ADHD Medications (cont.)
Roxanne Dryden-Edwards, MD
Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
In this Article
Some medical marijuana advocates have begun to propose marijuana for the treatment of ADHD due to marijuana's effects of decreasing activity and anxiety levels. However, marijuana's addiction potential and side effect -- like impaired memory, judgment, and coordination, mood changes, low motivation, and possible psychosis -- in addition to the lack of research of its benefits for ADHD, keep the use of this drug from being a viable treatment for this disorder. While some over-the-counter medications for adult weight loss, like ephedrine, may improve focus and alertness, their appetite suppression and abuse potential preclude their being a viable option for treatment of a chronic condition like ADHD.
What are the different types of ADHD drugs?
The types of ADHD medicines include stimulants and nonstimulants. Some medications that usually treat depression have been found to be helpful in treating some people with ADHD as well. Stimulant medications include methylphenidate and its derivatives, like Ritalin, Methylin and Metadate (methylphenidate) and Ritalin-LA, Focalin, Metadate-CD, Daytrana and Concerta (extended-release methylphenidate). It also includes amphetamine derivatives like Dexedrine (dextroamphetamine), Adderall (combination amphetamine and dextroamphetamine salts), and Vyvanse (lisdexamfetamine).
Nonstimulant medications used in the treatment of ADHD symptoms include Strattera (atomoxetine), Tenex or Intuniv (guanfacine), and Catapres or Kapvay (clonidine), as well as medications that are used primarily in the treatment of depression or anxiety, including Wellbutrin (bupropion) and Effexor (venlafaxine).
What are the differences among the ADHD drugs?
In addition to the chemical differences among ADHD medications just described, there are differences in how long the effects of a dose of medication lasts and how they are taken. The length of time a dose of medication can last ranges from about two to four hours as with Ritalin, four to six hours as with Adderall or Dexedrine, 10-12 hours with Focalin-XR and Concerta, and up to 12-13 hours with Vyvanse.
Ways of giving ADHD drugs have increased. While medications to treat this disorder used to come only in pill form, there is now the option of the Daytrana and Catapres topical patches for children, teenagers, or adults who have trouble swallowing. Just in the past year, Quillivant-XR (methylphenidate) and Methylin liquid, which are two liquid forms of stimulant medications, have received FDA approval to treat ADHD.
Are any side effects associated with ADHD medications?
Side effects associated with ADHD medications are primarily related to the group of medications to which the medication is related. However, like any other psychiatric medication, they may uncommonly cause negative changes in mood or behavior, including suicidal thoughts or actions. For example, stimulants are known to be a group that can decrease appetite and weight, cause stomach upset, headaches, and insomnia as well as raise blood pressure, uncommonly unmask tics, and rarely cause psychosis. While there has been concern expressed that stimulant medication may decrease physical growth of children who take it, that tends to be uncommon and only amounts to a decrease of ½ to 1 inch in children who do experience that side effect.
When taken in excess or snorted, stimulants that treat ADHD can produce euphoria and result in addiction. Stimulant abuse has increased over the past four years, in apparent parallel to the decrease in teens of perceived risk of abusing these substances.
Serious but uncommon side effects that can be associated with stimulant medications include sudden death, stroke, and heart attack. While those usually occur when stimulants are abused, people who have a preexisting heart problem are particularly at risk.
Nonstimulant medications like Strattera, Intuniv, and Kapvay may cause drowsiness and tiredness, with Intuniv tending to cause those side effects 12 hours after it is taken as opposed to Strattera and Kapvay, which may cause drowsiness within an hour after being taken. Tenex and Intuniv (guanfacine) and Catapres and Kapvay (clonidine), both effective at treating high blood pressure, may drop blood pressure to the point of causing dizziness and palpitations or decrease the heart rate. They have also been known to cause decreased appetite, headache, stomach upset, nausea, dry mouth, constipation, and irritability. While other mood changes, including suicidal thoughts, have been documented with the use of Strattera, people taking any psychiatric medication should be monitored for the possibility of suicide, given that any psychiatric medication by definition is designed to alter brain chemistry. In contrast, Strattera may slightly increase blood pressure. Strattera also has been known to cause dry mouth, insomnia, decreased appetite, constipation, decreased libido, dizziness, and sweating as side effects.
Medically Reviewed by a Doctor on 6/6/2013
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