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Writer's pictureDr Titilayo Akinsola

The Pros and Cons of ADHD Medications: Understanding Your Options



man confuse about which pill to take


The developmental illness known as attention deficit hyperactivity disorder (ADHD) impairs focus and attention. A number of drugs, including Ritalin, Strattera, and Adderall XR, can help control symptoms. Typically, stimulants are used in ADHD treatments. Concerta, Vyvanse, and Adderall XR are popular choices. But patients can also use nonstimulant medications like Intuniv XR or Strattera. 

The effects of medications might be short-, medium-, or long-acting.

Numerous factors determine which drug is best for an individual. These include of a person's personal preferences, the duration of the medicine, and any adverse effects. Knowing the advantages and disadvantages of each type is helpful, but a doctor can offer advice on which is ideal. The many drugs that people might take to help control the symptoms of ADHD are compared in this article.


The ideal medicine for a person depends on a number of criteria. These include the duration of the medication, any side effects, and the individual's personal preferences. It is beneficial to be aware of the benefits and drawbacks of each type, but a physician can provide guidance on the best option. 

 ADHD symptoms may be lessened by taking medications that affect dopamine and norepinephrine, two brain chemicals implicated in the disorder. Stimulants and nonstimulants are the two primary pharmacological classes that doctors prescribe to treat ADHD symptoms.



In children, adolescents, and adults, stimulants work better than nonstimulants. But they also have the potential to be abused and can result in rebound effects. Because of this, a lot of people switch to nonstimulants. Furthermore, stimulants with longer half-lives can lessen the risk of abuse.



 Stimulants have existed for a lot longer, for starters. They are the most effective kind of drug for the majority of children and have been used to treat ADHD (also known as ADD) since the 1960s. Additionally, they are the most often prescribed. This category contains numerous brands, such as Adderall, Ritalin, and Focalin.

Non-stimulants are a newer option. One of the most common, atomoxetine, has been used to treat ADHD since 2002. (This drug is widely known by its brand name, Strattera). Less commonly used are drugs called alpha-2 adrenergics, which at much higher doses are used to treat high blood pressure.

Stimulants include brand names like Adderall, Vyvanse, Ritalin, Concerta, and Jornay PM. Non-stimulants include Strattera, Qelbree and Intuniv, among others. So what are the important differences between stimulants and non-stimulants?


Stimulants

Since it helps 70–80% of kids with ADHD, the stimulant class of drugs is usually recommended first. Dopamine and norepinephrine levels between synapses in the brain are raised by stimulants. After they pass through the blood-brain barrier, which takes 45 to 60 minutes, they start working. The outcome? decreased impulsivity, hyperactivity, and/or distractibility. Methylphenidate or amphetamine are the only two compounds used in all FDA-approved stimulant drugs.

The biochemistry of an individual determines the best option. When using the same drug, even family members may have varied outcomes. In adults, stimulants known as amphetamines are more efficient and cause fewer adverse effects. 


Non-stimulants

For 20–30% of ADHD sufferers, stimulants are ineffective. They then try one of these non-stimulants that have FDA approval: 

Strattera (atomoxetine)

Kapvay (clonidine)

Intuniv (guanfacine)

Qelbree (viloxazine)

It often takes seven days to several weeks to evaluate a non-stimulant medication's full benefits.

The treatment is effective if the patient exhibits sustained focus, improved mood, increased attention to detail, enhanced memory, better sleep, and less impulsive.

What are the side effects of stimulants?


The following are the most typical adverse effects of stimulant medicines for ADHD: 



Serious issues connected to the heart are uncommon. Patients with heart issues who take stimulants should be closely watched by their doctors. Stimulants of the central nervous system carry a significant risk of abuse and dependence. Doctors prescribe longer-acting formulations more frequently because they are less likely to be abused.

Stimulants of the central nervous system carry a significant risk of abuse and dependence. Doctors prescribe longer-acting formulations more frequently because they are less likely to be abused.


Effectiveness and side effects of ADHD medications 



Stimulants

Non-stimulants: Atomoxetine (Strattera) and alpha-2 adrenergics

How they function

Primarily target dopamine receptors in the brain. incredibly successful in lowering impulsivity and hyperactivity while increasing attentiveness.

Atomoxetine (Strattera): Targets norepinephrine, a neurotransmitter. can lessen hyperactivity and impulsivity while increasing focus. It's unclear how alpha-2 adrenergics function in the brain to support ADHD. However, they lessen impulsivity and hyperactivity. They might also enhance focus.

When doctors might prescribe these drugs

This is typically the initial course of medication for kids with ADD and ADHD.

If a child is unable to handle the negative effects of stimulants, atomoxetine (Strattera) may be administered. For teenagers and young adults who would benefit from 24-hour coverage, this could also be an option. To aid children with severe symptoms, alpha-2 adrenergics are most frequently administered in conjunction with stimulants.

Effectiveness

Enhances focus and lowers impulsivity and hyperactivity in 70–80% of individuals.

About half of individuals who take atomoxetine (Strattera) report improved attention as well as decreased impulsivity and hyperactivity. 60 percent of people with alpha-2 adrenergics have less impulsivity and hyperactivity.

How quickly they start and stop working

Quick-action. Based on the medicine and the child's sensitivity, symptoms will manifest 30 to 90 minutes after the initial dosage. 

Depending on whether they are long-acting or short-acting, these medications and their effects leave the body in three to twelve hours.

The full effects of atomoxetine (Strattera) take two to four weeks to manifest. Children can typically be tapered off in a matter of days. Alpha-2 adrenergics: It takes two weeks to determine whether a medication is working. Children who take high doses for an extended period of time may need to be weaned down gradually to prevent adverse effects when the medication is stopped.

Side effects 

-Appetite loss

-Difficulty sleeping -Increased anxiety

-Agitation

-Headaches, tics, and psychosis 

Atomoxetine (Strattera): 


Moodiness (nausea, appetite loss, and lethargy are uncommon adverse effects.) 


Alpha-2 adrenergics: 


  • Fatigue and drowsiness 

  • Loss of appetite

  • Reduction in blood pressure.

  • Nausea 


Risks

May result in weight loss and have an effect on height. (Weight and height ought to be shown.) Because these medications might occasionally result in difficulties, use cautious when administering them to children who already have heart issues. The child should have a cardiologist's approval before taking it

Liver problems from atomoxetine (Strattera) are quite uncommon. Alpha-2 adrenergics: If they significantly affect blood pressure, they may produce lightheadedness and fainting.





Alternative remedies for adhd

According to some study, a good way to manage ADHD symptoms is to combine psychosocial therapy with medication. Five primary categories of interventions exist: 

1. Psychoeducation 

2. Interventions in behavior 

2. Social interventions

4. Accommodations for education and employment


Psychoeducation works well for kids older than eight. Children and their caregivers are educated about ADHD and its consequences through this intervention. For individuals with ADHD of all ages, healthcare providers create behavioral therapies like coaching and lifestyle modifications. To improve conduct, they employ incentives and penalties. People can manage their anger and develop better social skills with the use of social treatments.

Family therapy, behavioral therapy, and self-talk are beneficial for older adults and children. In addition to supportive psychotherapy, a psychotherapist may employ expressive arts therapy and play. Special education programs and workplace treatments are offered by educational and vocational institutions to aid individuals with ADHD.


Conclusion

The first line of treatment for individuals with ADHD is long-acting stimulant formulations. They enable people to take advantage of the medication's effects all day long at work or school. Because longer-acting drugs are less likely to be abused, doctors also favor them. To help persons with ADHD live better lives, medical practitioners may suggest a mix of psychosocial therapies and medication.










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