Managing Medications

10 Things Your Doctor May Not Have Told You About ADHD Medications

Some ADHD medications wear off too early. Or suppress appetite. Or make you jittery. Here, doctors Larry Silver and William Dodson tell you what to look out for, how to adjust dosages, and when to switch prescriptions. Essential reading for any parent or adult with ADHD.

A doctor fills out a perscription for ADHD medications.
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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 a variety of other psychological conditions, as well as by learning disabilities. To confirm an accurate ADHD diagnosis before prescribing medication, the characteristic behaviors must be shown to be chronic (to have existed before age 12 and for at least 6 months) and pervasive (to have been observed in at least two life settings — at school, at home, with peers, and so on).

A doctor conducts an interview and explains ADHD medication and treatment options.
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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 patient with ADHD 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?

A depiction of common ADHD medications.
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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.

[Free Download: 13 Questions to Ask Before Starting Any ADHD Medication]

Starting at the lowest dose of ADHD medications can help establish a baseline response and improve further treatment.
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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.

A psychiatrist explains the possible effects of an ADHD medication treatment plan to a patient.
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The Correct Dose is Unique to You

With stimulant medications, the dose is based not on gender, age, or body mass 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.

ADHD medication doesn't mean you can't still do the things you love, such as this boy playing on the swings.
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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.

A woman suffering from serious side effects of ADHD medication, which should be monitored and minimized.
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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.

[Free Expert Resource: Is It ADHD or a Misdiagnosis?]

ADHD medications is different for everybody and it should be monitored
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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.

ADHD medication can help when experiencing certain symptoms or engaging in certain activites such as this man trying to acheive a difficult task.
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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.

A balanced diet can complement ADHD medications as an effective way to manage symptoms.
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Food 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, certain supplements, steroids, and cold/sinus/hay fever medications that contain decongestants may cause a mildly unpleasant “buzz” in people on ADHD medications.

[Free Guide: 6 Steps to a Thorough ADHD Evaluation]

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  1. I imagine it’s very difficult to find the right dose, and even the right medication. I’m taking a fairly low dose of generic Adderall (let’s face it, amphetamine), and I hardly notice it at all. When I first started, I felt such a difference. I started with 5 mg and now I’m supposed to take 10 mg twice a day. I cut back to mornings only because I’ve found that the midday dose (even when taken by 11:30) causes me to have trouble sleeping. So, now I’m sleeping well (lately), but mornings are so hard for me! I often feel like I’m in a fog the first few hours. Arghh.

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