The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider, and according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.
Medications for ADHD can help control hyperactive and impulsive behavior and increase attention span.
The Food and Drug Administration has directed all manufacturers of ADHD drugs to notify patients about potential cardiovascular and psychiatric side effects. Patients or their parents should read the information before taking the medication and should speak with their doctors about the warnings.
There have been reports of sudden death in patients with underlying serious heart problems and reports of
stroke
and
heart attack
in adults with certain risk factors. There is also a slight increased risk (about 1 per 1,000) for psychiatric side effects, such as hallucinations, paranoia, and mania, even in patients without previous psychiatric problems.
The drugs that are the focus of the revised labeling are:
- Adderall and Adderall XR (amphetamine)
- Concerta (methylphenidate)
- Daytrana (methylphenidate) Transdermal System (patch)
- Desoxyn (methamphetamine)
- Dexedrine (detroamphetamine)
- Focalin and Focalin XR (dexmethylphenidate)
- Metadate CD (methylphenidate)
- Methylin (methylphenidate)
- Ritalin, Ritalin SR, and Ritalin LA (methylphenidate)
- Strattera (atomoxetine)
For specific information on each drug go to:
http://www.fda.gov/cder/drug/infopage/ADHD/default.htm.
Common names include:
- Methylphenidate (Ritalin, Concerta, Metadate)
- Dextroamphetamine (Dexedrine, Adderall)
Note:
A new “black box” warning has been added to Dexedrine, warning that misuse of amphetamines may cause sudden death and serious cardiovascular adverse events.
- Amphetamine (Adderall)
- Daytrana Transdermal System (methylphenidate patch)
- Pemoline (Cylert)
Note:
Pemoline can cause rare but severe liver problems. Only 15 cases have been reported in the past 23 years, but 12 of these patients died or required liver transplantation. For this reason, pemoline is no longer recommended.
Stimulants are the most common treatment for ADHD. These drugs increase activity in parts of the brain that appear to be underactive in children with ADHD. When used properly to treat ADHD, they produce a calming effect that promotes concentration, rather than a stimulating effect. However, they also have the potential to become addictive. Your child’s physician will prescribe the lowest effective dose, monitor the response closely, and stop treatment occasionally to determine the need for on-going treatment.
Common side effects of stimulants include:
- Insomnia
- Stomach ache
- Headache
- Reduced appetite
- Irritability
- Rage
- Confusion
- Shakiness
- Hallucinations
- Seizures
- Possible decrease in growth rate
There are currently 22 different antidepressants in nine separate categories available in the United States. New ones appear frequently. Common names include:
- Amitriptyline (Elavil)
- Imipramine (Tofranil)
- Desipramine (Norpramin)
- Bupropion (Wellbutrin)
- Doxepin (Sinequan)
- Protriptyline (Vivactil)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
All of these drugs prevent the inactivation of natural chemical stimulants in the body, either norepinephrine (noradrenalin) or serotonin. Most of these drugs act on both chemicals, but some act mainly or exclusively on only one. All are used to treat depression.
Common side effects include:
- Dry mouth
- Dizziness
- Sedation
- Insomnia
- Sweating
- Nausea
- Constipation
- Urine retention
- Blurred vision
- Mental changes
Side effects of
bupropion
include:
- Weight loss
- Agitation
- Anxiety
- Seizures
- Dry mouth
- Insomnia
Atomoxetine is not a stimulant but prevents the inactivation of norepinephrine.
Note:
There have been a small number of reports of severe liver injury associated with atomoxetine, which reversed after stopping the drug. Atomoxetine should be discontinued in patients who exhibit jaundice or laboratory evidence of liver injury.
Common side effects include:
- Decreased appetite
- Nausea
- Vomiting
- Fatigue
- Weight loss
- Slowed growth rate
- Mild increase in blood pressure and heart rate
Modafinil is a drug that is used to promote wakefulness in
narcolepsy
, a neurological condition. It has also been somewhat effective in patients with ADHD.
Common side effects include:
- Insomnia
- Abdominal pain
- Decreased appetite
- Cough
- Fever
- Runny nose
- Headache
Clonidine acts in the brain to stimulate certain areas, but not others, in a fashion similar to the stimulants. It is also used to treat
Tourette syndrome
. Morning dosing increases the sedative effect; bedtime dosing minimizes it. It is also available in a patch that provides a steady dose for a week at a time.
Clonidine is relatively safe except in patients with certain forms of heart and circulatory disease.
Possible side effects include:
- Dry mouth
- Sleepiness
- Dizziness
- Constipation
- Stomach upset
- Mental changes
Whenever you or your child is taking a prescription medication, follow these precautions:
- Take it as directed—not more, not less, and not at a different time.
- Do not stop taking it without consulting your healthcare provider.
- Don’t share it with anyone else.
- Know what effects and side effects to expect, and report them to your healthcare provider.
- If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
- Plan ahead for refills so you don’t run out.
Contact your physician or mental healthcare professional if:
- Expected results of treatment are not happening
- Unexpected results occur
- Drug side effects are bothering you
- You want to change the medication
Last reviewed April 2007 by Janet Greenhut, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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