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ADHD Medications: 10 Ways to Get It Right

Insider strategies from the top doctors on getting the most out of your ADHD medication.

Sources: Larry Silver, M.D., and WIlliam Dodson, M.D.

Make Sure the Diagnosis is Correct

Not all people who are hyperactive, inattentive, or impulsive have ADHD. These behaviors can also be caused by anxiety or depression, as well as by learning disabilities. To confirm an accurate ADHD diagnosis, the characteristic behaviors must be shown to be chronic (to have existed before age six) and pervasive (to have been observed in at least two life settings—at school, at home, with peers, and so on).

Your Doctor Should Closely Monitor the Medication

You may want to find an ADHD specialist, such as a psychiatrist, developmental pediatrician, or neurologist, who may offer greater experience, knowledge of the newest medications, and more one-on-one time with you. A doctor should see a new ADHD patient at least every two to four weeks for the first few months. He should ask: How are the meds working? Are there any troubling side effects? 

Expect to Try Several Different Medications

Some people respond well to methylphenidate and others to dextroamphetamine/ levoamphetamine. Others fare better on a non-stimulant medication, such as a tricyclic antidepressant, an alpha agonist, or atomoxetine. The only way to tell whether a particular medication works for you or your child is through trial and error.

Start at the Lowest Dose

Doctors start at the lowest dose to establish a baseline and increase as necessary—a method called titration. For example, you might start with 5 mg., review within three to five days, and move up to 10 mg., then 15 mg., and, if necessary, 20 mg. At signs of unusual irritability, tearfulness, or being in a cloud, the dose should be reduced. Did You Know: Doctors typically adjust medication dosages every three to seven days.

The Correct Dose is Unique to You

With stimulant medications, the dose is based not on gender, age, or body weight but on the rate at which the body absorbs the medication. The only way to find the correct dose is through trial and error. Because everyone has a unique response to medication and metabolizes it at a different rate, your physician may need to adjust the dose to find the correct one.

Note the Medication's Impact on Behavior

Track the effect of the medication on behavior closely both at home and, for a child, at school. The SNAP-IV Scale and the Conners' Rating Scales gauge physical symptoms and emotional behaviors at home and in the classroom. Scales can help parents assess a child’s behavior throughout the day and detect patterns and problems with medication. Download the SNAP-IV here.

Be Patient. Avoid Side Effects.

William W. Dodson, M.D., a Denver-based psychiatrist specializing in ADHD, says, “Getting ADHD meds to work to their optimal benefit requires patience.” Stimulants can cause sleep problems, loss of appetite, headache, and stomachache. A very uncommon side effect is motor tics. The doctor should work with you to minimize any side effects that occur. If side effects cannot be controlled, another medication is needed.

The Medication's Duration Is Unique to You

Just because a pill is listed as controlling ADHD symptoms for a certain length of time doesn’t mean that it will. A four-hour pill might work for only three hours. An eight-hour capsule might last for six to 10 hours, a 12-hour capsule, 10 to 14 hours. Observe your own or your child’s behavior to determine how long each dose lasts.

Take Medication According to Symptoms

Although some people need medication all day, every day, others need coverage only for certain activities. Adults are likely to need coverage at the office and children are likely to benefit during the school day. How about homework time? What about leisure activities? While you're driving? Once you determine when symptoms dictate coverage, your physician can work out a suitable medication regimen.

Diet Affects ADHD Medication Effectiveness

A high-fat breakfast and juices rich in vitamin C can hinder the absorption of methylphenidate, compromising medication's effectiveness. Did You Know: Asthma medications, weight-control supplements, steroids, and cold/sinus/hay fever medications that contain decongestants may cause a mildly unpleasant “buzz” in people on ADHD medications.

For More on ADHD Medications

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