ADHD Stimulant Medication
Stimulants can help people suffering from ADHD manage their impulsive behavior and focus. They can be either long- or short-acting and are prescribed by psychiatrists, paediatricians or neurologists (and GPs in some circumstances).
Stimulants influence dopamine and norepinephrine within the brain. They are tightly controlled and can only be prescribed by a doctor.
Methylphenidate
Methylphenidate is a drug that is part of the family of stimulants and enhances activity in certain areas of the brain. It increases the levels of chemicals like dopamine and noradrenaline that help to regulate attention and behaviour. Methylphenidate can be used to treat ADHD and narcolepsy, among other disorders. It may also be prescribed to treat depression in adults, although it is not approved by the Food and Drug Administration (FDA). Methylphenidate gets absorbed from the gut into the bloodstream rapidly and works within hours. It is available in the form of an immediate-release tablet or chewable extended-release capsule or tablet. The doctor will prescribe the most suitable formulation based on the person's symptoms and risk of side effects.
Side effects of methylphenidate tend to be minor and go disappear over time as the body adjusts to the drug. If they continue to bother you, talk with your doctor, who can lower the dosage or recommend another medication. It is important to take this medication exactly as prescribed and not exceed the recommended dose. This reduces the risk of addiction or abuse. The US Drug Enforcement Administration has classified the drug methylphenidate as a Schedule II substance, which means it is extremely susceptible to abuse. Stimulants have the potential to cause withdrawal and dependence if not taken in the prescribed manner.
It is essential to inform the doctor whether your child has heart issues, such as an irregular heartbeat or history of heart attack. Methylphenidate can increase the rate of heartbeat and that's why the doctor will check their heart rhythm and blood pressure before they start treatment. Inform the doctor about any other medications your child takes such as herbal remedies, vitamins and supplements.
The doctor will provide you with instructions on how much and how often to take the medicine and any other special precautions. Methylphenidate is usually taken twice a day with meals. Certain brands of the long-acting methylphenidate chewable tablets (Quillichew ER, Cotempla XR-ODT and Adhansia XR) contain aspartame, which is a source of phenylalanine, and should not be taken by people suffering from phenylketonuria (an inheritable condition that requires a low-protein diet to prevent the development of severe intellectual disabilities.).
It is important to stay clear of drinking alcohol or other substances when taking this drug. Some people may notice that their appetite declines when they take methylphenidate. Encourage your child to eat regular snacks and meals in case they are losing weight. You may need to encourage them to drink a lot of water or squash to keep well-hydrated.
Lisdexamfetamine
Lisdexamfetamine which is available under the brand name Vyvanse is a central nervous system stimulant that acts on chemicals in the brain and nerves. adhd and medication improves concentration and control of impulses in adolescents, children and adults with ADHD. It treats the disorder of binge eating (BED) as well by increasing dopamine and norepinephrine levels in the brain. This reduces uncontrolled eating.
Lisdexamfetamine is one of the prodrug class of medicines that are altered to render them inactive until metabolized by the body.27 It has been found to be safe and well-tolerated in a number of placebo-controlled trials, showing efficacy in both stimulant-naive and stimulant-exposed patients with ADHD. It is also believed to be more effective than other stimulants and could have fewer rebound symptoms.
Adler et al27 reported that the ADHD-RS-IV scores significantly improved during a 12-week-long controlled trial. They also noted that the majority of the patients who switched to placebo relapsed after 2 weeks.28 Additionally, Brams et al29 used an innovative design for an uncontrolled withdrawal study which they followed 116 adults for 12 weeks after stopping the lisdexamfetamine treatment. They found that most of those who relapsed were not exposed to other stimulants in the two weeks prior to their relapse.
It is important to tell your doctor if there are any allergies to this medication or any other medications. Tell your doctor if you suffer from high blood pressure, heart problems, or other heart conditions. These stimulants increase the risk of heart attacks or sudden deaths among people suffering from these conditions.
Lisdexamfetamine can be absorbed into breastmilk and cause harm to a nursing infant. It is advised not to breastfeed while taking this medication. Some patients may experience dizziness, shakiness or stomach upset when taking this medication. Lisdexamfetamine is not approved for children under six years of age. Lisdexamfetamine is not a prescription drug for use by women who are breastfeeding or pregnant. You should not stop taking this medicine unless your physician tells you to stop, even if you feel better. Your doctor may want to monitor your heart rate and blood pressure when you take this medication.
Atomoxetine
Atomoxetine, also known as Strattera is a non-stimulant that blocks presynaptic transporters that are part of norepinephrine. It is highly specific for this transporter and minimal affinity for other neurotransmitter transporters and receptors [115, 136136). In multiple placebo-controlled trials, it improved the inhibitory control of ADHD patients by reducing overactivation of the right inferior cortex (Chamberlain and coworkers 2009). It has also been proven to increase working memory and concentration in children suffering from ADHD. It has a slow onset of action, and may take up to 12 weeks for its full effect to be seen. The dosage is based on weight and should be increased gradually. A once-daily dosage is typical. A poor metabolizer of drug cytochrome P4502D6 (CYP2D6) has a higher exposure and a slower elimination of atomoxetine. Pharmacogenetic testing should be done before prescribing atomoxetine in these individuals.
In a number of controlled studies it has been proven that it can be effective in decreasing symptoms of ADHD. It is typically used as the first-line treatment. It is generally well-tolerated and safe, and it does not increase the likelihood of suicidal behavior. It's not as effective as stimulants in decreasing anxiety and tics and does not seem to reduce sleep problems, but it has been proven to help with aggression in a few children. Atomoxetine is more akin to the antidepressant the fluoxetine. Therefore it is recommended that they not be taken in conjunction.
Two other drugs that are frequently prescribed as a first-line treatment option for ADHD are Clonidine (Catapres, Kapvay) and Guanfacine (Tenex, Intuniv). These medications were initially developed to reduce blood pressure in adults. They are known as alpha agonists. They work by stimulating specific receptors in the brain to release the neurotransmitter norepinephrine, which can reduce hyperactivity and impulsivity. These drugs have a long onset of action, and many children will require between two and four weeks before seeing any benefit from them. In addition, they are not recommended for use with MAOIs (e.g. Phenelzine is not recommended due to the risk of serious and possibly fatal adverse events, such as severe hypothermia and rigidity, myoclonus and autonomic instabilities.
Other Stimulants
Stimulants are drugs which increase activity in the nervous system. They comprise a variety of substances - some of them legal, while others are illicit. They are employed for a variety of reasons, including performance improvement, to stay awake or alert and to treat specific medical conditions, such as ADHD, narcolepsy, and depression. Examples of prescription stimulants are amphetamines and methylphenidate. The term stimulant can also be applied to nonprescription medications like caffeine and some diet pills that are utilized for a variety of reasons but may not be safe when used in conjunction together with other medications or some food items.
Stimants aren't habit-forming in the doses prescribed to treat people with ADHD however, they do have side effects. They can make some people feel anxious or nervous. They can cause a tense stomach and elevate blood pressure.
Children and teens who take stimulants may experience the tics that are repeated sounds or movements, such as eye blinking and throat clearing. They may also experience a slight delay in growth.
A doctor will determine the most effective stimulant for your child or yourself. They will consider other factors, such as weight, age, and whether your child or you have any allergies. They will then prescribe the medication. Always follow the doctor's prescriptions. You should read the Medication Guide that comes with the medication you are taking.
The first option for treating ADHD is usually medication. It's not the only option, but it's the most popular. People of all ages are able to benefit from psychosocial interventions, such as family therapy and behavior modification.
Patients who are prescribed ADHD medication should be screened for the possibility of misuse and abuse assessed, and be counseled not to share their medication with others. Also, they should be encouraged to store unused medications in a secure place and dispose of them in a safe manner. Health professionals should regularly assess and monitor patients for indications of abuse, misuse or addiction. The FDA has demanded that more consistent information is included on the labeling of drugs in order to educate patients and families about the serious risks.