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“Side effects of ADHD stimulant medications”
Frank Barnhill M.D.
All medications,
including oxygen, have side effects.
Of course, some of
us can take the strongest dose of a drug and have few or what “appears
to be” no side effects, while others may be on the smallest dose
possible of the very same drug and suffer terrible side effects. As in
everything else in life, we’re all uniquely different. That means there
are those of us who have a metabolism that can handle certain drugs
better than others who are very sensitive to most drugs.
Fortunately, drug
manufacturers have provided us the most common side effects of
both a particular medication, as well as those expected from the broad
class in which the drug is included. What follows here is a generalized
list of side effects of the common ADHD drugs and a few very specifics
about certain medications with more detailed known side effects.
Remember, everyone
responds differently to a specific drug. So, don’t assume you or your
child will experience a side effect just because someone else in the
family or a friend had problems with that medication. If you do so, you
may very well cheat yourself or your child out of a true
opportunity to have a positive treatment experience!
The general
class side effects of ADHD stimulant medications include:
- Elevated blood
pressure (occurs more often in adults on amphetamines, but can be
seen even in 7 year olds)
- Rapid heart
rate (same as above)
- Shortness of
breath (induced by a very high heart rate)
- Problems going
to sleep (wide awake at bedtime, hard to get to go to bed)
- Problems with
awakening (due to late night sleep onset, “hard to get out of
bed”)
- Headache (dull
to throbbing)
- Nausea and
rarely vomiting
- Loss of
appetite and weight loss
- Feelings of
anxiety or panic attacks
- Confusion or
disorientation
- Rarely,
hallucinations or seeing-hearing things
- Anger and
sometimes open hostility (usually has never occurred before)
- Worsening
of ADHD symptoms (occurs
because of the anxiety and “brain confusion caused by the drug).
This list includes increased fidgeting and hyperactivity.
- Rarely,
problems with urination, libido, and sex
- Symptoms of
withdrawal if the drug is stopped abruptly
It’s quite a list
isn’t it? Fortunately, the ADHD stimulant drugs are some of the
best-studied medications on the face of the earth. They have been
around a long time and appear to be very safe to use. Of course, if
these symptoms were to show their ugly presence, you need to contact the
prescribing doctor right away. In some cases, the medication will need
to be stopped or changed right away.
Here are the
stimulant ADHD drugs:
-
Methylphenidate (Ritalin, Ritalin LA, Metadate, Concerta)
- Amphetamine-dextroamphetamine
(Adderall, Adderall XR)
- Focalin
- Provigil
In general, long
acting or extended release ADHD drugs (SR, LA, ER, XR) have fewer
side effects than rapid onset drugs. Usually this occurs because the
longer acting formulations have a small dose rapid onset part that works
within an hour or so, and also slow onset components, which will last
for up to 10-12 hours. Therefore, a second dose of medication (to help
with homework) is not required around 3 to 5 in the afternoon and
doesn’t interfere with the sleep awakening cycle.
Let me point out
again, if your ADHDer is
having problems with a drug, you should discuss the situation with the
prescribing doctor. ADHD drugs are very potent and can cause
life-threatening side effects if stopped suddenly or the dose is
increased abruptly.
Here’s to the
success in life we all wish for our loved ones!
Dr. Frank |
