The Ins + Outs of ADHD Meds

There are a couple types of medications used to manage ADHD symptoms: stimulants and non-stimulants. These medications work by impacting the levels of neurotransmitters in certain areas of our brain. Neurotransmitters, such as dopamine, serotonin, and norepinephrine, play a big role in our emotions and body functions. Individuals with ADHD tend to have lower levels of dopamine and norepinephrine. While talk therapy can help manage ADHD symptoms for some, medication can be the key to managing ADHD for others. Of course, ADHD medications can only be prescribed to those who have an ADHD diagnosis. 

Stimulants and non-stimulants both increase levels of dopamine and norepinephrine, but in different ways. Stimulants are called this because they stimulate areas of the brain that produce these neurotransmitters. The most common non-stimulant medications impact how the brain absorbs these neurotransmitters, essentially increasing their levels in certain parts of the brain. Most anxiety medications work very similarly to non-stimulant medication, just targeting different neurotransmitters. There is a less common form of non-stimulant medication called alpha2-agnoists; these work by mimicking the effects of norepinephrine. 

Stimulants

When we think of ADHD medication, we often think of stimulants first. This includes brand-name medications such as Adderall, Vyvanse, and Ritalin, among others. The two main types of stimulant medications are methylphenidate and dextroamphetamine. These medications have been used since the 1930s, and all brand-name simulates are made from a variation of these medications. Adderall and Vyvanse are made with dextroamphetamine, and Ritalin and Concerta are made from Methylphenidate. Stimulants tend to be the first pharmaceutical option given to manage ADHD symptoms. 

Nonstimulants

Non-stimulant ADHD medication tends to be less commonly known, but it can be as effective without the same side effects we see in stimulants. The most common non-stimulants work as selective norepinephrine re-uptake inhibitors, leading to these neurotransmitters becoming more present in certain parts of the brain. This medication does not impact our nervous system like stimulants do, which generally leads to less noticeable side effects. A major draw to non-stimulant medication is the lower risk of dependence or abuse compared to stimulants. Non-stimulant medication, such as Strattera, is not addictive, while stimulants contain addictive properties. Non-stimulants can be used on their own or with stimulant medication.  

Side Effects

Like any medication, stimulants and non-stimulants can lead to side effects. With both medications, common side effects include increased blood pressure, irritability, and difficulty sleeping. Stimulants may also increase heart rate and anxiety, as well as decrease appetite. As mentioned above, stimulant medications have the risk for addiction and abuse. When taken as prescribed, we find less abuse with stimulants, but they are not without risk. These side effects will impact everyone differently, for some individuals they go unnoticed. If you experience significant side effects from a form of ADHD medication, it is likely worth switching to a different brand or form. As with any medication, we want the benefits to outweigh the side effects. 

What's the difference, and which one should I take?

Stimulants and non-stimulants will affect everyone differently. Stimulants have historically been the first option for medication, but depending on your doctor, you may be recommended a non-stimulant.  Non-stimulant medication may be best for those of us with high anxiety, high blood pressure, a history of disordered eating, or a family history of addiction.  Anecdotally, some of my clients have found success in trying non-stimulants first and moving to stimulants if needed. Your Primary care doctor or psychiatrist can help you decide which brand is right for you.

All in All

We all have our own opinions on medication, and mine is that any psychiatric medication should be used after trying, or in conjunction with, talk therapy. Medications can be life-changing, but they are not always necessary or pleasant. Ideally, we try to resolve symptoms or issues without the use of medication, but when necessary, it is helpful to begin that journey with a therapist. While they are not the first or only line of treatment, stimulant and non-stimulant medications can be incredibly beneficial for managing ADHD symptoms. If you have been working to manage ADHD symptoms, and they have become exhausting or uncontrollable, it might be a good time to speak with your doctor about medication options.