Prescriptions for ADHD
For adults and children that live with ADHD, medication can be a vital component when looking at treatment options. Medications can only be prescribed by a licensed psychologist after a diagnosis of ADHD has been declared. While medication doesn’t cure ADHD, it can help ease the symptoms and better manage the everyday life of an individual who lives with ADHD.
Types of Medication to Help Manage ADHD
When it comes to prescription medication options for ADHD treatment, there are generally two options. Those are stimulant and non-stimulant prescriptions. Every family must weigh the pros and cons of choosing either one of these medication treatment options as part of your treatment for ADHD.
Types of ADHD Prescriptions
What are ADHD Stimulant Medications?
Stimulant medications are the most widely used medications for the treatment of ADHD. Despite the name, these medications do not work by increasing stimulation of the person directly. Instead, they help critical nerve networks in the brain communicate more effectively with one another. In some cases, the first medicine you try might not be the correct one, or a higher dose might be needed.
Types of Stimulant Medication
Common stimulant medications used to treat ADHD include methylphenidate, and dextroamphetamine (Dexedrine, Dextrostat). Methylphenidate, amphetamine are now available as both short- and long- acting prescriptions.
Here are a few of the most popular stimulant name brand prescriptions:
- Adderall XR (amphetamine)
- Concerta (methylphenidate)
- Dexedrine (amphetamine)
- Evekeo (amphetamine)
- Focalin XR (dexmethylphenidate)
- Quillivant XR (methylphenidate)
- Ritalin (methylphenidate)
- Strattera (atomoxetine hydrochloride)
- Vyvanse (lisdexamfetamine dimesylate)
How Do Stimulant Medications Treat ADHD?
ADHD is a neurological based disorder resulting from the deficiency of a neurotransmitter in specific areas of a persons brain. Neurotransmitters are chemicals that transmit signals between nerve cells by bridging the gap between them.
In theory, the primary medications used to treat ADHD stimulate specific nerve cells within the brain to produce more of a deficient neurotransmitter. That’s why these types of medications are called stimulants.
Types of ADHD Prescriptions
What are ADHD Non-Stimulant Medications?
Stimulant medications are the most widely used medications for the treatment of ADHD, but some children, adolescents and adults respond just as positive or even better to treatment with other medications that are not stimulants. Non-stimulants may be used when stimulant medications have been ineffective, unacceptable side effects have resulted, or the individual or child’s parents prefer a non-stimulant for personal reasons.
Unlike fast-acting stimulants, non-stimulant ADHD medications may take up to a week for full effectiveness.
Types of Non-Stimulant Medications
Generally, non-stimulant medications used to treat ADHD fall into one of the following categories:
- FDA-approved non-stimulant ADHD medication
- Antidepressant medication
- Blood pressure medication
- Wakefulness-promoting medication
- Anti-viral medication
FDA-Approved Non-Stimulant Medication
These non-stimulant ADHD medications were created to treat symptoms of ADHD and are approved by the U.S. Food and Drug Administration (FDA) as safe, proven treatments.
Strattera (atomoxetine) was one of the first non-stimulant ADHD medications. Its generic name is atomoxetine. Strattera works similarly to selective serotonin reuptake inhibitors (SSRIs) that are used to treat depression by raising levels of the neurotransmitter norepinephrine in the brain. This can help the primary symptoms of ADHD: hyperactivity, impulsivity, and inattention.
Intuniv (guanfacine) is a time-release version of the central alpha2A-adrenergic receptor agonist guanfacine. It is taken once daily and is thought to affect receptors in the brain in a way that improves ADHD symptoms such as hyperarousal, emotional sensitivity, and social aggression with limited side effects. It is not a controlled substance and has a low risk of abuse or dependence.
Kapvay (clonidine) is an extended-release alpha-agonist medication used to reduce blood pressure and relax blood vessels. It can also trigger the release of norepinephrine in the brain, which, in turn, can improve ADHD symptoms.
The most commonly prescribed antidepressant for ADHD is Wellbutrin.
Wellbutrin (bupropion) is a norepinephrine dopamine reuptake inhibitor (NDRI), meaning it slows down the reabsorption of dopamine and norepinephrine after these chemicals are released to the brain. This action makes these neurotransmitters more available and ready to send messages in the brain.
Effexor XR (venlafaxine) is part of a newer class of antidepressant medications called serotonin-norepinephrine reuptake inhibitor (SNRI). It is sometimes, but not often, used to treat ADHD due to its increased levels of norepinephrine and serotonin in the brain, which can improve mood or concentration.
Tricyclic antidepressants have been shown to improve ADHD symptoms for some patients who don’t respond to stimulants. The options include Tofranil (imipramine), desipramine (Norpramin, Pertofrane), and Nortriptyline (Aventyl, Pamelor). There is the most evidence for ADHD symptom control with desipramine, but tricyclic antidepressants can cause side effects that some patients find to be intolerable.
Monoamine oxidase inhibitors (MAOIs) such as Nardil (phenelzine) or Parnate (tranylcypromine) have been shown to improve ADHD symptoms in adolescents and adults. However, they are rarely used because they have serious and sometimes dangerous side effects and interactions.
The most common side effects of antidepressants are nausea and vomiting, weight gain, diarrhea, sleepiness, and sexual problems. Wellbutrin XR and Effexor XR generally do not cause as many side effects as tricyclic antidepressants and MAOIs.
Blood Pressure Medication
These medications have the same active ingredient as FDA-approved non-stimulant ADHD medications and can be used to help treat symptoms of ADHD.
Clonidine (Catapres) is an alpha-agonist medication used to relax blood vessels and reduce blood pressure. The extended-release formulation, Kapvay (mentioned above), is FDA-approved to treat ADHD.
Tenex (Guanfacine) is an immediate-release central alpha2A-adrenergic receptor agonist with the same active ingredient as Intuniv (mentioned above).
Wakefulness-promoting medications are not approved by the FDA to treat ADHD, however some physicians prescribe them because they have similar mechanisms of action in the body.
Provigil (modafinil) is the most commonly used in this class of medications. Some research has shown improvement in ADHD symptoms for adults. However, there is a lack of substantial evidence that modafinil can effectively improve symptoms of ADHD.
Symmetrel (amantadine) is an antiviral drug used to prevent certain types of the flu by stopping the virus’s growth. It is not a substitute for a flu vaccination. The Centers for Disease Control and Prevention (CDC) does not recommend treating the flu with amantadine in the U.S. because of a developed resistance caused by the circulating strains.
Symmetrel is thought to work by stimulating the production of dopamine. Increased dopamine can also help symptoms of ADHD; it is sometimes used off-label to treat ADHD symptoms in some patients.
ADHD Prescription Management
Monitoring Your ADHD Prescriptions
Starting ADHD Prescriptions
Every person considering medication treatment for ADHD should first have a comprehensive assessment to clarify the diagnosis, identify other medical, psychological or learning problems that may be present with ADHD.
After the diagnosis has been declared, a treatment plan should be developed in consultation with your physician or other medical professional. In this planning session, the patient, family and medical professional can work together to consider the various options for treatment including prescriptions. If medication is going to be used as part of your treatment plan, the medical professional will prescribe a specific medication for you to begin taking.
The medication trial should be monitored very carefully, especially in the early weeks so needed adjustments can be made to the dose and timing of the prescription you are taking. If the first medication you tried is not helpful or produces unpleasant side effects, the medical professional should make adjustments as needed. If the adjustments are not sufficient to bring a positive response, another medication option can be tried.
Most individuals with ADHD respond positively to any of the frequently used medications that help manage ADHD symptoms. Some patients respond highly to one more than another. If the first medication tried does not produce a satisfactory response, we recommend talking with your prescribing medical professional to get a different type of ADHD medication.
Continued Monitoring of ADHD Prescriptions
Ultimately, success with ADHD prescriptions depends on a collaborative effort between you and your committed medical professional. Medication treatment without proper monitoring, appropriate education about ADHD, and other appropriate treatment interventions is often not enough to help. ADHD prescription failure can be caused by non-compliance or when patients do not take the medication as prescribed by their medical professional.
Parents of children with ADHD sometimes report that medication used during their child’s earlier years no longer works once their child reaches adolescence. This problem can be solved by speaking with your child’s prescribing medical professional and adjusting the dose or switching to another ADHD medication.
ADHD prescriptions can be a powerful tool in your tool belt for managing symptoms of ADHD. We encourage all patients to be open and honest with their doctor during the duration of taking any medication.