Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. It is one of the most common childhood disorders and often continues into adulthood.
Symptoms of ADHD
- Inattention:
- Difficulty sustaining attention in tasks or play activities.
- Frequent mistakes in schoolwork, work, or other activities due to not paying attention to details.
- Difficulty organizing tasks and activities.
- Avoidance or reluctance to engage in tasks that require sustained mental effort.
- Frequently losing items necessary for tasks and activities.
- Easily distracted by extraneous stimuli.
- Forgetfulness in daily activities.
- Hyperactivity:
- Fidgeting with or tapping hands or feet, or squirming in seat.
- Inability to stay seated in situations where it is expected.
- Running or climbing in inappropriate situations (in adults, this may manifest as restlessness).
- Inability to play or engage in leisure activities quietly.
- Often “on the go” or acting as if “driven by a motor.”
- Talking excessively.
- Impulsivity:
- Blurting out answers before questions have been completed.
- Difficulty waiting for their turn.
- Interrupting or intruding on others’ conversations or games.
Medications for Attention-Deficit/Hyperactivity Disorder (ADHD) can be broadly categorized into stimulant and non-stimulant medications. Here’s an overview of the commonly prescribed medications in each category:
Stimulant Medications
Stimulants are the most commonly prescribed medications for ADHD and are considered first-line treatments. They work by increasing the levels of certain neurotransmitters in the brain, such as dopamine and norepinephrine, which help improve attention and focus while reducing hyperactive and impulsive behaviors. The main types of stimulant medications include:
- Methylphenidate-based Medications:
- Ritalin: Available in immediate-release, sustained-release, and extended-release forms.
- Concerta: Extended-release form of methylphenidate.
- Metadate: Available in controlled-release and extended-release forms.
- Focalin: Available in immediate-release and extended-release forms.
- Amphetamine-based Medications:
- Adderall: Contains a mixture of amphetamine salts and is available in immediate-release and extended-release forms.
- Vyvanse: Contains lisdexamfetamine, a prodrug that is converted into dextroamphetamine in the body.
- Dexedrine: Contains dextroamphetamine and is available in immediate-release and extended-release forms.
- Evekeo: Contains racemic amphetamine sulfate and is available in immediate-release form.
Non-Stimulant Medications
Non-stimulant medications are generally prescribed when stimulants are not effective, cause undesirable side effects, or are not suitable for the individual. They work through different mechanisms to help improve ADHD symptoms.
- Atomoxetine (Strattera):
- A selective norepinephrine reuptake inhibitor (NRI) that increases norepinephrine levels in the brain.
- Alpha-2 Adrenergic Agonists:
- Guanfacine (Intuniv): Works by stimulating alpha-2 receptors in the brain, which helps improve attention and reduce hyperactivity and impulsivity.
- Clonidine (Kapvay): Also stimulates alpha-2 receptors and is available in extended-release form for ADHD.
- Antidepressants:
- Sometimes used off-label for ADHD, particularly when there are coexisting conditions like anxiety or depression.
- Bupropion (Wellbutrin): An atypical antidepressant that affects norepinephrine and dopamine levels.
- Tricyclic Antidepressants (TCAs): Such as imipramine and nortriptyline, which can help with ADHD symptoms.
Side Effects
Both stimulant and non-stimulant medications can have side effects. Stimulants may cause insomnia, decreased appetite, weight loss, increased heart rate, and potential for misuse or dependence. Non-stimulants may cause drowsiness, fatigue, dry mouth, and blood pressure changes.
The effectiveness and side effects of medications can vary widely among individuals. It often requires careful monitoring and adjustment by a healthcare provider.In some cases, a combination of medications may be used to optimize treatment outcomes.
