Medication Management for ADHD

The role of medication in treating ADHD is to improve the symptoms of ADHD and allow the individual to function effectively– not to control behavior. Treatment with medication and proper  management of medication is the most effective avenue for reducing the core symptoms of ADHD. During our initial assessment, we will work to understand the patient’s goals for treatment to better understand what treatments to try. The FDA has approved several kinds of medications for ADHD that include stimulants and non-stimulants. 

ADHD can coexist with other conditions such as anxiety, depression and bipolar disorder. When these issues are present, it’s necessary to take them into account when considering medication. 

The Role of Medication

Medication can be an integral part of treatment for both adults and children. Psychostimulant medications are the most widely prescribed for the management of ADHD symptoms. Despite the name, these medications do not work by increasing the stimulation of the person. Instead, the support networks within the nerves cells in the brain to communicate better with each other. Between 70 to 80 percent of children with ADHD respond well on these medications. Attention span and impulsive behavior often improve– especially when coupled with a structured environment. Common psychostimulant medications used in the treatment of ADHD include methylphenidate (Ritalin, Concerta, Metadate, Focalin); mixed salts of a single-entity amphetamine product (Adderall, Adderall XR); and dextroamphetamine (Dexedrine, Dextrostat).

While stimulants are the most widely-available medication with the most testing, some children and adults will respond better to non-stimulant medications. Atomoxetine (Strattera) is neither a stimulant nor an antidepressant and works by affecting specific aspects of the norepinephrine system. Atomoxetine is a prescription medication, but it is not a controlled substance like a stimulant, allowing medical professionals to give samples and to place refills on the prescriptions. However, it does not start working as quickly as a stimulant will. Typically, patients will see the full effects after taking the medication consistently for three to four weeks. 

Some antidepressants will work to treat ADHD, though they are used far less frequently. Antidepressants that only affect the serotonin system—serotonin selective reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft) and citalopram (Celexa)—have not been shown to be effective for treating primary symptoms of ADHD but may be effective against co-existing conditions.

Part of the challenge of medication and why medication management is important is determining the specific dose and timining of medication for each individual. There are no consistent relationships between height, age and clinical response to a medication. Trial often is the best determining factor to finding the most beneficial dosage. Typically, patients will start with a lower dose, increasing dosage in three to seven day intervals until clinical benefits are achieved. 



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