Considering a New ADHD Medication? Ask These 13 Questions First

Medications used to treat attention deficit disorder (ADHD or ADD) generally fall into two categories: stimulant or non-stimulant.

• Stimulants include — but aren’t limited to — Adderall, Vyvanse, Ritalin, Concerta, Focalin, Evekeo, and Daytrana. If the medication is a stimulant, ask whether it’s a methylphenidate (like Ritalin) or an amphetamine (like Adderall). Though these medications work in similar ways, they’re not the same and can lead to different outcomes in adults and children.
• Non-stimulants include Strattera, Wellbutrin, Intuniv, and a few others.

Make sure you know the category of your prescribed medication; it will affect administration, expected side effects, and possibly diet.

The information offered here is for informational purposes only and is not intended to substitute or replace professional medical advice, diagnosis, or treatment. Always consult with your physician or other qualified health care professional before making any changes to your or your child’s health care regime.

Scientific research suggests that stimulants like Vyvanse work by changing the levels of dopamine in the brain; non-stimulants like Strattera instead interact with norepinephrine.

Ask your doctor to explain how your medication affects your mind and body, and what changes in ADHD symptoms you should expect.

All medications come with some risk of side effects. Ask your doctor to go over the most common side effects — as well as some rare ones that can be extremely dangerous — associated with your new ADHD prescription.

If you’re a parent asking about your child, ask the doctor what outward signs you should look out for — especially if your child isn’t old enough to properly articulate what she’s feeling.

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Most side effects — like nausea, appetite loss, or irritability — are mild and should be no cause for alarm. Others can indicate a serious problem with a medication.

For stimulants, these red flags include dizziness, fainting, pounding heartbeat, shortness of breath, weakness or numbness, or chest pain.

When taking non-stimulants, serious allergic reactions — like hives, swelling, or trouble breathing — should be reported to a doctor immediately. Strattera, in particular, carries an increased risk of suicidal thoughts or actions. If you notice these in yourself or your child, call your doctor immediately.

Some doctors insist on regular cardiovascular checks for patients taking stimulants, particularly those with pre-existing heart conditions.

On the other hand, non-stimulants — clonidine or guanfacine in particular — can cause blood pressure to drop to dangerously low levels, so many doctors monitor blood pressure carefully. Ask your doctor about the type and frequency of any tests you should expect.

“When your medication is working effectively, you will have a sustained focus,” says Laurie Dupar, PMHNP. “We’re not talking about hyperfocus or ‘zombie focus’ — we’re just talking about a sustained focus. You are able to perhaps get paperwork done, or you’re able to finish making the bed.”

Other signs include an improved mood, less extreme emotions, and less impulsivity — both physical and verbal. Ask your doctor which signs are typical for your particular symptoms, and how long they commonly take to appear.

Stimulants typically start working within an hour and wear off within set time frames, so patients should work with their doctors to determine the most effective dosage time(s) given their unique schedules.

Non-stimulants need to build up in the body over several weeks and tend to work best if taken at the same time every day. Some patients report feeling drowsy after taking a non-stimulant; in these cases, experts suggest taking them at night. Your doctor should be open to discussing timing strategies with you.

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Stimulants start working quickly and wash out of the body within a day, so most patients can skip a dose or two without suffering any withdrawal-related symptoms — still, this doesn’t mean inconsistent use is the best choice. Talk to your doctor about drug holidays and effective treatment schedules before you decide to skip a dose of your stimulant.

Non-stimulants usually need to be taken every day — otherwise, therapeutic levels of the medication in the bloodstream may drop and the medication may become less effective. If you want to stop taking a non-stimulant altogether, discuss it with your doctor. Otherwise, do your best to take the medication every day at the same time.

Stimulant medications generally do not cause withdrawal problems, but most experts recommend you taper off of them slowly instead of quitting cold turkey.

Non-stimulants are a little trickier, and may need to be tapered off in a structured pattern. Your doctor should be able to recommend an effective strategy for discontinuing medication; ask how other patients under her care have done so successfully.

Different medications carry different food requirements. Some stimulants, for example, react poorly to Vitamin C; they shouldn’t be taken with orange juice, a common breakfast drink.

Ask your doctor to explain what interactions your medication might have with your food, as well as how to time your meals to maximize your medication’s benefits.

Most stimulants start working within an hour, but make sure your doctor lets you know exactly what to expect from yours.

Non-stimulants can take a few weeks to start showing results.

When it comes to stimulants, you can’t always trust the projected dosage window. Ask your doctor how long the medication should last, but also ask what to do if it lasts for a shorter or longer time than projected.

When used properly, non-stimulants should offer around-the-clock coverage. Tell your doctor if this is not the case.

Whether you’re starting ADHD medication for the first time, or switching to a new medication, your doctor should always have a plan for assessing and optimizing the prescription’s effectiveness.

Doctors vary on this, so ask your provider what schedule he or she prefers for follow-up appointments.

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