ADHD Medication Information
In a certain percentage of cases of people diagnosed with more severe levels of ADHD, medication is sometimes considered as a first line treatment. This can certainly be the choice in younger children who are engaging in dangerous and impulsive behaviours, who will not necessarily respond well to a talk-based therapy. For others who may have important exams like the higher school certificate, medication can be a good short-term option to work to higher levels of potential. Sometimes psychologists experienced in treating ADHD may not be available in your area. At other times, other strategies have been tried with little success. Whatever the reason, at certain times medication can be appropriate, and at this stage you may wish to visit your psychiatrist or paediatrician. Note: We do not offer medication at our centre as our centre focuses on more natural alternative, however we do work together closely with paediatricians/psychiatrists to do assessments on and off medication to test for medication efficacy.
The ADHD stimulant medications that are currently prescribed in Australia are dexamphetamine, lisdexamfetamine and methylphenidate. Methylphenidate is available as a short-acting preparation (eg. Ritalin), and as a long-acting or extended release preparation (eg. Ritalin LA or Concerta). Short-acting Ritalin generally is effective for around 4 hours, whereas Ritalin LA and Concerta are effective for around 8-10 hours. Lisdexamfetamine is available as Vyvance in Australia, and is noted to be one of the longest acting medication on the Australian market. Other stimulant medications are used to treat ADHD overseas but are not available in Australia (eg. Adderall).
Some people get better results from dexamphetamine, while others get better results from methylphenidate. Currently it is not possible to predict which stimulant will be most effective, although this is currently being researched. The field of Precision Medicine is trying to understand specific factors that are involving in making certain medications work well for some, but either not work at all, or have severe side effects in others. In choosing the medication, the doctor has taken into account individual symptoms and circumstances, as there are numerous conditions (such as heart issues) which can result in these medications being inappropriate. If one stimulant medication does not relieve the symptoms, the doctor may suggest trying the other. At every visit you doctor should review your symptoms compared to a baseline and make sure that benefits are noted and that side effects are not present.
There can be numerous side effects associated with both stimulant and non-stimulant medications and it is essential that when you first take the medication you are in safe space and have your doctors contact details available. It is not advisable for a parent to give a child the medication for the first time on a school day where they cannot be very closely viewed. Likewise an adult should not take the medication for the first time on a workday or just before some important work is due, and it is unknown what response or side effects may occur. You should discuss with your doctor possible side effects in great length prior to taking the medication and have a plan of what to do if any side effects occur.
If a person has any heart problems, heart defects, high blood pressure, or a family history of these problems it is essential these are investigated in-depth prior to taking stimulants. Sudden death has occurred in people with heart problems or defects taking stimulant medicines. Present to your local emergency department right away if there are any signs of heart problems such as chest pain, shortness of breath, or fainting while taking stimulants. Other common side effects include anxiety, decreased appetite, dizziness, irritability, weight loss, issues sleeping, stomach pain, nausea and vomiting. You should discuss all side effects with your doctor as issues with sleep and difficulties eating on medication are both likely to make attention issues worse, hence that medication may not be a good option.
The costs of stimulations in Australia are dependent on the the Commonwealth Government’s Pharmaceutical Benefits Scheme (PBS). The scheme does change so it is important to check whether the medication prescribed is on the PBS, otherwise it can be quite expensive. Initially Dexamphetamine was the less expensive of the short-acting stimulant medications due to its listing on the PBS. In August 2005 however short-acting methylphenidate (Ritalin) was also included on the PBS as a treatment for ADHD.
In Australia, Atomoxetine (Strattera) has been the main non-stimulant medication approved by the Therapeutic Goods Administration (Commonwealth Department of Health and Ageing) for the treatment of ADHD. Atomoxetine is quite a different compound to the stimulant drugs and the effects it produces on chemicals in the brain is different to that of the stimulants. In May 2020 a newer medication Guanfacine (Intuniv) was added to the PBS. This medication can be considered when both stimulants and Atomoxetine prove ineffective.
The ADHD stimulant medications are found to have a short-term effectiveness of up to 80 percent in reducing the symptoms of Attention Deficit Disorder in school-age children. For these people, ADHD medications reduce their hyperactivity and improve their ability to focus, work, and learn. It is however found that often some skills are improved whilst others are not, or that even though there can be some alleviation of symptoms many people with ADHD on these medication still have attention skills that are not normalised, and continue to fall within clinical ranges on rating scales. Many doctors feel the side effects of ADHD medications should be carefully weighed against the benefits before prescribing ADHD medications like Ritalin, Dex, Concerta or Vyvnace.
ADHD medication as the “Quick Fix”?
Research is clear that stimulant ADHD medications can be helpful, at least in the short term. Parents and teachers often rush to applaud ADHD medications when the child’s schoolwork and behavior improve after starting ADHD medications. While the ADHD medications can allow these changes to take place, the effect wears off when the ADHD medications wear off.
The ADHD medications do not increase knowledge or improve academic skills, though the ADHD medications can help people pay better attention and complete their work. The ADHD medications only control the symptoms instead of addressing the causes of ADHD symptoms. ADHD medications are like glasses, braces or allergy medications. These ADHD medications don’t cure the disorder. They
only temporarily control the symptoms.
A growing number of health professionals, parents and educators believe that ADHD is a disorder, but they do not agree that a long-term course of medication is the answer. Since children do not outgrow Attention Deficit Disorder medications merely postpone dealing with the causes. Because of this, many health professionals believe that children displaying the symptoms of ADHD should not be treated
solely with ADHD medications. they encourage that the child receives other therapies which target a broad range of problems that children with ADHD suffer including:
Social skill training
Classroom & educational intervention
Training in organisational skills
Behaviour management training (for parents)