What to expect from ADHD medication

Medication should always be an informed choice.

Information you can trust

It matters to us that everything we share with you is evidence based, factual and in line with current clinical standards and NICE guidelines.

Our goal is simple. We want you to feel safe, informed and supported at every stage.

The two types of ADHD medication

Broadly speaking, there are two categories: stimulants and non-stimulants.

Stimulants are the first line treatment recommended by NICE and are generally considered the most effective for ADHD. They are flexible because they are short acting, they are safe for most people, and if you need to miss a day you can do so without physical complications.

Non-stimulants are usually explored if stimulants are not medically suitable for you, or if they have not had the effect you hoped for. With non-stimulants it is more important to stay consistent, because stopping suddenly can cause problems.

The stimulant options

• Methylphenidate. A first line choice for children, young people and adults. It comes in different release profiles, so some versions last around four hours and others up to twelve.
• Lisdexamfetamine, also known as Elvanse. Often used for adults. It is a pro drug, which means your body breaks it down into dexamfetamine over time, and it can last up to thirteen hours.
• Dexamfetamine. A short acting stimulant lasting around four hours, typically used when a longer acting medication does not fit your day.

You might notice some side effects, such as headaches, a dry mouth or disturbed sleep if you take your medication too late in the day. Most are minor and settle within a few days. If the medication is working well for you, it is usually worth persevering while your body adjusts.

Stimulants can also reduce your appetite, which is manageable. Many people make up those calories in the evening once the medication wears off. For children and young people we monitor growth closely, so we can be confident that appetite is not affecting their development.

When medication creates space for other feelings

You may have seen posts on social media about the downsides of Elvanse. Often, when ADHD symptoms are well managed, it creates mental space.

For some people, that space brings up difficult memories or feelings that were previously drowned out by hyperactivity. If that happens, we may suggest talking therapy to help you process them. You will not be left to manage it on your own.

The non-stimulant options

• Atomoxetine. This builds up gradually in your system and can take ten to twelve weeks before you notice the full effect. It works well for 24 hour coverage, and for people who also experience anxiety or who find the peaks and troughs of short acting medication difficult. Serious side effects are rare, though we do monitor for them, including changes to your liver and changes in mood. If you do not take it every day, you may notice withdrawal effects.
• Guanfacine. A very calming medication, often prescribed when emotional dysregulation or impulsivity are the main features. It is taken in the evening and can help with sleep. It can cause significant drowsiness, particularly in the first two weeks, and it may lower your blood pressure. It can also mean you need the toilet more often, which we keep an eye on.

Health monitoring at every appointment

For all ADHD medications, physical health monitoring is not optional. We check your blood pressure, pulse and weight, plus height for children and young people. You will need to take these readings at home or at a local pharmacy and bring them to every appointment.

If we do not have your readings, we cannot safely issue a prescription until they have been reviewed. That is not us making things difficult. It is how we keep you safe and help you avoid running out of medication.

With stimulants, running out is an inconvenience rather than a medical emergency. With non-stimulants it matters more, because stopping suddenly can cause problems.

Being open about anything else you take

Stimulants interact with other substances, including caffeine and illicit drugs such as cocaine. We will ask you openly about what you are taking so that we can make the safest prescribing decisions with you.

This is never about judging you or your lifestyle. It is about getting your medication right.

Why stimulants are controlled drugs

The stimulant medications we prescribe are classed as controlled drugs. That is not because they are dangerous or addictive. It is because some people might try to misuse them, for example to lose weight.

It means we can only prescribe a limited amount at a time, and we will ask you to keep your medication somewhere secure.

Finding the right dose for you

If a stimulant dose is too high, some people say they feel robotic, or that they have lost their creativity. That is why we are so careful with titration.

We are looking for the lowest effective dose, the one that manages your symptoms without changing your personality.

You are in good hands

If you have chosen Oakdale for your ADHD journey, you can rest assured you are in good hands. Our prescribers are highly experienced, qualified and dedicated to your safety.

We will do our very best to make sure you feel informed, heard and supported every step of the way.

‍