There has been a considerable increase in ADHD diagnoses in recent years due to a greater awareness of the condition. This is positive when it comes to people recognising symptoms in themselves and self-identification is valid and can help people. However, when people self-diagnose based on widespread misinformation around ADHD, they may end up with preconceptions about their symptoms, the medication that may or may not help them, and how they should treat their (or their child’s) ADHD.

Before you seek medication, make sure you have a formal ADHD diagnosis from an appropriate clinician, and avoid self-diagnosing with online tests or tools, especially free ones.

If you do have a diagnosis and are wondering what taking ADHD medication could look like, we’re here to demystify this tricky topic; the different types, what they do, who they’re for, the benefits, the side effects and more — all from qualified, relevant sources (i.e. not your social media feed)!

What is ADHD?

Attention-deficit hyperactivity disorder (known as ADHD) is a form of neurodiversity — a difference in how the brain is hard-wired when compared to neurotypical individuals. It affects the ability to regulate attention, impulsivity, hyperactivity and emotions, and can cause symptoms such as difficulty focusing for long periods (especially on topics that are not of interest), fatigue, impulsive actions and inattentiveness.

ADHD can be a form of disability, and depending on the severity it can interfere with learning, studying, working and getting day-to-day tasks done.

Different people experience different symptoms. For example, children with ADHD may struggle to play quietly, and the condition often presents differently in women and girls, who are more likely to ‘mask’ their symptoms, developing techniques to hide them to avoid being stigmatised or to feel accepted, which makes the condition less visible. They also might experience difficulty organising, completing tasks, remembering things, following through on instructions, and managing time. There are varying degrees of ADHD so you or your child may tick some or all of these boxes depending on the type you have.

ADHD can have its perks! For example, people with ADHD can be very creative, can hyperfocus on things they enjoy, maintain high energy levels which can be useful in certain situations, and more. Having ADHD is often more about understanding one’s traits and learning to manage and direct them in the best way.

"ADHD is an evolutionary condition which has been around since pre-historic times. People forget that it is genetic which means it has been there all along, right from the time of hunter gatherers. Hunters had to be hyperalert as something like the rustling of the leaves in a forest meant they could be someone’s prey. Therefore, ADHD was a survival tool kit for humans. The environment around us has changed, but the genes in certain geographic regions and families have not changed. It used to be called a normality and now it is debated if it should be called a condition or disorder depending how it is impacting the person. If it is a condition you don’t need medication, if it is a disorder which means it is impacting them in more than one way, then you could need medication. The gene has created a mismatch hypothesis where the genes don’t go with the environment anymore."
- Dr Khurram Sadiq, Consultant Psychiatrist

Does everyone with ADHD need medication?

In a word, no. There are two main methods of treating ADHD which can help relieve symptoms and make life easier. One is medication, and the other is therapy. It is often noted that a combination of both can work best for a lot of individuals, and can greatly improve symptoms, making normal daily tasks easier and helping with subsequent ADHD symptoms like anxiety, depression and sleep problems.

If you do decide to try out medication, it’s worth speaking to a specialist (a psychiatrist or mental health nurse trained in ADHD). It’s worth mentioning that — as well as helping to regulate attention, impulsivity, hyperactivity and emotions — ADHD medication has also been linked, in people with ADHD, to:

• A 9-32% reduced risk of injury
• A 38-58% reduced risk of motor vehicle accidents in males
• A statistically significant association with increased test scores
• A statistically significant association with grade improvements

That said, if you would rather not take medication for ADHD then there should be no pressure to do so, and your medical care provider may choose to recommend a combination of helpful therapies or coaching instead. There are many private options available too, such as our specialists at Augmentive. Our free 15 minute consultation can help you find the best specialist for you.

"Not every case of Attention Deficit Disorder or hyperactivity can be called a disorder. Now our lifestyle is more sedentary we see ADHD as a disorder as it is hard to live with. However, some say the medication kills their edge and their ability to multitask. They find it makes them less responsive and their ability to work in a crisis situation decreases significantly."
- Dr Khurram Sadiq, Consultant Psychiatrist

Does my child need ADHD medication?

According to the Centers for Disease Control and Prevention (CDC), children with ADHD younger than 6 years old can benefit from parent training in behaviour management as a first step, before medication is introduced. For children 6 years+, a combination of medication, behaviour therapy and classroom intervention may be recommended.

What types of ADHD medication are prescribed in the UK?

ADHD medications work in a variety of different ways, but all will increase the presence of various neurotransmitters in the brain — the chemicals that allow your brain cells to communicate — in order to improve the experience of living with ADHD. After the prescription and initial administration, the psychiatrist carefully titrates the medication to make sure it is the right type and dosage for each individual. Remember, if the first medication you are offered does not have the intended effect, your specialist will assess side effects on an ongoing basis to find the right balance.

The most common types of ADHD medication prescribed in the UK are either stimulants, non-stimulants, or antidepressants.

• Stimulants are the most common type of ADHD medication, and are designed to ‘stimulate’ the central nervous system. They work by altering the amount of neurotransmitters in the brain (like dopamine and adrenaline) to help improve attention, reduce impulsivity and decrease hyperactivity. Stimulants are typically the first line of treatment. Stimulants are fast-acting, taking around 45 to 60 minutes to start working.
• Non-stimulants are less common, but a good option if stimulants don’t work for a particular person, which happens in around 20-30% of cases. Unlike stimulants, they can take a few weeks to come into effect. They are sometimes used in combination with stimulants or as an alternative for anyone who doesn’t see results from stimulants, who prefers a medication with less risk of substance abuse, or who is taking other medications that could cause an adverse reaction. Unlike stimulants, they don’t stimulate the central nervous system so they can also be a good option for people with severe anxiety. They target neurotransmitters like norepinephrine which plays a role in executive function, and they’re not as fast-acting as stimulants.
• Antidepressants may be prescribed to help with some of the conditions which can co-occur with ADHD, such as depression or anxiety. They increase the levels of certain neurotransmitters in the brain related to mood, but have also been found to improve attention span, and lessen impulsivity and hyperactivity.

According to the NHS guidelines, in the UK there are typically 5 types of medication licensed for the treatment of ADHD; methylphenidate, lisdexamfetamine, dexamfetamine, atomoxetine and guanfacine. They differ in their mechanism of action and in how often they need to be taken to alleviate symptoms. Sometimes, a combination of the below is recommended. Let’s take a closer look at each:

Methylphenidate

Methylphenidate is the most common type of ADHD medication prescribed, and you may have heard it called by the brand name, Ritalin. It’s a stimulant that increases brain activity in the areas that help to regulate attention and behaviour.

It can be offered to adults, teenagers and children (aged 5+) with ADHD to help ease symptoms and make focusing easier. It can be taken several times a day as an immediate-release tablet for when you need extra focus, or once a day as a modified-release tablet, which means the medication will be introduced to your bloodstream slowly throughout the day.

Lisdexamfetamine

Lisdexamfetamine, which you may have heard called by the brand name Vyvanse, stimulates specific parts of the brain to help improve concentration, attention, and reduce impulsive behaviour. While the outcomes can be similar to Methylphenidate, the difference lies in the mechanism of action.

Lisdexamfetamine is a slow-release medication, meaning that it can take 1 or 2 hours to start working in the body, while Methylphenidate tends to work faster. However, Lisdexamfetamine has the added benefit of lasting longer throughout the day, so it could be a better fit for some people.

This medication is taken once a day and may be offered to adults as a first choice, but is for teens and children (aged 5+) with ADHD it tends to be prescribed after at least 6 weeks of methylphenidate has not seen improvements.

Dexamfetamine

Dexamfetamine, also known by its brand name Dexedrine, works in a similar fashion to lisdexamfetamine and tends to be fast-release, meaning that its effects can be seen shortly after administration. Is usually taken 2 to 4 times a day, depending on the dose prescribed. It can be taken in tablet form or as an oral solution, and may be offered to adults, teenagers and children (aged 5+) with ADHD.

Guanfacine

Guanfacine works to improve attention in specific parts of the brain, and has also been found to reduce blood pressure. You may know it by its brand name Intuniv, which is often given to teenagers and children (aged 5+) who cannot use methylphenidate or lisdexamfetamine due to the side effects or other reasons.

This medication is usually taken once a day, and is not currently offered to adults as there have not been enough studies on its effects.

Atomoxetine

Atomoxetine is a non-stimulant medication for ADHD so it works differently to the others above. You may know it by its brand name Strattera. Atomoxetin is also a selective noradrenaline reuptake inhibitor (SNRI) meaning it increases the amount of noradrenaline in the brain which passes messages between brain cells, resulting in improved concentration and impulse control.

This medication is taken once or twice a day. It’s typically given to adults, teens and children (aged 5+) who cannot use methylphenidate or lisdexamfetamine due to the side effects or other reasons.

What do these medications do for people with ADHD?

Medications for people with ADHD might not have a permanent effect, meaning their effect may not last if the treatment is interrupted, however some people have found it life-changing. For some, the effects have continued beyond interruption, especially when used in conjunction with therapy.

Are there any ADHD medication side effects I should know about?

Good question! It’s beneficial to know about possible side effects a new medication could cause. All of the above medications have slightly different side effects, which may include:

• Mood changes (feelings of irritability, agitation, aggression, depression or anxiety)
• An increase in blood pressure and heart rate
• A loss of appetite (this affects around 80% of people taking stimulant medications)
• Stomach aches or abdominal pain
• Stomach issues like diarrhoea, nausea or vomiting
• Headaches
• Sleep issues
• Feelings of drowsiness or fatigue
• Dizziness
• Dry mouth
• Severe mood changes leading to suicidal thoughts
• Liver damage

It is important to keep your specialist informed of any side effects. In particular, let them know about suicidal thoughts or symptoms of liver damage (yellow skin and whites of the eyes) which are associated with Atomoxetine, as these can be very serious.

Is ADHD medication addictive?

Deciding whether or not to start ADHD medication and which one to try can be a big decision, and one you should discuss with a specialist to determine the best option for your personal circumstances. The specialist will closely monitor the effects of the medication and find a suitable dose.

ADHD medication can be addictive, which is why it's a controlled substance and needs to be taken as prescribed. However, it is not a gateway drug, therefore it can’t lead someone to develop an addiction to other drugs. According to a UCLA research study, taking certain ADHD medications does not increase the risk of addiction to these medications, but those with ADHD tend to have an increased risk of substance abuse in general due to reduced impulse control. To clarify, this is due to certain ADHD symptoms, not the medication used to treat it.

Addiction is often influenced by how quickly a drug increases dopamine levels in the brain; the faster the increase, the higher the potential for abuse and therefore addiction. ADHD medication tends to increase dopamine levels very slowly, rather than — in the case of some drugs — just seconds.

Some studies show that abusing certain ADHD medications (i.e. taking more medication than you have been instructed to by your specialist) can increase the risk of addiction to the medication, so bear this in mind and always take your medication according to the treatment plan your specialist sets out for you.

Are there any withdrawal symptoms if I decide to stop taking my ADHD medication?

You are unlikely to notice any severe withdrawal symptoms unless you have previously abused the medication. If you do notice any withdrawal symptoms such as irritability, depression, sleep issues, nausea or vomiting, speak to your prescribing specialist.

I think my child has ADHD. What should I do before considering medication?

Many children can become restless or seem hyperactive for a period of time, which can look like ADHD symptoms. Hyperactivity in children is quite normal, however there is always a chance ADHD could be present. Start by discussing your concerns with their school teacher to get a broader picture of their temperament in all situations.

Next, visit your GP. A GP can’t formally diagnose ADHD, but they can refer you and your child for a specialist assessment if they believe it’s necessary. The steps below will also be relevant for your child’s diagnosis.

I think I have ADHD. What should I do?

You can see your NHS GP for a referral to a specialist, or directly speak to a private ADHD psychiatrist (such as through Augmentive).

Either way, a formal diagnosis of ADHD by a qualified psychiatrist is required before you will be prescribed medication. When speaking to an ADHD psychiatrist, an assessment will be required to determine if you have the condition, how severe it is, and whether or not you require medication. This assessment usually lasts up to 2 hours and can involve questionnaires and sometimes interviews with family members or friends to better understand the person’s symptoms.

If a medication is recommended, this must be prescribed by a psychiatrist, and like other prescriptions this medication will go to your local pharmacy to be picked up. Unlike with other medications, you will only be able to pick up one month’s supply at a time. If you believe you or your child has ADHD you can read more helpful information in our article here: Do you think you may have ADHD? Here's the support available.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from a private adult ADHD assessment or AuDHD assessment, to help finding an ADHD specialist near you to support you on your journey.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.