Benefits and Risks of ADHD Medications

Written by HealthyPlace.com Staff Writer

Analysis of benefits and risks of ADHD medications plus side-effects of medications for ADHD. And why using medications to treat ADHD is controversial.

Important Points

• Medications are NOT the only treatment for ADHD.
• The decision to use medications for treatment of ADHD requires knowledge and consideration.
• Other interventions (such as psychotherapy, educational accommodations, etc.) should always accompany the use of medications for ADHD.
• Periodic re-evaluation of ADHD medication use is essential, as a person's response and need can change over time.

What is ADD / ADHD?

Attention-Deficit/Hyperactivity Disorder (AD/HD, or ADHD) is characterized by two or more of the following:

• poor attention
• impulsivity
• hyperactivity.

The condition may take different forms: either inattentive or hyperactive/impulsive. Children are more often the ones diagnosed with ADHD, but many adults also maintain the attention impairments (ADD).

It is currently believed that ADHD is a neurobiological condition caused by genetics, conditions in utero, or possibly by relational trauma.

Why are medications often used for the treatment of ADHD?

Although the causes of ADHD are somewhat speculative, the source is generally believed to be a problem with either the structure or functioning of the brain. The most common view is that ADHD is a biochemical problem, related to an imbalance of the neurotransmitters in the brain. Thus, the use of medications is to regulate this presumed imbalance. Stimulants are the most frequently utilized type of medications for ADHD. Gabor Maté, M.D., author of Scattered: How Attention Deficit Disorder Originates and What You Can Do About It, offers this explanation and analogy:

• Even though ADHD individuals are generally hyperactive, their brain waves are slower at a time when they would be expected to be faster (when reading or other tasks are attempted).
• The brain's prefrontal cortex is supposed to sort out and organize sensations and impulses coming from the body and the environment, and to inhibit those that are not useful in a given situation. When this task is successful, there is order, as with a policeman directing traffic at a busy intersection.
• In an ADHD person, the prefrontal cortex is underactive, like a policeman asleep on the job, thus not prioritizing and selecting or inhibiting input. The result is a flood of data bits that keep the mind and body unfocused and in turmoil. Traffic is gridlocked.
• Stimulant medications wake the policeman and allow the prefrontal cortex to perform traffic direction more efficiently.

What are the medications for treating ADHD?

Stimulants

The most common medications for treating ADHD are stimulants. Stimulants have been the longest in use for treatment of ADHD, and have the most research studies on their effects. Although some have been used on children as young as age 3, most are recommended for age 6 or older. Long-term studies on the use of stimulants for the treatment of ADHD lean toward the discontinuation during adolescence, due to possible growth inhibition.

Stimulants for the treatment of ADHD may be shorter or longer acting formulations. Short/intermediate acting stimulants require dosages 2-3 times a day, while long acting stimulants last 8-12 hours, and can be taken once a day, thus not requiring a dose at school.

There are four main types of stimulants used for treatment of ADHD:

• amphetamines (Adderall)
• methylphenidate (Ritalin, Concerta, Metadate)
• dextroamphetamine (Dexedrine, Dextrostat)
• pemoline (Cylert - less commonly prescribed because can cause liver damage)

The newest medication for treatment of ADHD is Strattera. This medication is a reuptake inhibitor that acts on the neurotransmitter norepinephrine (which affects blood pressure and blood flow) in the same way that antidepressants act on the neurotransmitter seratonin, allowing the natural chemical to remain longer in the brain before being drawn back up. Because it is a non-stimulant, it may be less objectionable to some families. Nevertheless, it has similar side effects as other medications used for ADHD.