ADHD medications work by increasing the levels of certain neurotransmitters (chemical messengers) in the brain. Dopamine and norepinephrine neurotransmitters play vital roles in a person’s ability to stay focused and motivated. Dopamine plays a role in reinforcing rewarding behaviors. Norepinephrine affects blood vessels, blood pressure and heart rate, blood sugar level, and breathing.
Common brand names of stimulant ADHD medications include:
- Ritalin
- Focalin
- Adderall
- ProCentra
- Concerta
Stimulant ADHD medicines can be further distinguished according to the speed at which the medication enters the bloodstream and so how quickly it takes effect:
Immediate-Release
These quick-acting medications are released immediately and typically last about four hours.
Extended-Release
These medium to long-acting medications are released gradually and can last up to 14 hours.
For both short-acting and long-acting stimulant ADHD medications, there are two chemical subtypes. Each of these subtypes is produced from a different kind of stimulant:
Methylphenidate-Based Medications
These medications include Ritalin, Methylin, Concerta, Metadate, and the Daytrana Patch.
Dextroamphetamine-Based Medications
These medications include Adderall, Vyvanse, and Dexedrine.
Different people respond differently to these various types of stimulant ADHD medicines and different release formulas (the speed at which they enter the bloodstream). So, if there are unwanted side effects, it’s often possible to find another type of ADHD medication that is more effective and comfortable.
Non-Stimulants
Non-stimulants are a newer type of ADHD medicine. One of the most common non-stimulant medications is atomoxetine (brand name: Strattera) which has been prescribed as a treatment for ADHD since 2002. Non-stimulant ADHD medicines increase the neurotransmitter/hormone norepinephrine levels in the brain.
Non-stimulants take longer to start working than stimulants. It may require three to four weeks of regular use before their effects are felt. However, these medicines—like stimulants—can help a person with ADHD improve their attention, focus and impulsivity.
There aren’t nearly as many non-stimulant medicines currently available for treating ADHD as there are stimulants. Brand-name examples of non-stimulant ADHD medications include:
- Strattera
- Qelbree
- Kapvay
- Intuniv
A mental health professional may prescribe a non-stimulant ADHD medicine in cases where:
- Stimulant medications haven't been effective.
- There have been difficult side effects from stimulants.
- Pairing it with a stimulant may increase effectiveness.
Also, while non-stimulant ADHD medicines are prescriptions, they’re not controlled substances like stimulants are. This means that a person is less likely to become dependent upon or addicted to non-stimulant medications.
How Does ADHD Medication Affect the Brain?
ADHD medications help reduce the symptoms of ADHD by changing how the brain works. Specifically, these medicines increase levels of neurotransmitters (chemical messengers) in the brain of the person suffering from ADHD.
Stimulant and non-stimulant ADHD medications increase dopamine and norepinephrine levels in the brain. Increasing the amount of these neurotransmitters helps improve symptoms of ADHD by:
- Reducing hyperactivity
- Increasing attention span
- Controlling impulsive behavior
- Managing executive dysfunction
How Neurotransmission Works
The human brain works via a vast network of neurons (brain cells) that pass information to each other. This process of neurons communicating with one another is called neurotransmission.
Neurons send messages to each other in a particular way: The tail-end of the sending neuron releases a burst of chemicals into a tiny gap (called a “synapse”) between this tail and the tip of the receiving neuron. These chemicals are called neurotransmitters because they allow the neurons to transmit information.
Once released into the synapse, these neurotransmitters activate receptors on the receiving neuron, which allows the information to be received.
The sending neurons then vacuum up any extra neurotransmitters to get ready to send another signal. This process of sweeping up the extra chemicals in the synapse is called reuptake.
How ADHD Can Disrupt Neurotransmission
When a person has ADHD, this process of neurons communicating with one another can be disrupted in several ways:
- The sending neuron may not release enough neurotransmitters.
- The neurotransmitters may be unable to activate the receiving neuron's receptors, so the communication can't be completed.
- The sending neuron may vacuum the neurotransmitters before the receiving neuron gets the message.
These kinds of disruptions in communication among neurons can have adverse effects on attention and motivation. And it explains ADHD symptoms such as being impulsive and restless.
How ADHD Medication Works
ADHD medications can reestablish effective communication among neurons. They can increase the efficiency of neurotransmission in one of several ways:
- By enhancing the release of neurotransmitters.
- By stimulating the receptors so they can catch more neurotransmitters.
- By slowing down the reuptake process, so neurotransmitters have more time to activate the receiving neuron.
Some ADHD medicines work by helping the brain to release more neurotransmitters. Other kinds of ADHD medicines—called reuptake inhibitors—slow down the reuptake process. Both types of medicine increase the number of chemical messengers (neurotransmitters) that can effectively transmit information from one neuron to the next.
By improving neurotransmission, ADHD medication can help people pay attention, be less hyperactive, and learn new information.
How Does ADHD Medication Affect Children & Adults?
ADHD medications affect each person differently. So, what works for one child or adult may not be effective for someone else. The first ADHD medication that an individual tries may not be the right one for them if it creates side effects or doesn’t reduce symptoms.
So, a mental health professional may need to experiment with different types of ADHD medicines, different doses, and different delivery systems (immediate-release vs. extended-release) to find the one that is best suited to a particular client. Finding the right balance between benefits and side effects can take some time—but it is worth the effort.
Once they locate the proper medication and dose, most children and adults find that ADHD medication helps improve symptoms of hyperactivity, attention deficit, and impulsive behavior.
Do medical professionals prescribe the same ADHD medications for children and adults? Sometimes, and sometimes not.
ADHD specialists tend to recommend methylphenidates as the first-choice medication for treating children and adolescents and amphetamines as the first choice for treating adults.
Even when a given ADHD medicine is prescribed to both a child and an adult, such medications’ dosages may differ for children and adults. Also, children and adults may experience different side effects from the medicines.
Can ADHD Medications Be Dangerous?
Medications are an essential first line of treatment for ADHD. They can be highly effective for managing ADHD symptoms. But it’s natural to be concerned about the potential side effects of such medicines.
While side effects can occur during treatment with ADHD medication, they are usually mild and don’t last long. They typically resolve after a few weeks of treatment as the person’s body adjusts to the medication. Only rarely are side effects more severe or long-lasting.
When side effects are experienced, this usually means that the dosage of the ADHD medicine isn’t proper, that the medicine is being released into the person’s bloodstream too quickly or too slowly, or that the specific type of ADHD medication doesn’t work for that individual.
Side effects that don’t go away after a few weeks of treatment may be relieved by:
- Changing the medication dosage or schedule
- Switching to an extended-release formulation
- Using a different stimulant medication
- Trying a non-stimulant medication
Common ADHD Medication Side Effects
Some common side effects of ADHD medications include: 6
Sleep Problems
One common side effect of ADHD medications is sleep problems. A person may have trouble falling asleep or staying asleep, or the overall quality of sleep may be lower.
One strategy for reducing this side effect is to adjust the timing of the medicine, especially if it is an extended-release ADHD medication. For instance, taking it earlier in the day will mean there is less in the bloodstream at bedtime.
Upset Stomach
Experiencing nausea or vomiting or having a stomachache is another potential side effect of ADHD medication. This tends to resolve within a few weeks, though it can be minimized by changing the dosage and taking the medicine with food.
Headache
Some individuals may get headaches when taking a new ADHD medicine. These are usually mild and go away as the body adjusts to the medication within a few weeks. If not, the mental health professional may choose to change the dosage or type of medicine.
Decreased Appetite and Weight Loss
Around 80% of kids and adults who take stimulant ADHD medications experience decreased appetite. This may lead to unwanted weight loss.
Strategies for reducing this side effect include adding snacks or protein shakes to the person’s diet (to increase calories), taking medicine after rather than before meals, or not taking medicine on weekends or during the summertime.
Minor Growth Delay
Some kids who take stimulant ADHD medications may experience a minor growth delay. However, this won’t affect their final height. They just grow more slowly for some time but eventually make up for this delay.
Rebound Effect
The so-called rebound effect refers to being particularly agitated, fatigued, or in a bad mood as the ADHD medication wears off. Strategies for reducing this side effect include lowering the dose, trying a different kind of medicine, or adding a smaller dose a half-hour before the primary dose wears off.
Tics
Tics are sudden habitual twitches, movements, or sounds, such as blinking, grunting, or jerking. While ADHD medicines don’t cause tics, they may, in certain cases, increase their frequency or intensity, making them more noticeable. If this happens, the healthcare professional will likely suggest switching to a different type of ADHD medication.
Mood Changes
If an ADHD medicine causes a person to become incredibly irritable, anxious, sad, or depressed—or to look lethargic and sedated in a zombie-like way—this may mean that the prescription needs to be adjusted. The dose may be too high, or the type of medicine not be quite right.
Blood Pressure & Heart Rate Changes
Stimulant ADHD medicines can cause a slight increase in heart rate. Blood pressure may also increase or decrease in response to specific medications.
Such changes are typically minor and not dangerous. However, it’s essential for people taking such medications to let their healthcare provider know if they have a history of heart problems (e.g., fainting, heart murmur, or chest pain).
To help prevent side effects and other problems when taking ADHD medication, it’s always necessary to: 7
- Take only the recommended dose
- Take each medicine at the right time
- Talk to a healthcare professional before stopping the medicine or changing the dose
- Keep the medicines safe where others can't get to them
- Don't give any ADHD medication to anyone else
Are Stimulant ADHD Medications Addictive?
When they are used to treat ADHD, stimulant medications are not considered to be habit-forming. There isn’t any evidence that using them will lead to substance use disorders. In fact: recent research has shown that people with ADHD who are treated with prescription medications have a lower rate of substance use disorders than if they weren’t treated.
However, there is the possibility of improper use and substance use disorders with any stimulant medication, especially for people with a history of substance use disorder. 8
Help is Available
Wellness Retreat Recovery offers a peaceful, serene, and comfortable environment that supports people in healing from addiction and mental health disorders—including dual diagnosis addiction and ADHD.
There is a strong correlation between ADHD and the risk of alcohol abuse. The recovery programs offered by the highly trained and compassionate team at Wellness Retreat provide intensive one-on-one therapy and cutting-edge clinical and holistic treatments tailored to the unique circumstances of each client.
References
[1] Data and Statistics About ADHD. Centers for Disease Control and Prevention.
https://www.cdc.gov/ncbddd/adhd/data.html
[2] Neurodevelopmental Disorders (October, 215). America’s Children and the Environment. U.S. Environmental Protection Agency.
https://www.epa.gov/sites/default/files/2015-10/documents/ace3_neurodevelopmental.pdf
[3] Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association.
https://www.psychiatry.org/psychiatrists/practice/dsm
[4] Sibley MH, Arnold LE, Swanson JM, et al; MTA Cooperative Group. Variable Patterns of remission from ADHD in the multimodal treatment study of ADHD. Am J Psychiatry.
https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2021.21010032
[5] Treatment of ADHD. Centers for Disease Control and Prevention.
https://www.cdc.gov/ncbddd/adhd/treatment.html
[6] Boorady, Roy. Side Effects of ADHD Medication. Child Mind Institute.
https://childmind.org/article/side-effects-of-adhd-medication/
[7] Hasan, Shirin. (March, 2018). ADHD Medicines. Kid’s Health.
https://kidshealth.org/en/teens/ritalin.html
[8] Prescription Stimulants Drug Facts. HIH: National Institute on Drug Abuse.
https://nida.nih.gov/publications/drugfacts/prescription-stimulants
