Adult ADHD

The medical community is still learning how to best treat ADHD in adults. But with increased research focusing on adults with the disorder, medication treatment options have expanded.

Stimulant Treatment Options

Many of the first-line medications used to treat ADHD function as central nervous system (CNS) stimulants, and have been FDA approved for the treatment of both adult and childhood attention deficit hyperactivity disorder (ADHD) as well as narcolepsy in adults.

Although it is not known exactly how stimulants reduce the symptoms of adult ADHD, it is believed that they increase the flow of the neurotransmitters, chemicals that carry the signal between neurons (cells of the nervous system). This can enhance a person’s ability to focus over extended periods of time. The following are some of the stimulant medications used to treat adult ADHD.

The general categories of stimulants used to treat adult ADHD include these listed name brands followed by their generic equivalent:

· Brands: Concerta, Metadate CD, Metadate ER, Methylin ER, Ritalin, Ritalin LA, Ritalin-SR, Daytrana; Generic: Methylphenidate
· Brands: Dexedrine, Dextrostat; Generic: Dextroamphetamine
· Brand: Adderall; Generic: Amphetamine with Dextroamphetamine
· Brand: Cylert ; Generic: Pemoline*

Side Effects and Precautions of Stimulant Use

The common side effects of stimulants include:

· Dry mouth
· Upset Stomach
· Diarrhea or Constipation
· Irritability and Restlessness
· Loss of appetite
· Difficulty falling asleep
· Weight loss

Most minor side effects of stimulants resolve over the first week or two, as your body adjusts to the medication.

With the use of stimulants, there is the potential for increasing tolerance to the medication over long-term use as well as the danger of abuse. And this type of medication is not recommended for people who have a history of drug abuse. Amphetamines may also not be right for those who have a history of heart problems.

Many stimulants are not recommended for people with overactive thyroid, glaucoma, epilepsy and seizure disorders, severe anxiety or agitation and those who have recently taken MAO inhibitors.

Methylphenidate, dextroamphetamine and amphetamine are pregnancy category C medications, which may be harmful to an unborn baby. These drugs can also pass into breast milk and may be harmful to your baby if you nurse. Cylert is a category B medication.

Non-stimulant Treatment Options

Catapres® is the brand name for an anti-hypertensive medication FDA approved for the treatment of mild to moderate high blood pressure. Its generic equivalent is called clonidine hydrochloride. Although not FDA indicated for the treatment adult ADHD, Catapres® (clonidine hydrochloride) is generally well accepted as an alternative to the use of stimulants in treating ADHD.

It is unclear exactly how this blood-pressure reducing medication works in treating ADHD. It is known to reduce activity of the sympathetic nervous system and has been shown to have a calming effect on certain areas of the brain.

Side Effects and Precautions of Clonidine Use

Sedation is the most universal adverse effect of clonidine hydrochloride. Other common side effects include: constipation, dizziness, dry eyes, dry mouth, and decreased heart rate. After a few weeks of treatment, minor side effects usually diminish considerably.

It is very important that clonidine hydrochloride be taken as directed and that you do not stop this medication suddenly without consulting your physician. Sudden discontinuation can result in possible serious, and even fatal, withdrawal symptoms.

Hot weather and fever can significantly lower blood pressure and may necessitate that your current dose of clonidine hydrochloride be adjusted.

Catapres® is a category C medication that may be harmful to an unborn baby.

Total Treatment of ADHD

Medications used to treat ADHD, should be used as a part of a total treatment program. Comprehensive treatment of the adult ADHD often includes education, support groups, regular doctor appointments and therapy or counseling.

* Cylert has generally been one of the least favorite stimulant ADHD drugs, due to its potential to cause serious side effects, including liver damage. In 2005, the manufacture of Cylert was discontinued in US markets.

Sources

National Institutes of Mental Health Publication on ADHD (2006): http://www.nimh.nih.gov/health/publications/adhd/complete-publication.shtml

Watkins MD, C. (2006) New Medications for Adults with ADHD. Northern County Psychiatric Associates: http://www.ncpamd.com/NewADD_Meds.htm