Stimulants are the most commonly used medicine for the treatment and management of ADHD symptoms. Medications do not “cure” ADHD, rather they help reduce distractibility, improve focus and concentration, and decrease impulsiveness and hyperactivity. Stimulants have been found to be effective in treating ADHD throughout their life from preschoolers, to school-age children, to teens, and adults with ADHD.
Remember that medications may be used as an intervention for ADHD as a part of a larger treatment plan that may also include education, organizational strategies, behavior therapy, parent training, coaching, counseling, and support.
Stimulants “stimulate” the brain to make slightly more of the neurotransmitters that help us focus, organize, plan and control impulses.
The most common side effects of stimulants include decreased appetite, headache, stomachache, irritability, and difficulty sleeping. These side effects mostly occur early on in treatment, but if they persist a simple adjustment of the time or dose of medicine is often helpful.
Stimulant medicines are available in the following preparations:
Immediate-Release (short acting) - Releases the stimulant medication immediately after ingestion. Duration of positive behavioral effects lasts approximately 3 to 6 hours depending on the specific stimulant taken. Often taken two to three times a day.
Intermediate-Release (intermediate acting) - Has a slower onset of action. Lasts a little longer than the immediate release, approximately 4 to 8 hours depending on the specific stimulant taken. Often taken one to two times a day.
Extended-Release (once-daily preparations) - Comprised of both the immediate and extended release preparations, so it not only releases the stimulant medication immediately after ingestion, but also again approximately 4 to 6 hours later. Duration of positive behavioral effects lasts 10 to 12 hours. Taken once daily.
Stimulants include methylphenidate and amphetamines. Generic class and brand names for stimulants are listed below:
- Methylphenidate (Brand names: Ritalin, Methylin, Metadate)
- Dextromethylphenidate (Brand name: Focalin)
- Dextroamphetamine (Brand name: Dextrostat, Dexedrine)
- Mixed amphetamine salts (Brand name: Adderall)
- Methylphenidate (Brand names: Ritalin SR, Ritalin LA, Metadate ER, Metadate CD, Methylin ER
- Dextroamphetamine (Brand name: Dexedrine Spansule)
- Methlyphenidate (Brand name: Concerta)
- Mixed amphetamine salts (Brand name: Adderall XR)
- Lisdexamfetamine dimesylate (Brand name: Vyvanse)
There has been some concern in the general public that stimulants may pose an increased risk for substance abuse. However, studies find that appropriate treatment of ADHD (which often includes the use of stimulants) actually reduces the risk of future substance abuse disorders. Substance abuse appears to be more prevalent in those with ADHD who do not receive treatment. Stimulants are generally considered safe and to be the most effective medication used to treat ADHD.
Source: Russell Barkley. Attention Deficit Hyperactivity Disorder: Handbook for Diagnosis and Treatment (Third Edition). Guilford Press. 2006.