ADHD in Adults (cont.)

Medications

The medications available for attention deficit hyperactivity disorder (ADHD) can have slightly different effects from individual to individual, and currently no way exists to tell which will work best. Medications indicated for ADHD are thought to work by improving the imbalance of neurochemicals that are thought to contribute to ADHD. Some commonly prescribed medications include the following:

• Stimulants
  • Methylphenidate (Ritalin, Concerta, Metadate)
  
  
  
  • Dexmethylphenidate (Focalin)
  
  
  
  • Dextroamphetamine (Adderall, Dexedrine, Dextrostat)
  
  
  
  • Pemoline sodium (Cylert); no longer available in the United States due to severe liver toxicity
    
• Antidepressants
  • Bupropion (Wellbutrin)
  
  
  
  • Venlafaxine (Effexor)
  
  
  
  • Desipramine (Norpramin)
  
  
  
  • Imipramine (Tofranil)
  
  
  
  • Nortriptyline (Aventyl, Pamelor)
    
    
• Nonstimulants
  • Atomoxetine (Strattera)

If one medication does not work effectively, the others should be tried because individuals may respond quite differently to each one. In general, the medications used to treat ADHD in adults are the same ones used to treat ADHD in children.

Certain antidepressants such as imipramine, desipramine, and nortriptyline along with bupropion and perhaps venlafaxine may be tried. Other medicines and combinations of medicines are also available. Proper dose levels are determined on a case-by-case basis, not by weight or age.

Antidepressant medications and atomoxetine may increase the risk of suicidal thinking and behavior, particularly with a history of bipolar illness, or a personal or family history of suicidal behavior.

Medication should help in the following areas:

• Academic underachieving and inattentiveness



• Hyperactivity or fidgeting



• Verbal and/or behavioral impulsivity (for example, blurting out, interrupting others, acting before thinking)



• Difficulty falling asleep at night



• Trouble waking up (not getting out of bed in the morning)



• Excessive irritability without cause and/or easy frustration



• Episodic explosiveness, emotional outbursts, or temper tantrums



• Unexplained and persistent emotional negativity

If your ADHD medication is not significantly helping with most of these concerns or is causing uncomfortable or problematic side effects, ask about changing the dosage or changing medicine. Medication is not acceptable if it relieves only one dysfunction such as trouble falling asleep but not any others.

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