Medications

How Does ADHD Medication Work? With Lots of Monitoring

ADHD medication isn’t always a magic bullet, and sometimes it just doesn’t work for certain individuals. Experimentation can get frustrating fast when a med isn’t working the way you’d hoped. To aid the process of finding the best treatment plan for you, learn how to recognize good and bad signs of a medication’s effectiveness — as well as how to solve common problems — by using these strategies.

A pill bottle on top of a prescription. Read on to learn how ADHD medication works.
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Medication Works

We know from years of research that ADHD medications work — in fact, studies show they work up to 80 percent of the time. Unfortunately, many children and adults taking ADHD medications for the first time find their prescriptions don’t work the way they expected at first. Sometimes, the medication is the problem; other times, the expectations are the problem. Either way, it’s good to know the signs of success and the signs of a bad fit.

An older man looks at prescription bottles and wonders, "How does ADHD medication work?"
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Good Signs

I’m always surprised how often my clients come in and say, “My doctor keeps asking me how the medications are working, but I’m not sure what to tell him!” We will discuss some common medication pitfalls later on; but first we need to explain how to know that your medication is working, plain and simple. What follows are a few positive signs that your medication is doing its job.

A girl sits in class and writes an essay on how ADHD medication works.
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1. Sustained Focus

If your medication is starting to work, you’ll be able to focus for longer periods of time than you used to. This doesn’t mean hyperfocus or “zombie focus” — just a nice, sustained focus that you can direct where you want it to go. Maybe you can sit and finish paperwork that you couldn’t before. As a result of this sustained focus, you’ll be more productive.

A smiling boy holds a globe and wonders, "How does ADHD medication work?"
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2. Less Impulsivity

If your medication is working, you’ll notice less impulsivity — both physical and verbal. You will interrupt people or jump out of your seat less often. You’ll notice that your thoughts are less impulsive, too. Instead of jumping from one thought to the next, you’ll follow a train of thought more effectively — without getting distracted by “brain chatter.”

A woman with ADHD smiles as snow falls around her ski hill, and wonders, "How does ADHD medication work?"
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3. Improved Mood

With optimized ADHD medication, people typically report an improved overall mood. They’re less stressed, with less anxiety — usually resulting from higher productivity and fewer social challenges. When you’re able to plan out your day, act on those plans, and better control your words and actions, you’re bound to feel better emotionally!

A young woman works on paperwork at a cafe, and wonders, "How does ADHD medication work?"
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4. Greater Attention to Detail

You’ll notice that details stick out more — instead of skipping a row in your spreadsheet or skipping a step in a math problem, you or your child will find that you catch small mistakes before they happen. Once your attention to detail is improved, however, you might not always like what you see: The mess in the garage or the piles of your desk may suddenly bother you much more.

A person ties a string on a finger to remember to ask the doctor, "How does ADHD medication work?"
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5. Better Memory

Some people report improved memory once they start medication. I had a client who was writing a book. Before taking meds, she struggled to remember what she’d written from one day to the next, so before she could start writing, she’d have to reread what she had — which felt like wasted time. Once she started taking medication, she remembered what she’d written the previous day and could dive right in without reviewing. For her, this was a big improvement — and convinced her that medication was the right choice.

A girl sleeps peacefully after learning how ADHD medications work.
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6. Better Sleep

Some people report sleeping better once their medication begins working. This may be surprising, since many of us know that sleep problems are a common side effect of ADHD meds. This is true — sleeplessness is a red flag to watch for — but, in some cases, medication actually helps those with ADHD fall asleep by quieting the racing thoughts that kept them up before. If you struggled to fall asleep in the past but now find that you drift off comfortably and quickly, it may be a sign that the medication is working.

A boy sits in tall grass with his hood on, and wonders, "How do ADHD medications work?"
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Bad Signs

Now, for the bad signs. The most obvious sign a medication isn’t working? You aren’t feeling any of the positive signs mentioned in the last few slides. But even if you’re feeling some or many of them, the medication might still not be perfect. You might not feel the benefits as consistently or as strongly as you would like, or you might now be dealing with uncomfortable side effects — like headaches, nausea, or appetite loss. If this is the case, ask yourself these five questions:

A woman closes her eyes and wonders, "How does ADHD medication work?"
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1. Is It the Wrong Medication?

The first medication you try often isn’t right for you. If you’re taking the wrong medication, you may feel some of the benefits discussed earlier — but they’ll be faint, and any negative side effects will outweigh them by a considerable degree. To find out if you’re taking the wrong medication, ask yourself how you feel physically. Are you more irritable? Do you have a persistent headache? Are you sleeping worse than before? If you answer yes to any of these, you might be using the wrong medication.

A man sits in a waiting area, and asks his doctor, "How does ADHD medication work?"
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Fixing the Wrong Medication

If you think you’re taking the wrong medication, ask your doctor about switching. Make sure you try both types of stimulants (amphetamines and methylphenidates) — as well as a non-stimulant — before you give up on ADHD medication entirely. Remember: If you’ve only tried one ADHD medication, you haven’t really “tried ADHD medication” — you’ve just tried that one. If you don’t fully explore your options, you’re limiting your chances of finding the right treatment plan.

A woman sits at a cafe table reading and wonders, "How does ADHD medication work?"
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2. Is It the Wrong Dose?

Some patients report that their medication feels good — productivity, focus, and mood are all improved with minimal side effects — but it doesn’t feel like enough. Maybe you can focus for 20 minutes now instead of 5, but you still can’t get your work completed. In these cases, you might be taking the wrong dose — either too much or too little. In most cases, it’s too little, since prescribers typically start at the lowest recommended dose. But everyone responds to medication differently, and even a “low dose” might be too much for you. If you feel like your medication is helping, but could be doing more, talk to your doctor about adjusting your dose.

A woman holds a pill and a glass of water in her hands, and wonders, "How does ADHD medication work?"
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New Year, New Dose?

Staying on the same dose for too long can also be a de facto “wrong dose” — our brains change throughout our lives, and what worked for us when we started ADHD medication won’t necessarily work forever. This is particularly true for women, who cycle through dramatic hormonal changes as they age, which can greatly affect the effectiveness of their ADHD medication. If you’ve been on the same dose for a long time, periodically check in with yourself to assess how well it’s working. If it feels like it used to work better, you may need to change your dose.

A blur of people walking on the sidewalk wondering, "How does ADHD medication work?"
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3. Am I Taking It at the Wrong Time?

It's possible you're taking your medication at the wrong time — either too early, too late, or at an incorrect frequency. Taking it too early means it wears off before you want it to, while taking it too late means it doesn’t kick in by the time you need it. For example: if you take your medication right as you’re heading out the door, and then spend the first hour of your workday stressed and unproductive, you’re probably taking the medication too late. If this sounds like you, try taking your medication first thing every morning.

A man asks a pharmacist, "How does ADHD medication work?"
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Keeping Medication Consistent

People with ADHD often struggle to remember to take their medication on time, or to refill their prescription at the end of the month. This can lead to gaps in coverage — gaps that can make your medication less effective. To avoid this, implement a medication reminder system. This might mean setting an alarm in your phone or on your computer, or setting up a visual reminder like a note taped to your front door reminding you to take the medication or refill it as needed.

A group of elementary school children with ADHD run outsite to expend excess energy.
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Drug Holidays

People often ask about “drug holidays” — particularly for children on break from school. In most cases, this is a personal decision. Taking a medication holiday may help a child catch up on height or weight, or help an adult judge whether they can succeed without medication. However, be aware: most research shows that the best results are achieved when medication is taken consistently. If you’re considering a drug holiday, make sure you try it at an appropriate time (not when you have a big project coming up at work!)

A woman holds two prescription bottles in her hands and wonders, "How does ADHD medication work?"
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4. Is It a Drug Interaction?

Even if you’re doing everything “right” — right medication, right dose, and right timing — something might still feel off. In these cases, it’s important to look at additional factors that could alter a medication’s efficacy, like other prescriptions. While most medications interact well with those used to treat ADHD, there are a few exceptions — particularly antidepressants. If you’re using an antidepressant, make sure your doctor explains how it could affect your ADHD medication.

A woman walks down the street holding a coffee and wonders, "How does ADHD medication work?"
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Caffeine

Caffeine is another common culprit. It’s also a stimulant, and many people with ADHD unknowingly “self-medicate” with caffeine everyday. Once you start taking an ADHD medication, you may find that the levels of caffeine you used to tolerate easily now make you jittery and anxious. This is most likely because they’re supplementing your dose of ADHD medication, causing you to be overstimulated. You may need to lower your caffeine intake — or perhaps cut it out entirely.

A woman holds a handfull of different colored pills and wonders, "How does ADHD medication work?"
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5. Is the Problem My Generic Drug?

Generics can differ from brand name medications by about 25 percent — in fact, it’s perfectly legal for them to do so. But when you switch from a brand name to a generic medication, from generic to brand, or from generic to generic, you may find that the medication affects you in a vastly different way. If you switched due to insurance requirements but find that a previous medication was more effective, talk to your doctor. She may be able to work with your insurance company to get you back on your previously used medication.

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