What You Need To Know About ADHD Medications

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Types of ADHD Medication

There are two main types of medications used to treat ADHD. Stimulant medications (all of them are either a form of Adderall or Ritalin) and non-stimulant medications (Strattera, Kapvay, Intuniv). Stimulant medications are the most widely prescribed. I will be addressing those medications in this post.

Are ADHD Medications Safe?

The short answer to this question is “yes”. Any medication can have side-effects, and ADHD medications are no exception. You just need to be aware of the potential side effects and know what to do and how to manage them.

What Are the Side Effects?

By far the most common side effect is a decreased appetite. In fact, this pretty much happens to everybody, so you should be prepared to address it. You will be eating less, so you need to make it count nutritionally.Here are my tips:

  • If you aren’t taking a multi-vitamin, start now. 
  • Experiment with smoothies. You can add superfood powders, protein powders, coconut oil, etc to a smoothie to up your nutritional intake.
  • Try eating a big nutritious breakfast first thing in the morning before your medication kicks in.
  • You probably aren’t really going to be that hungry for lunch. Try a meal replacement bar or shake. But, find something organic, made with real food, as natural as possible.
  • Keep healthy snacks on hand (nuts, fruit, etc.) so if the mood strikes, you can eat something good for you. Don’t squander what appetite you have on junk.

As an adult, you can make yourself down that smoothie even if you aren’t really hungry. With kids, addressing a suppressed appetite can be more difficult. It’s hard to make a kid eat. Your best bet is to do your research on meal replacement options. Find something as natural as possible. Most meal replacement options are focused on weight loss. Since that is not your goal here, consider how to doctor them up. Mix them with fruit (bananas tend to add a lot of sweetness), for example. If you are desperate to get your kid to eat, consider a scoop of organic sherbet in a blender with the meal replacement. Get creative.

Other possible side effects of ADHD stimulant medications are increased anxiety, difficulty sleeping, a mood or energy crash when the medication wears off, and a blunting or flattening of personality. About 15% of people will experience one of these side effects. These side effects can often be successfully addressed by changing the dosing or changing the medication.

As with any medication, there can be other rare side effects and some of them could be serious. Be sure and discuss any concerns with your doctor right away.

How Effective Are the Medications?

In my experience, these medications are very effective at treating ADHD for just about everybody. If you find you are not getting good results from these medications, most likely, you need a different dose or a different medication. 

Many people see a pediatrician or general practice doctor to get these medications. While they are qualified to write these prescriptions, this is not their specialty. They will not have as much experience managing dosages and will not have as much experience across the set of medication options.  If you find that you are not getting good results from your ADHD medication and you are not seeing a psychiatrist, consider switching to a psychiatrist.

There are a very small number of people that don’t tolerate these medications. In my 20+ years of practice, I have encountered around 20 people that cannot take the stimulant ADHD medications. In general, the medication works for these people but they experience more intense versions of the side effects that they cannot tolerate. Different dosages and different medications do not bring relief. Again, this applies to very few people.

In my experience, these medications are a good option for just about everybody. Most of my patients see good results very quickly. For some patients, I need to work with them on dosing and trying different medications before we find the right one. In the end, these medications are effective for just about everyone. I will tell you that my results in my practice are much better than what the literature will tell you so if you are familiar with the statistics, you may be questioning my statements. I believe the reasons behind the success that I see are twofold:

  • The demographics of my practice are such that most of my patients are highly motivated to seek mental health treatment and I have a very high compliance rate with them taking medications as directed, following up quickly with concerns, and being able to work through dosing and medication issues to find what works for them.
  • As I mentioned above, psychiatrists are specialists with more experience prescribing ADHD medications than general practitioners. We have more experience with dosing, addressing side effects, and a greater breadth of medications.

I believe that both of these factors have led to very high success rates in my practice and support my statements that these medications can be extremely effective if prescribed properly.

Can These Medications Be Abused?

These medications do have the potential for abuse. If parents are concerned about this with their child, they should be the one who manages the medication and distributes the dose. Keep in mind that studies have shown that people with untreated ADHD have a higher likelihood of substance abuse. In my opinion, the benefits of treating ADHD far outweigh the potential for abuse.

Do These Medications Stunt Growth?

The answer to this question has gone back and forth over the years with the advent of each new study. The current thinking is that these medications could result in some decrease in height based on the overall load of the medication over a number of years. Taking breaks from the medication on the weekend or over the summer can help mitigate this risk. I have been treating people for ADHD with these medications for years and I do not have a bunch of short people for patients, so this is not a common or profound effect.

In my opinion, this potential risk for diminished height is far outweighed by the benefits of the medication. Being successful in school, staying on top of the details of your life, feeling like you are living up to your potential, being successful at work, etc are great contributors to self-confidence and happiness in general. 

Additionally, I personally believe that the appetite suppressing effects of the medication contribute to the risk for diminished height. This underscores the need to ensure you are eating what your body needs.

Are There Effective Non-Medication Treatments For ADHD?

My short answer to this question is “not really”, but there are things you can do to help. Before you roll your eyes and think that I’m yet another doctor pushing pills, hear me out.

Exercise and Omega 3 Fatty Acids have been demonstrated to offer some benefits for ADHD. Vigorous exercise for about forty-five minutes can improve focus for the following couple of hours. Taking roughly 800-1000 mg of EPA (one of the Omega 3 Fatty Acids and the one linked to mental health benefits) can also improve ADHD symptoms for some people. 

Additionally, there are a small set of people who will find a gluten-free diet helpful. If you want to try it, go for it. Dietary intervention is always better than medication in my opinion.

There is a growing body of evidence linking gut health to mental health and linking inflammation (reducing inflammation) to mental health. So you should absolutely clean up your diet, eat real foods, cut processed crap, eat foods that nourish your gut, eat fermented foods and take probiotics, etc. If you do this, you will feel better and you will look better and your ADHD symptoms will most likely improve. Additionally, there is a specific diet, the GAPS diet, aimed at solving a variety of mental health problems including ADHD. Dr. Natasha Campbell-McBride devised this diet as a way to reduce inflammation and heal your gut. She has had great clinical success in addressing mental health issues with her patients that stuck to this diet. This dietary protocol is very strict and very restrictive and definitely not something most people are willing to tackle. If you think you have the discipline and the drive to do it, I highly recommend that you go for it.

I’m not saying that a cleaner diet and exercise won’t help your ADHD symptoms. But, I have yet to have a patient cure themselves of ADHD through diet and exercise alone, and not need medication anymore. Sticking to these dietary protocols strictly enough for long enough to allow your gut and inflammation to heal is extraordinarily difficult in our society of processed food, industrial agriculture, etc. I encourage you to do what you can to improve your diet. You will reap many rewards for your physical and mental health. But, don’t be surprised if you still want to consider taking ADHD medication.

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