What to Know about Stimulant Medications
How They Work
ADHD is a neurologically based disorder, resulting from a deficiency of neurotransmitter(s) in specific areas of the brain. Stimulant medications stimulate cells in certain areas of the brain to produce the missing neurotransmitter. The result is improved organization, planning, impulse regulation, and information integration. The effect is immediate, and typically lasts about 6-8 hours.
These medications come in a variety of forms—capsule, tablet, liquid, patch. The generic names are methylphenidate and dextro-amphetamine, and various brand names are Ritalin LA, Focalin, Adderall, Vyvanse, Daytrana, Concerta, Metadate, and Methylin. Some are available in generic and some are not.
Stimulant medications have improved dramatically in the last 10-15 years—this isn’t the same “hyper pill” that you may remember from your childhood!
How to Give Stimulant Medications
We recommend giving the stimulant medication with a power-packed, healthy breakfast. If your child wakes up later than 10 AM, skip the medication that day to avoid insomnia that night. If your child takes a second dose of stimulant later in the day, be sure you give it with food.
If your child misses a dose, do not double up on the dose the next day.
Remember that treating ADD/ADHD with stimulant medications can be a trial-and-error process; it may take several tries of various medications and doses to find the right one for your child. Please be patient.
Potential Side Effects
Appetite suppression is a universal side effect, so we follow the child’s growth very carefully. We recommend you provide a power-packed, healthy breakfast and bedtime snack.
Some children develop headaches and stomach aches for the first several days. These typically resolve after the first week, so have your child continue the medication. Be sure he/she is taking it after breakfast, and drinking plenty of fluids.
Some children have difficulty sleeping when taking stimulant medications. For this reason we recommend taking it early in the morning. Some children can have a rebound hyperactivity or irritability as the medication is wearing off in the afternoon/evening. Please call if you notice this—we have strategies to prevent this.
Stimulants can bring out underlying heart problems. If your child experiences palpitations, chest pain or inappropriate shortness of breath, stop the medication and call. Stimulants can also bring out tic disorders. If this happens, do not stop the medication, but call us.
Some parents note that their child’s personality is a bit “flat” while taking stimulants. If your child has a “zombie” appearance, the dose is too high; call us.
Taking the medication with food will prevent nausea and jitteriness.
Children can have rare, idiosyncratic reactions to stimulant medications. In general, if you are concerned, please call us.
Should I give my child the medications on weekends and holidays?
Some children take the medication purely for academic reasons, and don’t require the medication on weekends and holidays. Some children benefit from taking the medication if they have a summer camp, if doing homework, for sports practices, or any other activity that would require increased focus. Some children have significant impulse control and mood regulation issues, and would benefit from continuing the medication on weekends and holidays.
Will my child take this medication forever?
Our hope is that your child will engrain good academic/behavioral habits while taking their stimulants so they don’t need to take them long-term. When your child has matured after a year or two, it may be appropriate to trial a week or two during the school year without the medications.
Are there risk of not taking medications?
Research shows that people with non-treated ADD/ADHD have an increased risk of accidents and substance abuse.
Sometimes we prescribe non-stimulant medications to treat ADD/ADHD. These may include Strattera, Kapvay, Intuniv, and Tenex. They typically don’t reduce the target symptoms as effectively as stimulant medications, but are an option for some children, such as those on high doses of stimulants.
Stimulants are controlled substances
Unfortunately, some people abuse stimulant medications. Please keep your medications in a secure location. For this reason, all these prescriptions must be printed out on paper; we cannot call or email them in to your pharmacy. Only a 30-day supply can be filled at a time, and the prescription expires if not filled within 30 days. This means you need to plan ahead when your supply runs low!
I highly recommend www.chaddofutah.com for a plethora of information regarding all aspects of ADHD, including classroom modifications, homework tips, parent classes and support groups.