Medications for ADHD

Anti-Hypertensives

Anti-Hypertensives

Catapres ® (Clonidine)–first used as an anti-hypertensive medication, this medication is an alternative to stimulants for ADHD. It seems to work best in decreasing hyperarousal, but does not always improve distractibility (as stimulants do). Some doctors have found benefits in using this medication with children that have ADHD and conduct problems.

Tenex ® (Guanfacine)–another anti-hypertensive drug that has been reported to be effective with ADHD. Longer acting than clonidine.

Rebound Hypertension

Never stop medication without talking to your doctor. Stopping clonidine or guanficine suddenly can cause a rapid and potentially dangerous rise in blood pressure. Your doctor can recommend a safe time table to gradually stop taking your medication.

Dry Mouth or Decreased Salivation

Dry mouth (or decreased salivation) can be rather annoying. Although it may not go away completely, it does usually improve with time.

Daily Routine Strategies to Help Combat Dry Mouth:

Drink plenty of fluids throughout the day
Suck on hard candy
Eat frozen grapes
Suck on ice chips
Visit the dentist more frequently to maintain tooth and gum health

Dizziness (or Orthostatic Hypotension)

You may feel dizzy or lightheaded as the result of sitting/standing up too quickly. This occurs because your blood pressure drops a significant amount when you change your posture. The condition should correct itself quickly, in a matter of moments, but it is important to let your doctor know about this problem right away.

To avoid injury from dizziness induced falls:

Make sure to change from a lying to sitting and sitting to standing position more slowly than you usually would.
Use solid supports when getting up. Have something strong to lean on should you become dizzy.

Stimulants

Stimulants

Stimulants are usually the first medications used for ADHD. Of all the medication used, the stimulants can have the most dramatic improvements in ADHD symptoms. Instead of the two weeks that anti-depressants may take to work, families can see improvements with stimulants in just a day or two. Improvement in hyperactivity is almost immediate when a child is receiving the right dose.

Specific Stimulants

Ritalin ® (Methylphenidate)–probably the most common stimulant used.

Dexedrine ® (Dextroamphetamine)–approved by the FDA for use in children as young as 3 years old.

Adderall ® (Dextroamphetamine Sulfate)–a longer acting form of dexedrine.

Cylert ® ( Magnesium Pemoline)–unlike the other stimulants, this medication make take a week or two to show improvements. But it does have the advantage of only having to give it once a day.

Short-acting vs. Long-acting

There has been a debate over whether short-acting (lasts 1-3 hours) or long-acting medications (lasts 6-9 hours) seem to work better. Early reports seem to indicate more improvements in behavior with short-acting stimulants. However, more recent reports indicate that long-acting medications were just as effective as the shorter-acting medication. Long-acting medications would have the advantage of less frequent doses during the day. Ritalin and Dexedrine have short and long-acting forms. Cylert and Adderall are both long-acting stimulants.

Growth Suppression

Growth-Suppression

Early reports seemed to indicate that there can some decrease in height and weight gain during stimulant treatment. However, later reports showed that there can be spurts and increases in growth once stimulants are stopped. Final height does not seem to be greatly effected. Still height and weight should be followed carefully, especially in children that might already be at risk for decreased growth.

Tics

Tics are movements or noises that a person has no control over. For example, a person might twitch, shrug their shoulders, sniff their nose, or clear their throat. Stimulants might bring out or make tics worse. A controversial topic, stimulant treatment in general is avoided in people with tics, Tourette’s Disorder, or a family history of tics.

Insomnia

Insomnia can mean difficulty with falling asleep, staying asleep, or both. The problem can range in severity. There are many medications that will cause insomnia. Your chances depend both upon your own physiology and the particular medication you are taking. Call your doctor. Most doctors will tell you to take the medication in the morning to reduce the effects of insomnia. Or, s/he may prescribe a medicine to help you sleep, change your dose, or change your medication.

Daily Routine Strategies to Help Combat Insomnia:

Many people say that reducing their caffeine intake helps with insomnia
Others say that practicing relaxation techniques, listening to music or reading, before going to bed helps
Avoid eating heavy meals before bedtime
Avoid exercising before bedtime

Irregular Heartbeat

Irregular-Heartbeat

On very rare occasions, a person taking medications can experience either heart palpitations or an irregular heartbeat. Normally people are not aware of their heartbeat. But when experiencing heart palpitations, people will notice that their heart is pounding, jumping, or fluttering. Some common symptoms include: palpitations – “pounding,” “fluttering,” “jumping”; irregular heartbeats – “missing beats,”or “skipping beats”; or the heart beat is “too slow or fast”. If you feel that you are experiencing these changes in your heartbeat, call your doctor immediately. Your doctor may order some tests to determine the exact cause of the palpitations or irregular beats and may modify your medications.

Liver Problems

On very rare occasions, a medication can irritate the liver and produce inflammation. The symptoms of liver irritation include extreme tiredness, severe nausea, and yellowing of the whites of the eyes and skin. If you notice any of these symptoms beginning to develop, call your doctor immediately. Your doctor will evaluate your symptoms and modify your prescription accordingly.