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ADHD and Stimulant Medications

Side Effects and Safety Issues of These ADHD Drugs

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Updated November 05, 2013

Stimulant medications are the most widely used drugs for treating ADHD. Commonly used stimulants include Ritalin, Dexedrine, and Adderall. Long- and short-term forms of stimulants are available. For a more complete list, read this article: ADHD and Medications

Stimulants affect the regulation of the neurotransmitters dopamine and norepinephrine. The drugs are thought to influence the availability of these chemicals in the brain in a variety of ways, helping the person taking them to focus his attention and control impulses, think through plans, and organize our thoughts. For ADHD individuals who respond positively to stimulant medication, quality of life is greatly improved.

Stimulants are the most researched and studied of any of the groups of medicines used to treat behavioral and emotional problems in children. They are proven to be safe and effective when used properly.

Still, placing your own child on medication can be a very worrisome decision for many parents. What are the side effects? What are the long term effects? What are the biggest concerns?

Common Side Effects of Stimulant Medicines

The following are the most common side effects of stimulant medications, especially in the first few weeks of treatment:

  • decreased appetite
  • difficulty sleeping
  • increased anxiety, nervousness or restlessness
  • irritability
  • mild stomach ache
  • headache
Stimulants are typically started at low dosages and adjusted upward as necessary. Higher dosages of the medication produce more side effects. When side effects occur, they can usually be reduced by simply lowering the dosage of medicine or, in the case of sleep issues, adjusting the time the medicine is taken. Individuals may also respond better to one kind of stimulant over another.

Tips for Reducing Common Side Effects of Your Child's ADHD Medicine

Most Commonly Expressed Concerns Related to Stimulant Use

Will stimulants affect my child’s growth?

Stimulant medications may cause an initial, mild slowing of growth in height, but most research indicates that height normalizes by adolescence and children reach their normal heights.

A 10-year study by the National Institute of Mental Health (NIMH) found that the brains of children and adolescents with ADHD are 3 to 4% smaller than children who do not have ADHD, but that this is not related to medication.

Additional research indicates that the brain actually matures a few years later in children with ADHD, but otherwise follows a normal pattern of development. The delay was most evident in regions at the front of the brain’s outer mantle (cortex), an area which helps control thinking, attention and planning.

Will long-term use of stimulants lead to substance abuse?

Stimulant medications are not addictive when used correctly. Though there has been much discussion about the potential risks of substance abuse associated with use of stimulants, studies have actually found that the risk of substance abuse is much more common in children and teens with untreated ADHD.

Will taking stimulants lead to sudden cardiac death?

Some of the stimulant medications may cause an increase in heart rate and blood pressure. While this is not usually a concern in a healthy individual, it may be dangerous in a person who has a pre-existing or undiagnosed heart condition. The stimulants have not been found to cause heart problems, but they may exacerbate one that already exists. Thus, it is very important for doctors to screen patients for heart conditions and monitor patients closely while they are taking the medication.

Stimulants and Your Child: Making the Decision

It should be clear that medications do not “cure” ADHD, they simply make it easier for the individual to manage the symptoms of ADHD by improving attention and decreasing impulsive and hyperactive behaviors on the day the medicine is taken.

The most effective treatment approach to ADHD includes behavioral modifications, organizational strategies, counseling and psychotherapy, support, and education about ADHD and its impact on daily life. For a great many, it also involves medication. The stimulant medications are the most widely used, but the U.S. Food and Drug Administration (FDA) recently approved Strattera (atomoxetine) for the treatment of ADHD. Strattera is not a stimulant, but it has been very effective in reducing symptoms of ADHD.

Speak with your child's doctor about the ADHD treatment options that may be best for your child.

Sources:

American Academy of Pediatrics. ADHD: A Complete and Authoritative Guide. The American Academy of Pediatrics. 2004.

American Heart Association. Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Stimulant Drugs. AHA Scientific Statement. 2008

American Psychiatric Association. ADHD Drugs' Growth Impact Found to Be Insignificant. Psychiatric News. June 16, 2006. Volume 41, Number 12, page 25.

National Institute of Mental Health. Brain Matures a Few Years Late in ADHD, But Follows Normal Pattern. National Institutes of Health (NIH). U.S. Department of Health and Human Services. November 12, 2007.

National Institute of Mental Health. Brain Shrinkage in ADHD Not Caused by Medications. National Institutes of Health (NIH). U.S. Department of Health and Human Services. October 8, 2002.

National Institute of Mental Health. The Treatment of ADHD. National Institutes of Health (NIH). U.S. Department of Health and Human Services. 2008.

National Alliance on Mental Illness. About Mental Illness: Attention-Deficit/Hyperactivity Disorder. 2003.

Timothy E. Wilens, MD, Stephen V. Faraone, PhD, Joseph Biederman, MD and Samantha Gunawardene, BS. Does Stimulant Therapy of Attention-Deficit/Hyperactivity Disorder Beget Later Substance Abuse? A Meta-analytic Review of the Literature. Pediatrics Vol. 111 No. 1 January 2003, pp. 179-185.

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