Side effects of the non-stimulant ADHD drugs   Frank Barnhill M.D.
 

Drugs that do not stimulate the brain activation parts of the frontal lobe have been used to treat ADHD for many years. Often, these medicines were used to control specific aspects of ADHD behavior or provide the chemicals our brain needs to produce neurotransmitters or brain messaging-processing substances.

Since most ADHD research has shown ADHD to be hereditary and comprised of a dysfunction in the brain frontal lobe areas, it is logical to assume drugs that affect this part of the brain may also help ADHD persons. On focus, the frontal lobes of our brains are responsible for executive thought processing or the handling of information input-interpretation-processing-output-storage. This means since ADHDer’s frontal lobes aren’t working well, the ADHDer will have varying degrees of problems interacting with his or her environment, peers, family and sometimes themselves. It’s hard to understand, learn, and socially interact in the proper manner when you can’t figure out how to process information.

With that in mind, let’s take a look at the most common non-stimulant drugs being used to treat ADHD.

Non-stimulant ADHD drugs include:

• Atomoxetine (Strattera)
• Divalproate (Depakote, Depakene)
• Lithium carbonate (Eskalith, Lithobid)
• A multitude of antidepressants (Wellbutrin, Paxil, Effexor, Prozac, Celexa, trazodone, Pamelor)
• Medicines that alter our adrenalin-epinephrine-nor-epinephrine responses (clonidine)

These medications have a general bunch of side effects and a few very specific ones associated with a certain drug. Here is the currently agreed list:

• Dry mouth, lack of saliva or tears or decrease in sweating (this pre-disposes you to heat strokes or heat related illnesses)
• Constipation or decrease in bowel movement frequency
• Difficulty urinating or rarely, inability to urinate at all (retention)
• Upset stomach and possibly vomiting
• Problems with sex (All)
• Elevation of blood pressure
• Decrease in blood pressure (clonidine)
• Increase in heart rate or skipping heart beats (All)
• Fatigue or feeling tired all the time
• Sedation or feeling sleep (Anti-depressants, clonidine)
• Worsened anxiety or depression (crying, sad)
• Confusion (very true with excessive doses)
• Worsening of ADHD symptoms (All)
• Muscle stiffness or weakness (more often divalproate or lithium)
• Loss of appetite and/or weight loss

Atomoxetine is the newest of the non-stimulant ADHD drugs and is similar in its side effects to some of the anti-depressants. Like the SSRI drugs (selective serotonin affecting anti-depressants), Atomoxetine changes neurotransmitter levels in the brain and can very rarely lead to:

• Depression
• Panic attacks
• Manic episodes
• Psychosis (confusion or hallucinations)

Most often, side effects occur as a result of trying to increase or decrease ADHD drugs too fast or stopping them abruptly. This point is very important! You should never suddenly change your child’s or your ADHD medications without consulting your ADHD doctor.

So, what can you do to lessen the likelihood ADHD medications will cause problems with your ADHDer?

• Give your doctor as much history about you or your child as possible
• Discuss all side effects of medicines with your doctor
• Avoid taking these medications on an empty stomach or with acid containing foods or drinks (absorbed too fast or too slow)
• Do not give vitamins or herbal supplements without discussing with your doctor
• Do not change these medications without the advice of your ADHD doctor
• Be alert in watching for early signs of side effects of all medications

Following these suggestions really just makes good sense, doesn’t it? After all, our common goal is to help ADHDers achieve their greatest potential in all aspects of life!

Dr. Frank
 

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