The Three Top ADHD Medication Pitfalls and How to Avoid Them

One of the most effective management strategies for minimizing the challenges and symptoms of ADHD is medication. This might not be the most popular statement I have ever made, but research over and over again has shown that ADHD medications can “level the playing field” for adults with ADHD. Medications can be effective in helping adults with ADHD increase their focus on less interesting tasks, reduce impulsivity of actions and words and calm inner restlessness. I often hear clients describe the experience of being on the right medication as similar to having “the fog clearing”, “the water globe settling” or a “light switch being turned on”. They feel more focused, energetic, calm and productive. However, many adults never have the chance to experience the full benefits of ADHD medication due to three problem areas that I call “ADHD medication pitfalls”…taking the wrong medication, the wrong dose or taking medications at the wrong time.
“Medication Pitfall” #1
The first of these ADHD medication “pitfalls” is that many Adults with ADHD are not on the right medication. For good or bad, there is not a lot of variety in medications used to manage ADHD. In fact there are really only three. The good news is that with such limited options these medications have been studied over and over again for the past 50 years and we know the long term effects. The bad, is that there is a very limited choice of medications when it comes to treating the core ADHD symptoms.

ADHD medications can be divided into three categories: 1) Stimulants, 2) non-stimulants, and 3) “other”. Even though stimulants tend to be the most effective in decreasing the key symptoms of ADHD in adults, many people tend to avoid these due to real or feared side effects of the ADHD medication. Medications in this category include: Ritalin, Adderall, Dexedrine, Vyvanse, Concerta, etc. These medications are designed to “stimulate” the dopamine neurotransmitters of the brain; the key neurotransmitter that seems to be functioning ineffectively or in insufficient amounts in the brains of people challenged with ADHD. This category of medications is typically very effective in decreasing hyperactivity, distractibility and impulsivity. The second category of ADHD medications is non-stimulants. These include such medications as; Strattera, Wellbutrin and Effexor. These typically increase the levels of norepinephrine and serotonin in the ADHD brain and can help increase the mood, energy and motivation of people with ADHD. The third category is what I call “others”. These include such medication as: klonopin, Tenex or Provigil. These ADHD Medications are typically prescribed to reduce ADHD symptoms such as impulsivity or to increase alertness (as in the case with Provigil). Each of these categories of medications works differently to help manage symptoms of ADHD.

“Medication Pitfall” #2
The second pitfall is not taking the right “dose”. The experience of ADHD is different for every adult and everyone’s experience of taking medications is a bit different. There are guidelines prescribers follow, but the dose that is right for you may not be right for someone else and vice versa. If you are on too low a dose of medication you will not get the full positive benefit of the medication. If you are on too high a dose, you may experience more negative side effects than you have to. The goal is to find just that right dose that balances the positive effects and minimizes negative side effects.

“Medication Pitfall” #3
The third pitfall is “wrong time”. You can be taking the right type of medication, at the right dose, but if you take it at the wrong time, you may not be experiencing the most benefit. Some medications work best taken when we wake to help get us started with the day. Some need to be taken multiple times a day at specific intervals to get their full consistent benefit. And finally, some medications, when taken at night, may help us sleep more soundly.

When you are trying to find the right ADHD medication for yourself, it is important to work with a prescriber who is knowledgeable about adult ADHD and ADHD medications. This may sound simple, but it’s not. You want your doctor to help you understand how the medications work, which ones might work best for you and support you in understanding your choices. Find out as much as you can for yourself about what choices are available and keep a consistent daily ADHD medication log or ADHD medication record to help you determine what medication works best, at what dose and at what intervals.