There is no scientific basis for choosing one type of stimulant over the other for a given individual who has not yet tried either. When an adult has been diagnosed with ADHD and decides to seek medical treatment, should the person try MPH or AMP first?Ī. Longer term controlled studies cannot be done because withholding treatment over many years from some patients suffering significant impairments, which is required in a controlled study, would be unethical.įrequently asked questions about psychostimulants ![]() There are no studies on the use of psychostimulant medications for more than a few years, but many individuals have been taking these medications for many years without adverse effects. Hundreds of controlled studies involving more than 6,000 children, adolescents and adults have been conducted to determine the effects of psychostimulant medications-far more research evidence than is available for virtually any other medication. The “booster” dose may provide better coverage for doing homework or other late afternoon or evening activities and may also reduce problems of “rebound” when the earlier dose wears off. Although there is little research on utilizing short-acting and long-acting medications together, many individuals, especially teenagers and adults, find that they may need to supplement a longer-acting medication taken in the morning with a shorter-acting dose taken in the mid to late afternoon. Longer-acting medications may cause fewer “ups and downs” over the day and may eliminate the need for taking additional doses at school or during work. Since effective longer-acting formulations of stimulants became available, many children, adolescents and adults have found these preferable. Of course, there can be wide individual variation that cannot be predicted and will only become evident once the medication is tried. Short-acting preparations generally last approximately 4 hours long-acting preparations are more variable in duration-with some preparations lasting 6–8 hours and newer preparations lasting 10–12 hours. ADHD medications approved for adults include methylphenidate Focalin, Focalin XR Concerta Daytrana Metadate CD and the amphetamines, Adderall XR and Vyvanse. The two stimulants most commonly used, methylphenidate (MPH) and amphetamines (AMP), are regulated as Schedule II drugs by the Drug Enforcement Administration (DEA) because they have a potential for abuse when not used as prescribed by a medical professional. Several long-acting psychostimulants are approved by the Food and Drug Administration (FDA) for the treatment of ADHD in adults and are routinely prescribed. Psychostimulant compounds are the most widely used medications for the management of ADHD symptoms in adults as well as children and adolescents. The trial usually begins with a low dose that is gradually increased at 3–7 day intervals until clinical benefits are achieved. Doctors will use a medication trial to figure out which medicine works best for each individual and at what dosage. Practitioners cannot know in advance what drug will work best for a particular patient without trying them. Both neurotransmitters appear to play a role in the attentional and behavioral symptoms of ADHD. The neurotransmitters involved are dopamine and norepinephrine. Medications that most effectively improve the core symptoms of ADHD seem primarily and directly to affect certain neurotransmitters (brain molecules that facilitate the transmission of messages from one neuron to another). Medication does not cure ADHD when effective, it eases ADHD symptoms during the time it is active.Thus, it is not like an antibiotic that may cure a bacterial infection, but more like eyeglasses that help to improve vision only during the time the eyeglasses are actually worn. Adults with ADHD may also frequently have other conditions such as depression or anxiety that may require additional treatment. However, medication improves attention and reduces impulsivity in adults who have been correctly diagnosed with ADHD. ![]() As a treatment of ADHD, it has been said that “pills do not substitute for skills.” This means that medication alone is not sufficient to help a person improve his or her problems in areas such as organization, time management, prioritizing and using cognitive aids. Although there is a significant amount of research on medication treatment for children with ADHD, much less controlled research data has been conducted on medication therapy in adults. Approximately 10 million adults have attention-deficit/hyperactivity disorder (ADHD).
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