If you have adult ADHD, medications can bring about huge improvements in your life, restoring your focus and giving you back a feeling of control. But for some people, these drugs come with a price – side effects.
Most of the time, ADHD medication side effects are mild -- like upset stomach or insomnia -- and fade after a few weeks or months of treatment. Other times, side effects can be more problematic. The good news is that there are plenty of things you can do – on your own and with your doctor -- to ease your symptoms and smooth out your treatment.
For adults with ADHD, the standard treatment is medication. But experts say that ADHD therapy -- and other psychosocial treatments -- can play a key role alongside drugs. “I think for many adults with ADHD, therapy is essential,” says David W. Goodman MD, assistant professor of psychiatry at the Johns Hopkins University School of Medicine. While ADHD medicines are effective, they may not be enough. To use a phrase popular among ADHD specialists, pills don’t build skills. Even with medication, a...
Here’s a rundown of some of the most common ADHD medication side effects along with tips on what to do about them.
Adult ADHD Medication Side Effects
There are four stimulant medicines that are FDA-approved for adult ADHD: Adderall XR, Focalin XR, Vyvanse, Quillivant XR, and Concerta. Ritalin, which is prescribed for children with ADHD, is also used to treat adult ADHD symptoms. There’s also one nonstimulant medication, Strattera, approved for adult ADHD. But while the drugs are different, they tend to cause a similar set of side effects.
Trouble sleeping. ADHD medications can rev you up and make it hard to fall asleep. First, try taking your medication earlier in the day, so it’s worn off well before bedtime. If you’re on a long-acting stimulant, you could ask your doctor about a short-acting one – the effects will fade more quickly. Caffeine is likely to compound the problem, so limit – or cut out – your intake of coffee, tea, and sodas. Finally, practice good “sleep hygiene.” That means following calming rituals before bed and removing distractions (like TV sets) from the bedroom.
Nausea. This is a relatively common complaint from people who take ADHD medications. To reduce the risk, always take your medicine with food. If you’re supposed to take it in the morning and you’re not a breakfast person, you may want to find something you can eat anyway.
Loss of appetite. Stimulants such as Adderall, Concerta, Focalin, and Vyvanse can reduce your appetite and, sometimes, cause weight loss. It’s one side effect that some people like. However, keep in mind that the weight loss is modest and the effect tends to diminish over time -- so your ADHD medication won’t double as pills for a miracle diet.
If the weight loss is a problem be sure to discuss it with your doctor. You also might try eating a number of small meals during the day instead of three bigger ones. Protein shakes are one easy way to take in nutrients. Try eating dinner later in the evening, after the effects of your medication have worn off and you are hungry.
Headaches. ADHD medications can trigger headaches in different ways. For some people, they happen after taking a medication on an empty stomach. For others, headaches come on as the medicine wears off. Your doctor may be able to ease the problem by tweaking your dosing schedule.
Dry mouth. Aside from trying a different dose or medicine, the best solutions are pretty obvious – drink extra fluids and use lozenges to keep your mouth moist.
Irritability and mood changes. Some people find that their medications make them tense and cranky. Like most ADHD medication side effects, this may fade in time. If mood issues are bothering you, see your doctor about adjusting the dose or changing your medication.
Tics. ADHD medications don’t cause tics, exactly. Rather, they can sometimes bring underlying tics out – maybe a tic that you had in childhood will return. Usually, the tics will fade once the medicine wears off or over time.
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Since most side effects are minor, many people feel that the benefits of their ADHD medications outweigh the negatives. But when side effects are a problem, your doctor can help.
First, your doctor might try to adjust the time you take the medicine or the dose. If that doesn’t work, he or she might try you on a different type of ADHD medication that has been approved for adults. For instance, if you’re using an amphetamine stimulant (like Adderall XR or Vyvanse), he or she might want you try a methylphenidate stimulant (like Focalin or Concerta.) Doctors can’t predict how well a specific medicine will work in any given person. Some people just do better on one drug than another, and it can take a few tries to find the right one.
Doctors occasionally treat adult ADHD with drugs that are not FDA-approved for the condition. This is called “off label” use. Some of the drugs they might use include stimulants approved for children with ADHD, such as Ritalin, as well as a number of antidepressants and blood pressure medicines. Because these drugs have different side effects – and benefits and risks – you should go over the specifics with your doctor.
ADHD Medications: Other Risks
While not typical side effects, some more serious risks associated with ADHD medications have grabbed headlines in recent years. These include:
Cardiovascular risks. ADHD medications can slightly raise blood pressure and heart rate. It’s not a serious concern for most people. But those with borderline hypertension sometimes find that the medicine bumps them into full-fledged high blood pressure. There’s also some controversial evidence that ADHD medications may slightly increase life-threatening risks to people with underlying heart problems or cardiac other risk factors.
Psychiatric problems. ADHD medications may be associated with psychiatric problems.An FDA review of ADHD medications found they may pose a small increased risk of psychosis – for about 1 in 1,000 people. In these cases, the person may experience symptoms such as auditory hallucinations, paranoia, and mania. The nonstimulant Strattera carries a warning – like all antidepressant medications -- about potentially causing a slight increased risk of suicide in young adults aged 18-24.
Drug Abuse. As with many drugs, short-acting stimulants such as Ritalin, Adderall and dexedrine have the potential for abuse. However, experts believe the risk of abusing longer-acting stimulants like Concerta, Adderall XR, and Vyvanse is low. Also, don’t forget that untreated ADHD poses an increased risk of substance abuse. In fact, some studies of adult ADHD have found that taking ADHD medication actually lowers the risk of substance abuse because the condition is better controlled.
So what should you do to lessen the risk of having side effects with ADHD medications? Talk to your doctor. Go over your concerns, and have your doctor review your medical history. Be sure to mention if you have high blood pressure, heart problems, or a history of mental health problems or addiction. Your doctor may want to run some tests to make sure that ADHD medications will be safe for you. For instance, you might need an EKG to monitor heart rhythm and rule out problems. After you start treatment, your doctor will probably want you to come in for regular checkups to see how you’re doing and to monitor your blood pressure and pulse.
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But remember this: Experts believe these ADHD medications are generally very safe. The risk of serious problems is extremely low. And keep in mind that untreated ADHD has health risks of its own. For many people, the benefits of treatment far outweigh the relative risks.
If you do have side effects from your ADHD medications, rest assured that most will diminish with time. But if they’re bothering you – if they’re severe or interfering with your life – don’t try to ignore them. Get help from your doctor. Together, you'll be able to come up with a way to work around the side effects or to resolve them altogether.