ADD Medication: Q&A for Newly Diagnosed Adults

Adults just diagnosed have questions about ADD medications. An expert addresses common concerns about stimulants, dosing, and side effects.

Manicured hand holding ADHD medicines

When you find the right medicine, you can experience substantial improvements in your ADHD symptoms.

— Russell Barkley, Ph.D.

When adults ask me questions about why they should try medication to manage their ADD, my answer always comes down to two words: Medication works. When you find the right medicine, you can experience substantial improvements in your ADHD symptoms.

Adults who have been diagnosed with ADHD later in life have many questions about stimulants, just as parents do about giving them to their child. After all, adults may be taking ADHD medication for the rest of their life. Here are seven common queries, and my answers to them.

Q. Why don't ADD meds make me more antsy than I already am?

The term "stimulant" is misleading. Stimulant medications, like methylphenidate (Ritalin, Focalin, Concerta, and so on), do make people without ADHD more alert and awake; they stimulate activity in the frontal regions of the brain. The reason they don’t make hyperactive adults more restless is that these parts of the brain are underactive in those with ADHD. There is not enough norepinephrine and dopamine to send signals between neurons

to stimulate the mind to pay attention or sit still.

Q. How long can I continue to take a stimulant without any long-term negative effects?

As far as we know, you can take it for as many years as you may need to manage your symptoms and reduce related impairments.

Q. Is there any evidence that Ritalin or other stimulants are safe or unsafe during pregnancy?

There is no evidence concerning the effects of any ADHD medications on pregnant mothers or their babies. At this time, manufacturers of such medications recommend that women discontinue taking ADHD medications when they become pregnant.

Q. Are generic versions as effective as brand-name stimulants?

Generic medications appear not to be manufactured with the same degree of precision as brand-name medications. The generics have had numerous reports of greater variability in controlling symptoms on a day-to-day basis and less success overall in managing symptoms.

Q. Is it possible to build tolerance to stimulants? If so, how do I avoid this, or how do I handle it once I’m experiencing it?

Actual physical tolerance seems unlikely with the current ADHD medications, but some individuals report that their medication seems less effective about three to six months after starting their treatment. This usually requires an adjustment of the dose, or, sometimes, changing to a different delivery system or medication. Clinically, we sometimes see people complaining that their medicine isn’t working as well as before, but these people are usually going through an unusually stressful or demanding period in their lives that may exacerbate ADHD symptoms. They may need to temporarily change their dose or address the source of the stress at these times.

Q. I've heard that ADHD stimulants can make people more irritable or angry or increase muscle tension. Is this true?

In rare cases, a side effect of stimulants is that they make people more irritable or angry. This may depend on your personality, what other disorders you may have, and which executive functions have been most affected by ADHD. Some people do experience increased muscle tension — your body may feel tense, or you may experience a clenched jaw — especially if you are taking higher-than-typical doses.

Q. Can I drink alcohol or take other drugs when I am taking a stimulant?

Yes, but do so in moderation. The only drugs you should avoid are other stimulants. Caffeine and alcohol do not interact adversely with ADHD meds. Nicotine, though, can act as a stimulant, compounding the effects of ADHD medication on your heart rate and blood pressure. If you are a smoker, discuss it with your doctor.

Excerpted from Taking Charge of Adult ADHD, by RUSSELL A. BARKLEY, Ph.D., with Christine M. Benton. The Guilford Press, Copyright 2010.

Download your free digital copy of 9 Rules for Using ADHD Medications Safely and Effectively and learn how to create the best possible treatment plan. Plus, get more treatment tips and tricks delivered straight to your inbox.

We never share e-mail addresses.

This article appears in the Winter 2012 issue of ADDitude.
SUBSCRIBE TODAY to ensure you don't miss a single issue.

To get more advice on using meds effectively, visit the ADHD Medications support group on ADDConnect.

TAGS: Adult ADD: Late Diagnosis, ADHD Stimulant Medications, Side Effects of ADHD Meds


What do you think of this article? Share your comments on, ADDitude's community site. Check out the new ADHD Medication User Reviews and the ADHD Adults Support Group. Your fellow ADDers want to hear from you!

Copyright © 1998 - 2015 New Hope Media LLC. All rights reserved. Your use of this site is governed by our Terms of Service and Privacy Policy.
ADDitude does not provide medical advice, diagnosis, or treatment. The material on this web site is provided for educational purposes only. See additional information.
New Hope Media, 108 West 39th Street, Suite 805, New York, NY 10018