The drugs that treat ADHD act by restoring levels of special chemicals in the brain, such as dopamine and norepinephrine, which control attention and impulse control and executive functioning. There are two main types of medication classes, stimulants (such as methylphenidate and amphetamines) and non-stimulants (such as atomoxetine and guanfacine).
Stimulants have a speedy effect and are effective in around 80% of children but can also be supported by non-stimulants, which take longer to act but work for those who are more likely to tolerate them. While medicine doesn’t cure ADHD, it can control symptoms to help a person function better in everyday situations.
Essentially, have you ever asked yourself how the medication work for ADHD? Then you’ve asked one of the most useful and essential questions about medication treatment. The more you know about how these medications work, the easier it is to understand how your brain works when you use them, how some people react to them and what to expect from treatment.
We hear the same questions from patients every day at Orlando Premier Psychiatry and we believe it is best to make better decisions when patients are well-informed. Let’s discuss science in terms you can understand, talk about the different kinds of medication, and find out what might be best for you or your loved one.
Key Takeaways
- ADHD medications boost amounts of dopamine and norepinephrine, neurotransmitters that control a person’s ability to focus, keep their impulse control, and fulfil basic brain functions. This neurochemical shift enables a person with ADHD to tune out distractions, hold focus from task to task and control impulsive actions in the course of his or her day.
- The three types of ADHD medicines are stimulants (the most commonly prescribed medicines), non-stimulants (slower acting but often better tolerated) and antidepressant medicines (which are sometimes used alone or with other medicines). The right medicine may be experimental; it may not work for everyone and dosage is very important.
- Time to effectiveness is dependent on type of medication. The onset starts within 30 minutes to an hour with stimulants and 3-4 weeks of regular use with non-stimulants before you see their effects in full. People can usually have a meaningful improvement in their symptoms within weeks of discovering a medication and dose they like.
The Brain Chemistry Behind ADHD
If you want to learn how ADHD medicine will affect you, you should first learn what ADHD is from a neurological point of view. ADHD is not a lack of good character or a lack of willpower; it is a difference in working memory, attention and impulse control.
Chemical substances which transmit the message between nerve cells in the brain are called Neurotransmitters. The neurotransmitters that are key to attention and impulse control are dopamine and norepinephrine.
Individuals with ADHD show fewer of these neurotransmitters in particular areas of the brain involved in concentration and decision-making and behavioral control. It’s not a low level that can be measured on a blood test, but rather a subtle, but significant shift in brain chemistry in processing and production.
Again, think of it like the volume of a radio. The vast majority of brains can tune into the proper frequency and maintain it at a steady volume. The volume is likely to be lower for a brain plagued by ADHD; thus, it is difficult for them to hear what is crucial, and they are more likely to get distracted by the background noise.
How ADHD Medications Actually Work
Essentially, all the ADHD drugs work by raising the levels of dopamine and noradrenaline in the brain. However, they do it in various ways so that some medicines will work better for some people than others.
Stimulant Medications
Stimulant medicines work by increasing the levels of dopamine and norepinephrine in your body (either blocking the reuptake by the brain or stimulating its release).
Two types of stimulants are used most commonly:
- Methylphenidate (Ritalin and Concerta)
- Amphetamine-based medications (Adderall and Vyvanse)
However, stimulants don’t stimulate the ADHD brain any more than they stimulate a typical brain they just communicate in another more normal manner.
Non-Stimulant Medications
Non-stimulant drugs act differently:
- Atomoxetine (Strattera) is a drug that mainly targets norepinephrine
- Alpha2 adrenergic receptor agonists such as guanfacine and clonidine target different neurotransmitter systems
These drugs work more slowly (after 3 to 4 weeks of regular use) but can be equally effective and are particularly helpful to individuals who are not well-tolerant of stimulant treatment.
Antidepressants
Antidepressants such as Bupropion affect dopamine and norepinephrine and can be used to treat ADHD, especially when used with concurrent depressive or anxiety symptoms.
The Two Main Categories: Stimulants and Non-Stimulants
Learning the differences in these types of medications can make it easier to discuss with your psychiatrist about which one is right for you.
Feature | Stimulants | Non-Stimulants |
Effectiveness rate | ~80% of users | Varies by individual |
Time to effect | 30 minutes to 1 hour | 3-4 weeks |
Abuse potential | Yes (controlled substance) | No |
Cardiovascular considerations | Yes | Lower risk |
Forms available | Immediate-release and extended-release | Extended-release |
Best for | Most adults and children with ADHD | Those who can’t tolerate stimulants |
Stimulants are the most commonly prescribed drugs for ADHD and studies indicate that they are effective in some 80% of people taking them. They are available in two forms: Immediate-release (short-acting) and extended-release (long-acting), which is used once a day in the morning and last for 6-16 hours depending on the medication.
Speed and clarity are the benefits of stimulants. The majority feel the differences in about 30 minutes to an hour. The drawback is that they need adjustments that are done more often, and they aren’t really good choices for individuals that have hypertension, heart issues, or previous experience of habit-forming disorder.
Others report a rebound effect from taking the drugs, in which they notice a decrease in energy or mood that lasts only temporarily.
Non-stimulants have a longer time to action but do have the advantage of certain patients. No abuse potential with them as they’re not controlled drugs. They do not have the same cardiovascular factors as stimulants. For people who are receptive to the side effects of stimulants, they can be life-changing.
But the downside is patience because it won’t be noticeable on day one. You will, in fact, see improvements in focus, organization and impulse control in 3-4 weeks.
Finding Your Right Medication and Dose
This is the place where art coexists with the science of psychiatry. Cleveland Clinic’s research indicates that ADHD medications work by increasing levels of neurotransmitters in your brain, but they affect each person differently. What’s great for one can fail or cause an unpleasant effect in another. That’s why sometimes it takes time to find the right medicine and communication with the health care provider is important.
Generally, a psychiatrist will prescribe the lowest dosage and increase the dose according to the person’s response and whether there have been side effects or not. They’re trying to find the right balance: just enough drugs to get better without having side effects. This does not happen in days, this takes weeks to complete.
Throughout this adjustment period, make detailed notes on:
- Attention and focus levels
- Mood changes
- Energy levels
- Appetite and sleep
- Any side effects
This can be invaluable for your provider, as they’ll know if the medicine is helping with the condition or if there’s a way to tweak it or something they can do to make it even more effective.
Managing Side Effects
Effective stimulants for ADHD have several side effects, with the most prevalent being loss of appetite (in about 80% of all users), slight weight loss, insomnia, and occasionally anxiety and mood shifts. These are side effects that typically happen but don’t last long and get better with the body getting used to the drug in the weeks that follow.
If the side effects aren’t going away or they’re becoming too much, there are several choices:
- A change in dosage
- Alteration in time of administration
- Use of extended release formulation
- Switching medications altogether
Non-stimulant medications cause a different set of side effects; they are not likely to decrease appetite, but they are likely to leave the person feeling sleepy or unwell initially.
It’s also a reality for some people that, as short-acting medications kick in, there is a rebound effect that causes some people to lose energy and feel bad. If this occurs, your psychiatrist may want you to take a longer-acting drug once a day in the morning or maybe an extra, smaller dose in the afternoon.
The Timeline: When Will I Feel Better?
One of the most common questions is: How long until this medication works? Well, it’s a complicated answer depending on what medications you are taking.
Medication Type | When Effects Begin | Full Effect |
Stimulants | 30 minutes to 1 hour | Same day |
Non-Stimulants | Gradual | 3-4 weeks of regular use |
Generally, stimulants have an effect of at least 30 minutes, and up to 1 hour. Improved concentration, decreased fidgeting or improved impulse control may be noticed most quickly. That is why stimulants are prescribed so extensively, because it is quick and there is ample feedback.
For non-stimulants, it’s another time course. The initial dose is not going to make for a drastic effect. However, it is important to take the drug regularly for 3-4 weeks before all the effects are experienced.
The reason is that unlike stimulants, non-stimulants do not provide a ‘release’ of neurotransmitters but instead slowly build these levels up over time. Your provider may suggest taking a non-stimulant for at least a month to see if it has an effect.
Ready to Understand Your ADHD Treatment Options Better?
Orlando Premier Psychiatry takes care of all aspects of evaluating and managing ADHD. With treatment, new or current, or perhaps just discovering treatment for the first time, we will be able to guide and offer a psychiatric examination by designating a specialist help. Call us today for a private consultation and to learn how we can help you.
The Importance of Professional Management
Even though it’s important to know about the medication used to treat ADHD, you should have a qualified psychiatrist who can monitor if the medication is effective, adjust it if necessary and coordinate medicines if you are taking other ones.
Things to be aware of include:
- Certain drugs may also interact with the ADHD drug, such as blood pressure drugs, other types of medications, and sometimes caffeine
- Some require an electrocardiogram check before they begin stimulants to ensure there are no underlying heart conditions. An electrocardiogram check is required before beginning stimulants for some people to rule out underlying heart conditions
- There is a crucial importance to your medical history when it comes to knowing what medication is safe and most effective for you
This is also why it is dangerous to take anti-ADHD medications without a psychiatrist’s supervision. Your psychiatrist isn’t being overcautious; they are looking out for your well-being and finding the best possible treatment for you.
Beyond Medication: A Comprehensive Approach
Medication works for many people, but is not always the sole solution. Treatment of ADHD is most effective when a combination of behavioral strategies, changing lifestyle, therapy and environmental changes, combined with medication, is used.
- Physical activity helps decrease ADHD symptoms
- Many medications do not function as well unless they are being used by someone who gets a good night’s rest
- Organizational systems and structure decrease processing demands in your executive system of the brain
Behavioral treatments are effective for some people who may experience a lower level of symptoms, or who may not even want to take medication. However, for many, these pills are necessary if they are to make any progress. The majority of folks can take advantage of the combination of the two.
Special Considerations: What You Need to Know
For Children
The ADHD medications can be given to children starting from the age of 6. There are different drugs available for children that have been approved by the FDA; however, they are not necessarily administered in the same way or monitored in the same way as would be done in adults.
For Adults
In adults, the recognition and treatment of ADHD are slowly improving with some adults being diagnosed for years after, or remaining undiagnosed. The treatment by medication is the same as in children, except that adults have a higher risk of having other medical problems that may affect the dosage of medication.
Pregnancy
If you are thinking about getting pregnant or are pregnant, talk to your psychiatrist about your specific ADHD medication and your obstetrician. Certain drugs are safer than others during pregnancy and while breastfeeding.
Frequently Asked Questions
What does ADHD medicine do to your brain?
ADHD medication increases levels of dopamine and norepinephrine in the brain, neurotransmitters responsible for attention, impulse control, and executive function. This neurochemical adjustment helps the ADHD brain regulate focus, reduce distractibility, and manage impulsive behaviors more effectively throughout daily activities.
What is the 24-hour rule for ADHD?
The 24-hour rule is an impulse-control strategy where someone waits a full 24 hours before acting on impulsive decisions, such as major purchases, commitments, or reactive responses. This pause allows the prefrontal cortex to engage more fully, enabling clearer, less reactive decision-making for adults with ADHD who struggle with impulsivity.
What are the pros and cons of ADHD medication?
Pros: Fast symptom improvement, proven effectiveness for 80% of users, ability to adjust dosing, and cost-effectiveness. Cons: Potential side effects like appetite suppression, sleep disruption, possible tolerance buildup, need for ongoing monitoring, controlled substance restrictions, and individual variability in response to different medications.
What are the 7 triggers that make ADHD worse?
The seven common ADHD triggers are: poor or insufficient sleep, high chronic stress without recovery time, excessive passive screen time, cluttered or unstructured environments, caffeine or alcohol misuse, social isolation with low accountability, and prolonged sedentary periods of low-stimulation activity throughout the day.
Why does Japan ban ADHD meds?
Japan strictly restricts or bans many ADHD stimulant medications due to the Stimulants Control Act, which classifies amphetamines and related compounds as high-risk substances with abuse potential. While medications like Concerta and certain non-stimulants are available with proper authorization, importing common stimulants like Adderall is illegal, even with a valid prescription from another country.
What is the 30% rule of ADHD?
The 30% rule suggests that untreated ADHD symptoms can cause individuals to function at roughly 30% below their actual capability level. Effective treatment, whether medication, behavioral strategies, or both, helps individuals access closer to their full potential and perform at levels more consistent with their actual intelligence and abilities.
Disclaimer
This content is intended for general informational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. ADHD medication decisions should always be made in consultation with a qualified psychiatrist or medical doctor who can evaluate your individual health status, medical history, and specific symptoms.
