FAQs on ADHD
What conditions can stimulants treat?
Stimulants are most commonly used to treat AD/HD, particularly in children. Some clinicians also prescribe stimulants on an off-label basis to treat depression, particularly if the depression appears to be related to ADHD or has led to difficulties with motivation. Some people with sleep disorders, particularly narcolepsy and shift-work sleep disorder, also benefit from stimulants to remain wakeful during the day.
How do stimulants reduce hyperactivity?
The idea that a drug that increases alertness and energy could improve concentration in people with hyperactive tendencies might seem strange. After all, when people without ADHD take stimulant drugs, they often find themselves overwhelmed with energy, anxiety, and distraction. Stimulants can also have a paradoxical effect in people with AD/HD. Rather than globally increasing activity, they help people to sharpen their focus and concentrate on the task at hand.
Doctors have proposed a number of theories to explain this phenomenon. One possibility is that people with AD/HD don't have as much of a chemical reward associated with concentration and work. Stimulants can increase brain chemicals associated with motivation and reward, making it easier—and more rewarding—to concentrate. Another possibility is that the hyperactivity common among people with ADHD is a desperate attempt to remain focused, so stimulants reduce hyperactivity by sharpening focus.
Who should take stimulant drugs?
Stimulant drugs can be highly effective for people who are properly diagnosed and whose dosage is monitored. However, they can also be addictive. Like all medications, they are not without side effects. For this reason, most medical bodies and almost all research argues that people—particularly children—should not take stimulant drugs until they have tried other options, such as psychotherapy, changes in the environment, and family support. People who do take stimulants should continue with psychotherapy. Since psychotherapy can amplify the effects of the drug, reduce the necessary dosage, and perhaps even shorten the length of time that the drug is necessary to take. RCBM has several therapists who are specialized in ADHD coaching to help cope with symptoms to improve your life.
What are the side effects of stimulants?
Like other drugs, stimulants can produce a range of side effects. Not everyone experiences these side effects, and very few people experience the most severe side effects. Many users find that the side effects appear immediately, but that as the body adjusts, the side effects disappear. If you experience side effects that are intolerable, talk to your doctor about a reduced dose or alternative medication. In some cases, lifestyle remedies may also help with side effects. For instance, the shakiness that some people experience when they take stimulants may improve with more frequent meals. The most common side effects of stimulant drugs include:
Changes in appetite that can lead to weight-loss, Weight-loss even without dietary changes, Restlessness, anxiety, or aggression, Shakiness and light-headedness, Insomnia, Increases in blood pressure or heart rate, Nausea, vomiting, or diarrhea, Changes in vision, Tics, Headaches, Very rarely, stunted growth in very young children who take high doses, Very rarely, suicidal thoughts and actions, Very rarely, extreme aggression, psychosis, or dangerous behavior.
How do I know if a stimulant is working?
Unlike some other psychiatric medications, stimulants begin working immediately after you take them. They do not need time to build up in your system. However, your body may need some time to adjust, and you might also find that you steadily make lifestyle changes that increase the effectiveness of the stimulant. If you do not notice improvements in concentration, mood, or motivation within a week, talk to your clinician at RCBM. You might need a higher dose, a different drug, or a different diagnosis.
Is there anything I can do to increase the efficacy of my stimulant medication?
Never increase your dosage without first consulting your clinician! Doing so can endanger your health and increase your odds of chemical dependency. Some steps that may increase the effectiveness of your drug include:
Talking with your clinician about the best time of day to take your medication, then continuing with that dosing schedule, Eating small, regular meals, Pursuing psychotherapy alongside medication, Making lifestyle changes such as planning your time, sticking to a routine, and avoiding common distractions such as social media and smartphones.
Do stimulants ever stop working?
As the body becomes more accustomed to stimulants, it may develop a tolerance that reduces or eliminates the effectiveness of the drug. Your clinician can discuss with you the best ways to deal with this. Do not increase your dosage without a medical consultation! Our clinicians do their best to respond to questions via phone or email. Sometimes, an increased dosage is all you need. In other cases, your clinician might recommend pairing your current drug with a different drug, trying a new medication, or taking a “drug holiday” to allow your body time to readjust.
What about the possibility of addiction or abuse?
When your body becomes dependent on a drug to feel normal, addiction becomes extremely likely. If you become addicted to stimulants, it's not your fault. The good news is that when monitored by a clinician and taken at the right dose, the chances of addiction are very slim. If you do become addicted, your clinician can help steadily wean you off of the drug, then work with you to find a more appropriate treatment.
I've read that stimulants are dangerous for kids, or are over-prescribed. Does my child really need to take a stimulant?
It's true that some children who don't actually need them take stimulant drugs. Most research suggests that this tends to happen when desperate parents seek help from family physicians—not psychiatrists, psychiatric nurse practitioner or physician assistant. In their zeal to help, family physicians and pediatricians may prescribe stimulants to children who do not really need them, or neglect to tell parents about the benefits of psychotherapy.
If you see a psychiatrist, psychiatric nurse practitioner or physician assistant, the likelihood that this will happen is much lower. Monitor your child closely. If he or she is thriving while using stimulants, it's likely you've found the right drug. If nothing changes, or your child gets worse, consult your doctor. Your child might have been misdiagnosed, or he or she might be taking the wrong medication.
Will my child or I have to take stimulants forever?
There's no easy answer to this question. Much depends on how severe your symptoms are, whether you continue with psychotherapy, and what lifestyle changes you are willing to make. Some children grow out of AD/HD, but for most, it continues to be a struggle. Many find that stimulants offer relief, allowing them to find other ways to manage their symptoms. If those management tools are sufficiently effective, you or your child might not need to permanently take stimulants.
In some cases, clinicians recommend cycling stimulants by taking them for a brief period of time to regain focus, taking a break, and then trying again later. If you or your child need stimulants for a long period of time, this is one way to minimize side effects, chemical dependency, and the risk of addiction.
What are the symptoms of AD/HD?
AD/HD are more than just difficulty concentrating, and symptoms manifest differently in different people. Some common symptoms include:
A constant need for stimulation; chronic boredom.
Frequently forgetting or losing things.
Unable to concentrate, despite making a great effort to do so.
Hyperactive, aggressive, or distracted behavior, particularly in children.
Depression; this is a common and often-overlooked symptom in adults, particularly those who struggle at work or in relationships because of AD/HD.
Difficulty following a conversation.
Frequently interrupting other people.
Inability to sit still; may be fidgety, bite nails, or shred scraps of paper.
Inability to maintain a tidy work space.
Difficulty with time management; may greatly overestimate or underestimate how long tasks will take.
Working very slowly due to the delays associated with frequent interruptions. Adults, for example, may compulsively check social media, causing a 30-minute task to take four hours.
For further questions or concerns, please call or email your clinician at RCBM. We will do our best to assist you and answer any questions you might have in a timely manner. Our team at RCBM is dedicated to giving those patients who are struggling from AD/HD the tools to manage their symptoms and live a normal life.
Why choose RCBM for ADHD treatment?
For over a decade, the Rochester Center for Behavioral Medicine has offered comprehensive diagnosis and treatment for Attention Deficit Hyperactivity Disorder (ADHD) and related disorders across the lifespan. Under the leadership of medical director and founder, Joel L. Young, M.D., all RCBM clinicians are highly qualified to deliver the most current and effective treatments for ADHD. Dr. Young is the author of two books on ADHD. He has also been the principal investigator in a number of clinical trials regarding ADHD, and related disorders. Furthermore, Dr. Young, along with our experienced clinical nurse practitioners, work with local medical residents to teach effective diagnosis and treatment interventions for ADHD and related disorders. Dr. Young and RCBM staff understand that ADHD symptoms are more than just a nuisance. These symptoms can negatively impact academic and work performance, romantic and familial relationships, and general psychological well-being. Lack of treatment or ineffective treatment can lead to increased risk of failed relationships, financial difficulties, chemical dependency, accidents and injuries, depression and anxiety, among other mental health disorders.
Facts About ADHD
Inattentive - Symptoms may include: difficulty sustaining attention, forgetfulness, trouble with follow-through, time management, organization or procrastination. Symptoms are longstanding and create distress in more than one realm of the patient’s life. This type is often overlooked because there may not be outwardly visible signs of the patient’s struggle.
Hyperactive/Impulsive - Symptoms may include: inability to sit still, being constantly “on the go,” excessive talking, impulsive decision-making, impatience. This type is more commonly seen in young males.
Combined - Symptoms of both the Inattentive and Hyperactive/Impulsive types. Combined type is the most commonly seen type of AD/HD in adults.
AD/HD can be difficult to spot at times; particularly when there are other mental health symptoms that are viewed as priority. Careful screening should be undertaken in order to determine the most accurate diagnosis. It is not uncommon for AD/HD patients to have been treated for the following prior to undergoing thorough assessment and treatment for AD/HD:
Major Depressive Disorder: It is important to remember that frustration related to longstanding struggles with ADHD does not necessarily mean clinical depression. Patients may present with symptoms of depression but, underlying these mood difficulties can be a history of untreated AD/HD. These untreated symptoms may have led to decreased self-esteem, poor school and work performance, or feelings of inferiority, all of which can create and intensify depressive symptoms. Although this depression is very real, it may be secondary to the AD/HD diagnosis, and may go away once the AD/HD is successfully treated.
Bipolar Disorder: The depression that is associated with Bipolar Disorder is commonly seen in individuals with untreated AD/HD (as discussed above). Furthermore, Bipolar mania can be easily confused with symptoms of hyperactive/impulsive AD/HD. Both disorders can be accompanied by racing thoughts, reckless behavior, trouble maintaining relationships and jobs, difficulty sleeping, and mood swings. AD/HD symptoms are chronic, unaccompanied by psychotic features, and do not typically reach the level of severity that manic symptoms can. Although Bipolar Disorder and AD/HD can occur together, sometimes Bipolar Disorder has been incorrectly misdiagnosed.
Career Advice for Finding the Right Work with ADHD
by Edward Hallowell, M.D.
Career Advice from Powerful ADHD and LD Executives
by Lois Gilman
‘I Realized Our Marriage Was in Trouble’
How one couple repaired their ADHD marriage with a professional coach.
by Maureen Connolly
Solutions for Intimacy Problems for Adults with ADHD
by Richard B. Austin, Jr., PhD
ADD and Your Legal Rights
Qualifying for work accommodations, getting a school to adhere to an IEP or 504 Plan, and more
By Robert Tudisco
What You Need to Know About the Americans with Disabilities Act
by ADDitude Editors
Raising a Child With ADHD
ADHD Parenting Advice from Michael Phelps’ Mom
by Judy Dutton
Manage Your Money with Adult ADD!
Celebrities With Attention Deficit Hyperactivity Disorder
Safeguarding Teenage Drivers with ADD
Young motorists with ADD need to be extra careful on the road. Here's how they can drive safely.
by Patricia Quinn, M.D.
Driving With ADD
Driving Safety With ADD: Is Your ADD Teen at Greater Risk?
By Keath Low