Clinically reviewed by Joey Lusvardi, PA-C
Receiving a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) can be both relieving and overwhelming. It’s a moment of clarity, finally understanding why you may have struggled with focus, organization, and impulsivity throughout your life. However, it’s also the beginning of a journey towards managing your condition effectively. Together, let’s explore the next steps you can take after an ADHD diagnosis, including medication options and insights for parents whose children have been diagnosed with ADHD.
Understanding ADHD
ADHD is characterized by core symptoms such as inattention, hyperactivity, and impulsivity. These symptoms can vary in severity from person to person and can significantly affect one’s quality of life. ADHD is not a one-size-fits-all condition, and it can manifest differently in children, adolescents, and adults.
After receiving an ADHD diagnosis, it’s crucial to consult with a healthcare professional who specializes in ADHD, such as a psychiatrist. They can help you develop a tailored treatment plan based on your unique needs and symptoms.
At Ellie, we’ve got a team of highly qualified psychiatrists for medication management. Click here to get started with one of our prescribers!
How Does ADHD Medication Work?
ADHD medications work by affecting two neurotransmitters: dopamine and norepinephrine. Norepinephrine is synthesized from dopamine so changes to one of these neurotransmitters often will affect the other one. The mechanism of action is slightly different between specific medications, but most medications will increase levels of one or both neurotransmitters in parts of the brain related to attention and motivation. By increasing activity in these important brain regions, people often have an easier time with motivation and staying focused.
Of course, like any medication, they don’t affect everyone the same way. Some people require higher or lower dosages of the medications to get the benefit they are looking for. Some people will get every side effect imaginable, and others will be on huge dosages with only benefit. When working with your provider to find a good choice for you, they will go over your past medical history, experience with other medications, and symptoms to determine a good medication to start with. You’ll work with them to figure out dosage based on how exactly you respond. Your dosage may need to be adjusted a few times to really see benefit and you will continue to work over time in case it needs further adjustment.
Types of ADHD Medications
Medication is one of the most effective treatment options for managing ADHD symptoms. Several different types of ADHD medications can be prescribed, including:
- Stimulants
- Non-Stimulants
- Antidepressants
- Anti-anxiety Medications
Stimulants
Stimulant medications are among the most-commonly prescribed treatments for ADHD. They are divided into two main categories: Methylphenidate-based medications: These include medications like Ritalin, Concerta, and Daytrana. Amphetamine-based medications: This category includes Adderall, Vyvanse, and Dexedrine.
Stimulants are believed to work by increasing the levels of certain neurotransmitters, like dopamine and norepinephrine, in the brain. This helps improve focus, attention, and impulse control.
Stimulant medications for ADHD are divided into two main classes: Methylphenidate-based medications such as Ritalin, Concerta, and Daytrana, and amphetamine-based medications such as Adderall, Vyvanse, and Dexedrine.
Stimulant medications are available in two different forms: immediate-release (short-acting) and extended-release (intermediate or long-acting). Different formulas work better for different people, depending on their metabolism, when they take the medication, side-effects they experience, or when they need the medication to work best.
Immediate-Release, Short Acting Medication
Immediate-release stimulants get absorbed and head to your brain quickly so you notice the benefits and any side effects rapidly after taking them. Because you get the full dose at once, these medications can come with more side effects and, for some people, a bigger drop in mood after the medication wears off. They also offer a bit more control over when exactly they are working. These medications should be taken during waking hours when you will have a few hours before you need to sleep next as they can cause insomnia if taken too late in the day. For most people, they’ll get around 4 hours of benefit from the medication though there are a lot of factors influencing how long they last.
Extended-Release, Intermediate or Long-Acting Medication
Extended-release stimulant medications have a few mechanisms of action that delay the full release of the medication. Some of them have a coating that dissolves slower in your body while others may be metabolized differently before they have effects. These usually last between 8 and 16 hours depending on the specific formulation of the medication so you should take them in the morning. Extended release stimulant medications are usually “smoother” in that they offer more consistent effects and have less of a hard landing when they wear off. They are also less likely to be misused compared to immediate release medications.
Non-Stimulants
Non-stimulant medications are typically prescribed when stimulants are ineffective, cause adverse side effects, or are not recommended for a specific individual.
Examples of non-stimulant medications include Strattera (atomoxetine), Intuniv (guanfacine), and Kapvay (clonidine). These medications work differently by targeting various neurotransmitters or brain functions.
Antidepressants & Anti Anxiety Medications
In some cases, other medications may be prescribed to address specific symptoms or comorbid conditions associated with ADHD. For example, antidepressants or anti-anxiety medications may be used alongside traditional ADHD treatments.
ADHD and mood disorders don’t exist in isolation as much as we’d like to neatly package them up into separate boxes. They can affect each other or, at times, even look like separate disorders. It’s a good idea to work with your provider to determine if your ADHD requires additional treatment in order to address your mood symptoms or if your mood symptoms may be impacting your ADHD.
Commonly Prescribed ADHD Medications
There are numerous different types of medications that can be helpful for people with ADHD. We talked with Joey Lusvardi, PA-C to learn more about all of this.
Common Stimulant Medications for ADHD
| Medication | Type | Onset of Action | Duration |
|---|---|---|---|
| Methylphenidate (Ritalin) | Stimulant | 30-60 minutes | 4-6 hours (immediate-release), 8-12 hours (extended-release) |
| Amphetamine (Adderall) | Stimulant | 30-60 minutes | 4-6 hours (immediate-release), 10-12 hours (extended-release) |
| Lisdexamfetamine (Vyvanse) | Prodrug of Dextroamphetamine | 1-2 hours | 10-12 hours |
For more detailed information, visit here: Cleveland Clinic – Stimulant ADHD Medications.
Common Non-Stimulant Medications for ADHD
| Medication | Mechanism of Action | Onset of Action | Common Side Effects |
|---|---|---|---|
| Atomoxetine (Strattera) | Norepinephrine reuptake inhibitor | 1-2 weeks | Appetite suppression, fatigue, dizziness |
| Guanfacine (Intuniv) | Alpha-2 adrenergic agonist | 2-4 weeks | Drowsiness, low blood pressure, fatigue |
| Clonidine (Kapvay) | Alpha-2 adrenergic agonist | 2-4 weeks | Drowsiness, dry mouth, irritability |
For more detailed information, visit here: Cleveland Clinic – Non-Stimulant ADHD Medications.
Common Antidepressant & Anti-Anxiety Medications for ADHD
| Medication | Type | Mechanism of Action | Common Side Effects |
|---|---|---|---|
| Bupropion (Wellbutrin) | NDRI | Inhibits norepinephrine and dopamine reuptake | Insomnia, dry mouth, weight loss |
| Nortriptyline (Pamelor) | TCA | Inhibits norepinephrine reuptake | Drowsiness, dry mouth, weight gain |
| Desipramine (Norpramin) | TCA | Inhibits norepinephrine reuptake | Drowsiness, dizziness, dry mouth |
For more detailed information, visit here: Cleveland Clinic – Antidepressants for ADHD.
Common Side Effects of ADHD Medications
With any medication, it’s not unusual to experience some negative side effects, but if that’s what’s holding you back, it’s important to note that not everyone experiences side effects either.
Common side effects include:
- Decreased Appetite
- Difficulty Sleeping
- Fatigue
- Headache
- Stomach Ache
- Moodiness
- Weight Loss
- Increased Heart Rate
- Irritability
- Moodiness
- Anxiety
- Changes in Blood Pressure & Heart Rate
For most folks, medication side effects will lessen after a few days or few weeks of taking the medication. If they persist longer than that time frame, they’re more likely to be a concern the entire time you are on the medication. Talk with your provider about options for addressing the side effects. In some cases, they may be no big deal so you’ll decide that the benefit of the medication outweighs the side effects. In other cases, a dose adjustment, addition of another medication, or change in medication may help.
How Long Do ADHD Meds Take to Start Working?
The time it takes for a medication to kick in depends on the specific medication. Stimulants usually begin working within an hour, act for a few hours, then wear off. That said, there is a delayed release form of methylphenidate, Jornay, that takes effect about 10 hours after taking it. Some extended release medications like Vyvanse usually take a bit longer to kick in than other stimulants.
For non-stimulant medications, many of them take time to begin working as they need time to take effect. They can begin working within a few days for some people, but often will take about a month to really see benefits.
Benefits of Seeing a Psychiatrist for ADHD
Psychiatrists know their stuff when it comes to how the brain works, how people behave, and mental health. This helps them create treatment plans that work well and fit each person’s needs. When you work closely with a psychiatrist, it not only helps pinpoint ADHD accurately but also finds the right treatment, meds, therapies, or behavior tricks that can really make a difference. Plus, keeping in touch and ongoing management means they can tweak things if needed, making sure your symptoms are managed well and your life gets better with ADHD.
Personalized Treatment Plans
ADHD is a complex condition with a wide range of symptoms and individual variations. Working with a psychiatrist ensures that your treatment plan is tailored to your specific needs, taking into account your unique symptoms and any other underlying mental health conditions.
Monitoring and Adjustments
Finding the right medication and dosage can be a process of trial and error. A psychiatrist can manage your medications, closely monitor your progress, make necessary adjustments, and ensure that you are getting the maximum benefit from your treatment while minimizing side effects.
Comorbidity Consideration
Many individuals with ADHD also have coexisting conditions such as anxiety, depression, or learning disabilities. A psychiatrist can address these comorbidities and develop a comprehensive treatment plan that addresses all aspects of your mental health.
Education and Support
Psychiatrists are well-equipped to provide education and support to both individuals with ADHD and their families. They can offer coping strategies, behavioral therapy recommendations, and guidance on managing ADHD-related challenges.
Interested in learning about more tools and skills for ADHD? Check out our other blog post here.
If Your Child Is Diagnosed with ADHD
Parenting a child with ADHD can be challenging, but it’s important to remember that with the right support, your child can thrive. Here are some essential steps for parents:
Educate Yourself
Learn about ADHD, its symptoms, and how it affects your child’s behavior and learning. Understanding the condition is the first step towards effective parenting.
Seek Professional Help
Consult with a pediatrician or child psychiatrist experienced in ADHD. They can provide guidance on treatment options, which may include behavioral therapy, medication, or a combination of both. We have many prescribers who see children for medication management; fill out our form here to get matched with the right prescriber.
Create Structure and Routine
Children with ADHD benefit from a structured environment with consistent routines. Establish clear expectations and consequences to help them manage their behavior.
Be Patient and Supportive
Encourage your child and focus on their strengths rather than their challenges. Provide a supportive and loving environment to boost their self-esteem.
Children’s ADHD Medication
Most ADHD medications are used for both children and adults. That said, children generally are started on lower dosages of medications and their dosage may need to be adjust as they grow.
ADHD medications can be highly effective in managing the symptoms of this condition and improving the overall quality of life for those affected. However, it is crucial to recognize that there is no one-size-fits-all solution. Finding the right treatment plan requires collaboration with a psychiatrist who can provide personalized care, monitor progress, and ensure that the chosen medications are both effective and safe. By working together, individuals with ADHD and their psychiatrists can navigate the complexities of the condition and make informed decisions about the most suitable treatment options. Remember, there is hope and help available for those living with ADHD, and seeking professional guidance is the first step towards a brighter future.
