What Should I Know About ADHD Medication?
The History. The Effectiveness. The Different Options & Questions to Consider
Attention Deficit Hyperactivity Disorder (ADHD) is a condition that affects both children and adults, leading to difficulties with focus, hyperactivity, and impulsiveness. For many people, medication plays an important role in managing symptoms and improving quality of life. If you or your child has recently been diagnosed with ADHD, you might have questions about medication. Let’s explore the history of ADHD medications, their effectiveness, the different types available, and important questions to consider when deciding whether or not medication is right for you or your child.
The History of ADHD Medication
ADHD medications have a long history, with stimulants being the first choice for treating symptoms. The use of stimulants to treat behavioural disorders began in the 1930s. In 1937, Dr. Charles Bradley discovered that the stimulant Benzedrine improved behaviour and school performance in children with behavioural disorders. This marked the beginning of using stimulants to manage ADHD symptoms.
In 1955, Ritalin (methylphenidate) came onto the market and eventually became one of the most commonly prescribed treatments for ADHD. In the 1990s, Adderall, a mixed amphetamine salt, became a popular treatment option. Since then, other medications, both stimulants and non-stimulants, have been developed, giving families a range of options to consider.
Effectiveness of ADHD Medication in Kids and Adults
ADHD medication has been shown to be effective in reducing symptoms of inattention, hyperactivity, and impulsivity in both children and adults. Studies indicate that approximately 70-80% of children with ADHD experience significant improvement in their symptoms when taking stimulant medication. For adults, the effectiveness rates are similar, with many finding that medication helps them stay organized, focused, and productive.
It's important to note that medication works differently for everyone. What works well for one person may not work as effectively for another. Medication is often most effective when combined with other forms of support, such as behavioural therapy, lifestyle changes, and educational accommodations.
Different Families of ADHD Medications
ADHD medications can be divided into two main categories: stimulants and non-stimulants. Each category includes several different drugs that work in unique ways.
1. Stimulants
Methylphenidate-Based Medications: This includes drugs like Ritalin and Concerta. These medications work by increasing levels of dopamine in the brain, which helps improve focus and reduce impulsive behaviour.
Amphetamine-Based Medications: This includes medications like Adderall, Vyvanse, and Dexedrine. These also increase dopamine and norepinephrine levels to help with attention and self-control.
Stimulants are the most commonly prescribed ADHD medications and tend to have a quick onset of action, usually within 30 to 60 minutes of taking the dose. They are available in both short-acting and long-acting forms.
2. Non-Stimulants
Atomoxetine (Strattera): This medication works by increasing norepinephrine levels and is often prescribed for individuals who do not respond well to stimulants or have side effects that make stimulants unsuitable.
Alpha-2 Adrenergic Agonists: Medications like guanfacine (Intuniv) and clonidine (Kapvay) can also be used to treat ADHD. These drugs can help with hyperactivity, impulsiveness, and improve attention.
Non-stimulants may take longer to show effects compared to stimulants but are a valuable alternative for individuals who cannot tolerate stimulants or have co-existing conditions that make stimulant use problematic.
Questions to Ask Yourself and Your Doctor Before Starting ADHD Medication
Deciding whether to start ADHD medication is a personal choice and can feel overwhelming. Here are some questions to consider and discuss with your doctor:
1. What Are the Benefits?
How might this medication help with specific symptoms that are causing the most difficulties? Understanding the potential improvements can help clarify whether medication is the right choice.
2. What Are the Potential Side Effects?
ADHD medications can have side effects, including appetite suppression, sleep difficulties, and mood changes. Knowing the potential risks helps you prepare and monitor for any adverse effects.
3. How Long Will It Take to See Results?
Stimulants work quickly, while non-stimulants may take several weeks. Discussing the expected timeline can help set realistic expectations.
4. Is This Medication Safe for My Child or Me?
Consider any pre-existing medical conditions or potential interactions with other medications. Your doctor can help assess whether the medication is safe given your medical history.
5. What Are the Alternatives to Medication?
ADHD management often works best with a combination of strategies. Ask about behavioural therapies, lifestyle changes, and other non-medical interventions that could be used alongside or instead of medication.
6. How Will We Monitor the Effects?
Tracking progress is crucial. Ask how you can monitor the effectiveness of the medication and how often you should check in with your doctor to evaluate progress or make adjustments.
7. What If This Medication Doesn’t Work?
Finding the right medication and dosage often involves some trial and error. Talk with your doctor about what steps will be taken if the first medication doesn’t provide the desired results.
When You’re Hesitant to Start Medication: How to Build Confidence in Your Decision
It's natural to feel hesitant when considering starting medication for ADHD, whether for yourself or your child. Medication can feel like a big commitment, and the fear of potential side effects can make the decision even harder. Here are some ways to break down this decision to feel more confident:
1. Educate Yourself
Gather as much information as possible from reliable sources. Understanding how the medication works, its benefits, and its side effects can help demystify the process and reduce anxiety about taking this step.
2. Take It Step by Step
Remember that starting medication isn’t a permanent decision. You and your doctor can adjust the dosage, switch medications, or stop if it doesn’t work well. This flexibility can make the decision less intimidating.
3. Think About Quality of Life
Consider how ADHD symptoms are impacting day-to-day life. Imagine what life might look like with better symptom control—improved focus at work or school, better relationships, or reduced stress. Focusing on the potential positive outcomes can make the choice feel more worthwhile.
4. Talk to Others Who Have Experience
Connecting with other parents or individuals who have gone through similar experiences can provide reassurance. Hearing how others have benefited from medication can help you make a more informed decision.
5. Make a Pros and Cons List
Writing down the pros and cons of starting medication can help you visualize the benefits and concerns. This exercise can provide a clearer picture of why medication may (or may not) be the right choice at this time.
When Parents Aren’t on the Same Page About Medication: How to Work It Out
When parents are not on the same page about giving ADHD medication to their child, it can create a lot of tension and stress. Here are some strategies for navigating these difficult conversations:
1. Communicate Openly and Respectfully
Set aside time to discuss each person’s concerns without judgment. One parent might be worried about side effects, while the other is focused on immediate symptom relief. Acknowledge each other's perspectives to find common ground.
2. Seek a Professional Opinion Together
It can be helpful to attend doctor’s appointments together and ask questions as a team. Having a healthcare professional explain the benefits and risks can help both parents feel heard and more informed about the decision.
3. Focus on Shared Goals
Shift the conversation towards shared goals for your child. For example, both parents likely want their child to succeed at school, build positive relationships, and be happy. Framing the discussion around these common goals can help redirect the focus away from disagreements and towards solutions.
4. Consider a Trial Period
If one parent is more hesitant, consider agreeing on a trial period for the medication. This way, you can evaluate its effectiveness together and decide if it’s worth continuing.
5. Use Counseling or Mediation
If you’re struggling to come to an agreement, involving a neutral third party, such as a therapist or counsellor, can provide an objective perspective. A professional can help facilitate the conversation, address underlying fears, and work towards a solution that works for everyone.
ADHD medications have a long history of helping individuals manage symptoms and lead more productive lives. Understanding the different types of medication, their effectiveness, and the questions you should ask before starting can help you make an informed decision. If you’re feeling uncertain or hesitant, remember that you are not alone—many people face similar questions, and there are resources and support systems available to help you through this decision.
Whether it’s educating yourself, consulting with professionals, or navigating differing parental views, taking these steps can help ensure that the choice you make is the best one for you or your child. Always work closely with your healthcare provider to determine the most appropriate treatment plan and stay confident that you are making choices in the best interest of your family.
For more information on this topic, you can read the following books and visit these websites:
Books
ADHD: What Everyone Needs to Know by Stephen P. Hinshaw and Katherine Ellison
The ADHD Effect on Marriage: Understand and Rebuild Your Relationship in Six Steps by Melissa Orlov
Taking Charge of ADHD: The Complete, Authoritative Guide for Parents by Dr. Russell A. Barkley
Straight Talk About Psychiatric Medications for Kids by Dr. Timothy Wilens
Articles and Guides
CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder)
Medication for Attention Deficit Hyperactivity Disorder (ADHD)" - American Academy of Child and Adolescent Psychiatry (AACAP)
Guide to ADHD Medications
https://www.understood.org/en/articles/adhd-medication#ADHD_drug_holidays_and_adjusting_medication
