Adhd Medication With Least Side Effects

Stimulant Medication Safety Concerns

Beyond the potential side effects, there are a number of safety concerns associated with the use of stimulant medications for ADHD.

Effect on the developing brain. The long-term impact of ADHD medication on the youthful, developing brain is not yet known. Some researchers are concerned that the use of drugs such as Ritalin in children and teens might interfere with normal brain development.

Heart-related problems. ADHD stimulant medications have been found to cause sudden death in children and adults with heart conditions. The American Heart Association recommends that all individuals, including children, have a cardiac evaluation prior to starting a stimulant. An electrocardiogram is recommended if the person has a history of heart problems.

Psychiatric problems. Stimulants for ADHD can trigger or exacerbate symptoms of hostility, aggression, anxiety, depression, and paranoia. People with a personal or family history of suicide, depression, or bipolar disorder are at a particularly high risk, and should be carefully monitored when taking stimulants.

Potential for abuse. Stimulant abuse is a growing problem, particularly among teens and young adults. College students take this medication for a boost when cramming for exams or pulling all-nighters. Others abuse stimulant meds for their weight-loss properties. If your child is taking stimulants, make sure he or she isnt sharing the pills or selling them.

ADHD stimulants are not recommended for those with:

What Is Medication Titration

Titrating medication means changing the dose slowly over time to see how your body reacts to the drugs. In most cases, your doctor will start you with a low dose and increase your dosage every couple of weeks until you reach your target dose. A target dose means that youre getting the most therapeutic effects with the fewest side effects. Medications can also be titrated down.

Shrinkage Of The Frontal Lobe

Brain volume has also been studied in patients treated with ADHD medication. A 2017 study revealed that multiple regions of the brain in patients on ADHD medication were smaller in size compared to the control group . This study correlated a higher CEM, or continuous exposure to ADHD medication, with smaller brain volume across multiple regions, but specifically the left hippocampus seemed to be most affected.

The mega-analysis by Hoogman et al. 2017 reported reduced volumes in the accumbens, amygdala, hippocampus, putamen, and overall brain in comparison to control children .

The frontal lobes are not only what separate man from apes, they are in control of attention and executive functioning. Our executive functions are the job manager of the brain and without good abilities and skills here, kids cant get tasks done independently.

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Guidelines For Taking Adhd Medication

If you decide to take medication for ADHD, its important to take the drug as directed. Following your doctor and pharmacists instructions will help you maximize the effectiveness of medication for ADHD and minimize the side effects and risks. Here are some guidelines for safe use:

Learn about the prescribed medication. Find out everything you can about the ADHD medication you or your child is taking, including potential side effects, how often to take it, special warnings, and other substances that should be avoided, such as over-the-counter cold medication.

Be patient. Finding the right medication and dose is a trial-and-error process. It will take some experimenting, as well as open, honest communication with your doctor.

Start small. Its always best to start with a low dose and work up from there. The goal is to find the lowest possible dose that relieves you or your childs symptoms.

Monitor the drugs effects. Pay close attention to the effect the medication is having on your or your childs emotions and behavior. Keep track of any side effects and monitor how well the medication is working to reduce symptoms.

Taper off slowly. If you or your child wants to stop taking medication, call the doctor for guidance on gradually decreasing the dose. Abruptly stopping medication can lead to unpleasant withdrawal symptoms such as irritability, fatigue, depression, and headaches.

Irritability And Mood Problems

Oftentimes, ADHD is comorbid, or experienced together, with other mental health disorders such as anxiety and depression. This complicated mix of symptoms can cause frustration in both children and their parents, and lead to increased irritability, unmotivation, and worry. A study conducted at Yale showed that adderall is associated with an increase in irritability .

Medication may increase emotional symptoms and also affect patients without comorbidity or emerge as adverse drug events . Meta-analysis showed that methylphenidates reduced the risk of irritability, anxiety, euphoria, whereas they worsened the risk of apathy and reduced talk amphetamines worsened the risk of emotional lability. .

Normal development means that in some way, shape or form, your child will be cranky or snarky at some point. These medications can add fuel to the fire and cause a real uptick in irritability because stimulants throw the nervous system into a hypervigilant overfocused state.

That means the brain is in a rev state. While a child or teen may be initially more focused, increasing irritability may overshadow any gains they have made.

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What Are The Side Effects Of Adhd Non

If stimulants cannot be used because their side effects prove uncontrollable, consider using one of the non-stimulant medications. Some patients experience side effects on both stimulants and non-stimulants. In this case, combining much smaller doses of a stimulant and a non-stimulant might be the solution.

Pros And Cons Of Adhd Medication

Medication helps many children with attention deficit hyperactivity disorder , but it’s not a cure-all, as our survey of 934 parents revealed. We found that most of the families turned to medication84 percent at some point. And more than half of the children in our survey had tried two or more medications in the past three years.The children who were prescribed medication tended to be older and their symptoms more severe before treatment than those who had never tried medication. The average age of the children who had tried medication was 13, while the average age of those who had never tried medication was 10.

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What Are The Side Effects Of Adhd Drugs

The stimulants share common side effects. Most common among them is their potential for abuse. When doses of methylphenidate or amphetamines start low and are slowly increased, the result is a slow rise in brain dopamine levels. That pattern of therapeutic use is unlikely to trigger enticing side effects, such as euphoria. However, taken inappropriately, brain dopamine levels soar — as does the risk for addiction.

To help prevent abuse, the government has put limits on how much of the medication can be dispensed at one time, and how often it can be dispensed.

The main side effects of stimulant medications are

• problems sleeping,

• Neurologic problems including hallucinations, psychosis, tics, Tourette’s syndrome, seizure
• Other effects such as skinrash, vision problems, and nausea

The side effects associated with atomoxetine include:

• Gastrointestinal effects such as dry mouth, nausea, abdominal pain, vomiting, and serious liver problems
• Suicidal thinking, headache, sleepiness, dizziness, irritability, change in libido, erectile and ejaculatory dysfunction, menstrual changes, decrease in appetite and, urinary dysfunction

Guanfacine can have the following side effects:

Side effects associated with tricyclic antidepressants include:

• Suicidal thoughts
• Low blood pressure, rapid heartbeat, and possibly arrhythmias
• Drowsiness, confusion, restlessness, dizziness

Bupropion may produce the following side effects:

What Are The Side Effects Of These Drugs

The most common side effects include:

For Kapvay:

These drugs can rarely cause irregular heartbeats. They can lower blood pressure and slow heart rate.

Careful screening for heart rhythm irregularities and regular monitoring of blood pressure and EKGs is recommended.

Both drugs can cause significant drowsiness use caution when operating dangerous equipment or driving until you know how these drugs affect you.

This is not a complete list of side effects. If you experience a potential side effect while taking these drugs, please consult a healthcare professional.

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Are Stimulant Adhd Medications Habit

When used to treat ADHD, stimulant medications arent considered to be habit-forming. There isnt any evidence that using them will lead to substance use disorders. Nevertheless, theres a potential for improper use and substance use disorders with any stimulant medication, especially if you have a history of a substance use disorder. However, recent research states that medically treated people with ADHD had a lower rate of substance use disorders than if they werent treated.

A note from Cleveland Clinic

An ADHD diagnosis can be scary for you or your child. But your healthcare provider is there to help. There are many different ADHD medications available. Your provider will work with you to choose the correct medication and dosage for you or your child. Theyll continue to track your progress and watch for side effects to make sure the drug remains effective. In addition to medication, they may recommend other treatment options such as behavioral therapy. Theyll work with you to provide the best possible outcome for you or your child.

Last reviewed by a Cleveland Clinic medical professional on 10/06/2022.

References

For What Conditions Are Adhd Medications Used

Some stimulant ADHD medications are used for treating both ADHD and narcolepsy, a condition in which there is excessive daytime One non-stimulant medication, atomoxetine , is indicated only for ADHD.

Other non-stimulant ADHD medications include Kapvay and Intuniv .

• Kapvay and Intuniv are FDA-approved to treat ADHD in children and adolescents 6 to 17 years old.
• However, they have not been studied extensively in adults and are therefore not FDA-approved for adult ADHD treatment. However, a small placebo-controlled, double-blinded crossover study showed a possible benefit of using immediate-release guanfacine to treat ADHD in adults.
• Immediate-release clonidine and guanfacine are indicated for high blood pressure.
• In addition, medications used to treat depression, including tricyclic antidepressants as well as bupropion , may be used in ADHD treatment.

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My Adult Adhd Drugs Felt Like A Lifeline Then Came The Scary Side

After a year on prescription stimulants, I started to unravel. Would a desperate experiment with street narcotics make me see things differently?

At first being diagnosed with ADHD came as a relief. I cried in the psychiatrists office: maybe I wasnt lazy after all. Hegave me pills that, within days, offered me a glimpse of what I thought a neurotypical persons brain might feel like: focused and smooth, like a game of leisurely tennis rather than a ball machine going berserk.

Dexamphetamine felt like a silver bullet. Suddenly I could plan ahead, follow entire meetings, and pack a bag without having a nervous breakdown. Gone was the constantly harried feeling that had bullied me into perpetual motion for most of my 34 years. There seemed to be more time in each second to listen, absorb and think. I no longer wanted to punch people in the back of the head when they were blocking my way in the supermarket.

But after a year on stimulants, things began to unravel. I had constant migraine-like headaches, and was anxious and impatient. When I decided to quit, I was mired in lethargy and mental confusion that lingered far longer than the supposed withdrawal window. Had I always felt this foggy before the drugs? Or was it the drugs?

Still, the idea that I might have ADHD never came up. In the UK in the 90s, it was cast as a disorder of naughty boys who struggled at school. I was socially adept and academically successful gifted, even.

Have you tried juggling? he asked.

Factors Affecting Medication Titration

The way your body responds to the most common ADHD medications has more to do with factors like metabolism, medication history, and severity of symptoms than it does with your height or weight.

To find your target dose, titrating can be done with any ADHD medication, including non-stimulants. Since ADHD medications are taken long-term, the goal is always to reduce the number of side effects and take the lowest dose possible for therapeutic benefits.

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The Right Dosage And Medication

Your child’s doctor may choose to prescribe a different type of stimulant, as this can be an important factor in managing side effects, particularly sleep disturbance and agitation/irritability.

Examples of this include:

• Concerta may be used in the morning with an addition of short-acting Ritalin in the early afternoon to allow for coverage that lasts all day but wears off before bedtime.
• An individual may sometimes have more or fewer side effects on Ritalin versus Adderall .
• Jornay PM , which is indicated for the treatment of ADHD in patients age 6 years and older, is specially formulated to release its contents slowly enough that it doesn’t impair sleep and then begins relieving ADHD symptoms upon waking up in the morning.

These are all issues your childs doctor can assess. Another factor your doctor will likely consider to help minimize side effects is adjusting the medication dosage.

Dealing With Side Effects

Most children and adults taking medication for ADHD will experience at least a few side effects. Sometimes, side effects go away after the first few weeks on the medication. You may also be able to eliminate or reduce unpleasant side effects with a few simple strategies.

Loss of appetite. To deal with reduced appetite, eat healthy snacks throughout the day and push dinner to a later time when the medication has worn off.

Insomnia. If getting to sleep is a problem, try taking the stimulant earlier in the day. If you or your child is taking an extended-release stimulant, you can also try switching to the short-acting form. Also avoid caffeinated beverages, especially in the afternoon or evening.

Stomach upset or headaches. Dont take the medication on an empty stomach, which can cause nausea, stomach pain, and headaches. Headaches can also be triggered by medication thats wearing off, so switching to a long-acting drug may help.

Dizziness. First, have you or your childs blood pressure checked. If its normal, you may want to reduce your dose or switch to a long-acting stimulant. Also make sure youre drinking enough fluids.

Mood changes. If medication is causing irritability, depression, agitation, or other emotional side effects, try lowering the dose. Moodiness may also be caused by the rebound effect, in which case it may help to overlap the doses or switch to an extended-release medication.

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Adhd Medication Side Effects

Medications always have the potential for side effects. Not everyone will experience the same side effects or any at all. Some side effects go away, while others may not.

Talk with your doctor about the specific side effects of the medication youre prescribed, and let them know if you experience any side effects.

Are There Any Risks

Like any medication, ADHD medicines can have side effects. Not everyone gets side effects, though.

The most common side effects are loss of appetite and trouble sleeping. Other ADHD medicine side effects include jitteriness, irritability, moodiness, headaches, stomachaches, fast heart rate, and high blood pressure.

Side effects usually happen in the first few days of starting a new medicine or taking a higher dose. They often go away on their own after a few days or weeks as the body adjusts to the medicine.

If a side effect doesn’t go away, a doctor may decide to lower the dose or stop that medicine and try another. ADHD medicines only stay in the body for a few hours, so the side effects wear off as the medicine leaves the body.

Your health care team will give you more information about possible side effects for the medicine they prescribe. If you notice anything that worries you, tell your parent and talk to your doctor right away.

Some people don’t like the idea of taking medicine for ADHD. But the right medicine can make a big difference. Talk to your doctor if you have concerns. Ask questions. Your health care team can help you and your parent decide if trying a medicine for ADHD is right for you.

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What Are Adhd Medications

An ADHD medication is any prescription drug used to address, reduce, and treat symptoms of ADHD. Medications for ADHD vary greatly, producing very different results.

Whatever the medicine, the goal of ADHD medications is to:1

• Improve attention and concentration

• Mood swings with agitation, anger, and aggression
• Increased blood pressure and heart rate
• Trouble falling asleep and staying asleep
• Anxiety and physical tension

Another side effect comes from the stimulant medications mechanism of action. Stimulants are designed to begin working each day after the mornings dose is taken. It will then wear off at different times of the day depending on how long-acting the medication is designed to be.

When blood levels are low, the person could have a return of symptoms. At times, the reemerging symptoms could be more intense than their normal presentation.

The Safety Of Stimulant Medication Use In Cardiovascular And Arrhythmia Patients

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First-line stimulant class medications, such as methylphenidate and amphetamine formulations are FDA approved for the treatment of Attention Deficit Hyperactivity Disorder and narcolepsy. It is estimated that 4.4% of US adults experience some symptoms and disabilities of ADHD. However adults receive 32% of all issued stimulant prescriptions.1 Off-label treatment for conditions including weight management, fatigue related to depression, stroke, traumatic brain injury, or hyper-somnolence due to Obstructive Sleep Apnea may account for the high prevalence of stimulant use in adults. Such conditions are frequently associated with history or risk of cardiovascular disease. Of note, OSA and other forms of sleep-disordered breathing have unfavorable effects on cardiovascular physiology, predisposing affected individuals to cardiovascular disease and cardiac arrhythmias.2,3

Few reports have been made of arrhythmic events associated with modafinil use. One published case report details a 54-year old male who developed premature ventricular contractions with modafinil usage that resolved after discontinuation.28 Upon rechallenge with modafinil, the PVCs returned after 10-days of treatment, and resolved once again after re-discontinuation.

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