Managing Medications

Your Toughest ADHD Medication Questions, Answered!

The best ADHD treatment plans all begin with one thing: accurate information. Here, a trusted expert answers your questions about the medications most commonly used to treat attention deficit.

ADHD doctor smiling
ADHD doctor smiling
1 of 13

Questions, Questions!

Everyone gets a little nervous when the doctor prescribes ADHD medication. So many questions, so little time. Is the medication safe? How long will you have to take it? How will you know that it is working? What about side effects? Will you feel like a zombie, or will it put a spring in your step and give you the ability to manage symptoms? Asking those questions about your child escalates your worries even more. Here are straightforward answers about ADHD medication.

A doctor answering a patient's questions about ADHD medications
A doctor answering a patient’s questions about ADHD medications
2 of 13

Will Meds Work for Me?

The first-line stimulant medications for ADHD are among the most effective treatment in all of medicine. Unfortunately, as many as one in five people do not respond to the two standard stimulants, methylphenidate and amphetamine. If you have tried both stimulants at optimal dosages, and haven’t seen benefits or side effects, you may be part of the 3 percent of people who do not absorb these medications orally. The formulation to try next is the transdermal delivery system, Daytrana, also known as the patch.

A doctor answering a patient's questions about ADHD medications
Doctor talking to a patient
3 of 13

How Do You Determine the Correct Dose?

Start with the lowest dose of stimulant medication, increasing it periodically. Continue to increase the dose, as long as the target symptoms improve without side effects. At some point, however, you'll increase the dose and won't see further improvement. At that point, the previous dose is the optimal dose. When working with small children who have difficulty giving feedback, clinicians use scales (the Connor global index scale, for instance), which compare the patient to children of the same gender and age who don't have ADHD.

[Free Download: The Ultimate Guide to ADHD Medication]

A doctor answering a parent's questions about her child's ADHD medication
Mother daughter and doctor
4 of 13

What Is the Optimal Dose?

Stimulant medications have a "therapeutic window." Doses that are too low or too high are ineffective. Since there is no factor that predicts either the optimal class of medication or the optimal dose in a given individual, dosing needs to be determined on the basis of target symptoms — determining the impairments the person is experiencing that they would like medication to manage. Each person will have his or her own list.

Doctor talking to woman with ADHD and answering questions
Doctor talking to woman with ADHD and answering questions
5 of 13

How Long Does it Take for Meds to Work?

The stimulant medications are effective as soon as they cross the blood-brain barrier, which takes 45 to 60 minutes. Consequently, in adults, it is possible to change the dose of stimulant meds every day to determine the optimal dose in less than a week. Children often lack the ability to tell the clinician how the medication is affecting their functioning and mood. For patients under the age of 15, the medication dose can be raised only once a week, to allow time for parents and teachers to assess the effect on symptoms.

A father asking his child questions about his ADHD medication
A father asking his child questions about his ADHD medication
6 of 13

Is a Flat Expression Common for Individuals Taking ADHD Meds?

A flat, dull, unemotional expression, known as "Zombie Syndrome," almost always suggests that the medication dose is too high. Talk with your doctor about lowering the dosage.

A doctor answering questions about ADHD medication for her young patient
Doctor and young blond patient in overalls
7 of 13

Do ADHD Medication Side Effects Go Away?

Most side effects of stimulant medications should resolve in three to five days (with the exception of appetite suppression). Side effects that the patient finds intolerable, or those that last longer than three to five days, warrant a call to your clinician. It is vital that neither the patient nor the parent has a bad experience when starting ADHD medication in order to ensure long-term use and success. I always recommend that side effects be addressed and managed promptly.

[Free Download: What to Ask Before Starting ADHD Medication]

A girl looking upset next to her meal because her ADHD medication has decreased her appetite
Girl looking bored/upset next to meal of fish sticks and peas
8 of 13

Does Appetite Suppression Suggest Too High a Dose?

Not necessarily. Appetite suppression is the only side effect of stimulants that is not necessarily dose-related. More predictive of appetite suppression is the child who is already thin and a picky eater. You can try a lower dose of stimulant medication while you're waiting for the next appointment with the pediatrician, but this usually results in loss of benefits for your child's ADHD. Although no one likes to take several medications, additional medication is often required for children who have appetite suppression lasting longer than two months, or who continue to lose weight. Talk with your doctor.

A doctor talking to his patient, asking if she has questions about her ADHD medication
Doctor and patient together
9 of 13

Are There Withdrawal Symptoms When You Stop Taking ADHD Meds?

There is little cumulative effect from the stimulant medications. If you stop taking them, the benefits dissipate quickly, usually in a matter of hours rather than days. Luckily, these medications work for a lifetime without the development of tolerance, but they need to be taken reasonably consistently in order to get full benefits.

Blond boy drinks orange juice and looks at camera after taking ADHD medication
Boy looks suspiciously at camera while drinking orange juice
10 of 13

Does Vitamin C Affect ADHD Meds?

You shouldn't take ascorbic acid or vitamin C an hour before and after you take medication. ADHD stimulants are strongly alkaline and cannot be absorbed into the bloodstream if these organic acids are present at the same time. High doses of vitamin C (1000 mg.), in pill or juice form, can also accelerate the excretion of amphetamine in the urine and act like an "off" switch on the med.

Young child is upset about taking ADHD medications
Angry child pulling at ears or head
11 of 13

Do Stimulants Help ODD?

ODD coexists with ADHD in up to 40 percent of children. ODD is almost unheard-of in people who do not have ADHD. For decades, the medication of choice for the treatment of ODD has been either methylphenidate or amphetamine, with more than 26 studies demonstrating that the stimulants reduce symptoms of ODD by up to 50 percent if taken in therapeutic dosages.

A mother scolding her child after answering questions about ADHD medication
Mother scolding son
12 of 13

My Child with ODD Refuses ADHD Meds — Now What?

A child with ODD is hardwired to defeat an authority figure — typically, a parent. I find that kids with ODD tuck the ADHD medication in their cheek and spit it out later. That's why I prefer the amphetamine Vyvanse, which can be dissolved in water. A liquid form of methylphenidate, Quillivant XR, which came out recently and is approved by the FDA, is another way to get medication into a recalcitrant child.

ADHD woman looks confused
ADHD woman looks confused
13 of 13

How Do You Treat ADHD Plus a Mood Disorder?

Seventy percent of people with ADHD will have another major psychiatric condition at some time in their life. Mood disorders are the most common conditions that coexist with ADHD. Most clinicians determine which condition is of most concern to the patient and proceed to treat that condition first. If the patient has suicidal thoughts, is unable to get out of bed, or is manic, the clinician will treat the mood disorder first and then reassess the symptoms of ADHD. If there is no urgency to treat the mood disorder, most clinicians will treat the ADHD first.

18 Comments & Reviews

  1. Is it reasonable to think that the gradual increase in medication should increase until a significant improvement is seen? I am 55 and recently diagnosed with combined ADHD. There are so many things that make sense now, and I want to get to the best dose as quickly as possible, but the Nurse Practitioner I am seeing (previously for depression and anxiety) doesn’t have the same view. She doesn’t specialize in ADHD though, and insists that I need to work on my behavior changes before she will increase my script from 10mg ritalin to 15mg. It COULD be that I am not looking at it from the proper perspective, but now, learning how much of what I had experienced along the way might even be BECAUSE of the ADHD, I just don’t want to be waste any more time getting to a dose which makes it easier to DO the behavior modifications. Does any of this make sense?

    1. I had the same problem with the Nurse Practitioner that I was seeing when I was first diagnosed. I was diagnosed at 38 years old and at that point I had been having issues for so long that I was so ready to get on the right dose or the right med and get my life together! It took a month to get diagnosed, then another 2 weeks to get an appointment. I quickly learned that my NP did not know much about treating ad/hd (although she pretended like she did) because I had read a ton of information about proper treatment and she was doing the opposite. I was on the first med for 6 weeks before I even saw her again. At that point, I voiced my concerns and she said she would switch me, but she wouldn’t let me pick up my new meds for another 2 weeks, since I had gotten a script 2 weeks before. She said she couldn’t do that, although I knew that she could if she wanted to, she just didn’t want to. She was also very cold and unfriendly:( So, I was on the wrong med for 2 months and then switched. At that point, I started looking around for a new doc. Here it was 3 and a half months after the journey began and I was still trying to find the right medication. I felt like I had lived 38 years of my life and a lot of time had been wasted not being able to live up to my potential and the NP didn’t seem like she had my best interest in mind- I felt like I was being treated like an addict even though I went through the steps to get diagnosed. So, five minutes after I visited my new doctor, I knew that I had made the right decision to switch. She was great, really took the time to talk with me and know my opinions AND she followed everything that I had read was the proper way to treat adult ad/hd. There’s a lot of medical professionals who really don’t know the right way to treat it, so it pays to read up and be educated about what is supposed to happen. I would definitely look for someone else if your current practitioner isn’t working out too well.

  2. Totally does make sense. Not only are they supposed to raise it until you see no more improvements and have side effects then dial back a dose; some adults need higher (much higher) dosages than the caddra or fda max – there are articles about this on the web but you have to really research to find them as most searches about raising your stimulant dose end up with hits about addiction to Adderall or the whole is ADHD even real debate – I am really glad for this website as I also finally got meds late in life but years later only just getting my dose right after much research as was scared to ask for raise and feeling “lucky I got anything at all” (typical ADHD/ I’m not worth it behaviour) I print out articles to bring to my doc you have to advocate for yourself society treats kids with ADHD as problems to be treated but adults with ADHD are treated like lost causes/problems to bear

    1. Could you PLEASE forward these articles to me? It would be sooo much appreciated. This is an issue I’ve been trying to find info on for over a year. Thanks in advance for any help you can give on this!

    2. I also would greatly appreciate these links, or articles also? ( ) being a 58 year old male I feel I need augmentation, have researched but never really found anything of real substance, most research has been done on younger folks, but Adults metabolize differently, have longer days than teens, have responsibilities after a work day, and the Adderall has lost it effectiveness. But there the FDA “Guidelines” and many are hesitant to go above it. Even though there is a research paper in the NIMH database that states that providers need to rethink how they treat adults with ADD, as they have totally different metabolism, Burn Rates, etc. You are 100% correct, most articles get into the potential for abuse, YadaYada. Granted one cannot dismiss their concerns about such things. I also have noticed that many of the psychiatrists are of the age that Adult ADD was not even a diagnosis when they went through schooling, so there are many providers that have not had formal training on Adult ADD. Thank you

    1. Heyy ytruly, I was wondering if you could possibly send me the link(s) that you used to take to see your doctor. I’m new to this site so I’m not sure how to message. Hope to hear back soon, thanks.

    2. Hi. I”m Jimiann & I IM’d you in May 2018 re: article on increasing my adhd meds. I was unable to find site again for your response. Would you please send into to me as I’m still struggling to get improvement on standard dose. It would mean sooo much. Thank you in advance either way.

      Thanks again,

    3. Whoops, having trouble posting comment for some reason.

      Since SO MANY ppl here on this site are asking for info. re: Higher med doses are sometimes needed (and generally safe), it seems it would be easier for the OP to please just post the links to those studies, articles, etc. right here on this page. Easier than sending separate PMs to multiple ppl, AND could benefit so many others who are interested but just not commenting. Thanks!

    1. Is there any way you’d be willing to email me those articles also by chance?(
      I genuinely hate asking since your offer to provide this info was directed at one specific individual and not as a general “come one and all” sort of thing and debated with myself relentlessly about doing so for fear that it may be irritating (most especially if multiple people have asked or do ask) and cause you to regret the fact that you even made the original offer to the 1st person to begin with. I would truly be so genuinely grateful to you though as the depth of defeat I feel at this point regarding my particular circumstances/difficulties surrounding medication management combined with a desperation to reach my optimal treatment outcome, quite simply, made meet feel that I MUST. Thank you so very much!

  3. Hello,
    What health issues should be checked before going on medication? I would like to visit my family doctor before I decide to get consultations on ADD medications. I have an Inattentive ADD and I want to try stimulants to help me focus and gain energy.
    Thank you

  4. Ytruly, could you please send me those websites I have also suffered for years and the last 2 years went from doctor to doctor bc nobody will listen to anything l suggest please if u would send me those articles and websites thanks so much and god bless

Leave a Reply