ADHD (Attention Deficit Hyperactivity Disorder)
The Facts About Medication for Adult ADHD
From Childhood to Adulthood
Two thirds of children with attention deficit hyperactivity disorder (ADHD) are likely to grow up to be adults that continue to have the condition. As a result, an estimated four percent of adults end up with ADHD.
If you were that hyperactive kid, you may find yourself calmer as a grown-up, but perhaps still working on problems with organization and impulsivity. You may want to explore medication options with your doctor to keep ADHD from impinging on your work.
Click through the slideshow to learn more about medication for adult ADHD.
Choices and Mechanisms
Adults with ADHD can take either stimulant or nonstimulant medication. Both types of medication work by blocking certain chemicals in the brain. For example, scientists believe that stimulants work by blocking the reuptake in the neurons of norepinephrine, a stress hormone, and dopamine, a chemical messenger.
In simpler terms, stimulants rev up people who don’t have attention deficits. But they have a calming effect on people with ADHD.
The Most Common Choice
Stimulants such as methylphenidate tend to work well for three out of four patients, according to a study at Massachusetts General Hospital led by Thomas J. Spencer. They are considered the first-line choice for treating ADHD.
Methylphenidate is sold under the brand names of Ritalin, Concerta, Metadate, and Daytrana. Doctors also can prescribe amphetamine compounds, which increase dopamine. This allows you to increase your focus. Amphetamine compounds include Adderall, Dexedrine, and Vyvanse.
You can also take atomoxetine, which is sold under the brand name Strattera. This drug works to strongly increase levels of norepinephrine. It can be taken long-term if necessary.
The first nonstimulant drug approved for adult ADHD, atomoxetine may lead to hepatitis or liver injury in rare cases. Talk to your doctor immediately if you notice any yellowing of your skin or eyes. These are telltale signs of jaundice.
Still, atomoxetine provides a valuable option if you can’t take stimulants and need a medication that allows once-a-day dosing.
The FDA doesn’t officially approve them for adult ADHD, but antidepressants can help if you have a complex case. If you have ADHD and depression, bipolar disorder, or addiction to nicotine, bupropion may be able to help. Known by the brand name Wellbutrin, buproprion affects the brain chemical dopamine.
Tricyclic antidepressants also can work by increasing norepinephrine. Your doctor may prescribe a tricyclic if you have tics, anxiety, or depressive symptoms. These drugs often interact with diabetes or high-blood pressure medications.
Guanfacine and Clonidine
Guanfacine is sold under the brand name Tenex or Intuniv. Clonidine is sold as Catapres. Both take several weeks to work and come from sources used to fight high blood pressure. These medications work well for certain cases of ADHD in children and adults.
Clonidine may reduce impulsivity and hyperactivity, but not inattention. It may help particularly if you have Tourette’s syndrome or tics. Guanfacine has less of a sedating effect than clonidine. It lasts longer, and helps you focus better.
Potential Side Effects
Carefully go over any medication you receive with your doctor and pharmacist. Look over the labels and literature. Don’t use stimulant drugs and atomoxetine if you have:
- structural heart problems
- high blood pressure
- heart failure
- rhythm disturbances
Stimulants can decrease appetite, or lead to headaches or sleeplessness. Check the packaging of antidepressants for warnings regarding potential irritability, anxiety, insomnia, or mood changes.
Managing Your Life
Medication provides just half the treatment picture for the adult with ADHD. You can also initiate calm and focus by setting up your environment effectively. Install a large bulletin board to organize your schedule and contacts. Designate specific spots to store your keys, wallet, and other items.
Cognitive behavioral therapy may help you take additional steps in mastering organizational, study, and social skills. A therapist can help you work on time management and ways to curb impulsive behavior.
- Arnsten, A.F. (2006). Stimulants: Therapeutic Actions in ADHD. Neuropsychopharmacology, 31(11), 2376-2383. Retrieved December 6, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/16855530
- Attention Deficit Hyperactivity Disorder. (2012, January 1). National Institute of Mental Health. Retrieved December 6, 2013, from http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/index.shtml
- Clarke, P. E. (2012, January 25). ADHD: Not Just for Kids. U.S. Food and Drug Administration. Retrieved December 6, 2013, from http://www.fda.gov/Drugs/ResourcesForYou/SpecialFeatures/ucm289089.htm
- Fone, K., & Nutt, D. (2005). Stimulants: Use And Abuse in the Treatment of Attention Deficit Hyperactivity Disorder. Current Opinion in Pharmacology, 5(1), 87-93. Retrieved December 6, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/15661631
- Heiligenstein, E. (2012, April 26). ADHD in Adults; Best Practices for Mental Health Providers. Wisconsin Department of Health Services (DHS) Bureau of Prevention, Treatment, and Recovery. Retrieved December 6, 2013, from http://www.dhs.wisconsin.gov/mh_bcmh/docs/confandtraining/2012/4-26-12ADHDAdults6perPage.pdf
- Kolar, D., Keller, A., Golfinopoulos, M., Cumyn, L., Syer, C., & Hechtman, L. (2008, April 1). Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatric Disease and Treatment, 4(2), 389-403. Retrieved December 6, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518387/
- Ledbetter, M. (2006). Atomoxetine: A Novel Treatment For Child And Adult ADHD. Neuropsychiatric Disease and Treatment, 2(4), 455-466 2.4 (2006): 455-466. Retrieved December 6, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671957/
- Methylphenidate. (2012, November 20). National Institutes of Health. Retrieved December 5, 2013, from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682188.html
- Simon, H. (2013, March 7). Attention deficit hyperactivity disorder. University of Maryland Medical Center. Retrieved December 6, 2013, from http://umm.edu/health/medical/reports/articles/attention-deficit-hyperactivity-disorder
- Stimulant and Related Medications: Use in Adults. (2013, August 1). Centers for Medicare & Medicaid Services. Retrieved December 6, 2013, from http://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Pharmacy-Education-Materials/Downloads/stim-adult-factsheet.pdf