How Do I Choose the Right Medication for ADHD?

There is no one-size-fits-all approach to finding the right medication for everyone with ADHD, including the strength of dosage. Even though stimulant medications have been used for more than 80 years, safely and effectively, which medication suits certain individuals, and the strength of dosage, is still trial and error.

If you have recently undergone an ADHD assessment and received a diagnosis, you may wonder what the next steps are for finding the right medication. This article aims to explain how medication is prescribed and how to understand whether it’s working for you.

Types of ADHD Medication and How They Work

There are five types of ADHD medication, that help some individuals to concentrate better, be less impulsive, feel calmer, and learn and practice new skills, they are:

• Methylphenidate – most commonly used and is a stimulant that increases activity in the brain, and controls attention and behaviour.

• Lisdexamfetamine – stimulates certain parts of the brain and helps to improve concentration, focus attention, and reduce impulsive behaviour.

• Dexamphetamine – similar to and works in the same way as Lisdexamfetamine.

• Atomoxetine –a selective noradrenaline reuptake inhibitor (SNRI) that increases the amount of noradrenaline in the brain, which passes messages between brain cells, helping to improve concentration and control impulses.

• Guanfacine – helps to improve attention and helps to reduce blood pressure and needs to be prescribed with specialist advice.

How is ADHD Medication Prescribed?

After receiving an ADHD assessment and diagnosis, your doctor may recommend trying medication to see if it helps. If after a period of time, either medication isn’t effective or causes adverse side effects, then communicate with your doctor to either tweak the dosage or look at alternatives, this is called medication titration. The good news is that there are many to try. It’s also important to understand that although taking any medication can be daunting, with ADHD medication, if it really doesn’t suit you, then by stopping taking it, it will be out of your system within a day.

What is Medication Titration?

ADHD medication titration is the systematic adjustment of medication dosage to find the optimal balance between symptom management and side effect minimisation. Once a specific type of ADHD medication has been decided upon based on your symptoms and your doctor’s guidance, they will then prescribe a low dose and gradually increase the dosage until you report feeling relief from symptoms. 

There is no average starting dose for any ADHD medication, however, the starting dosage is influenced by several factors, including:

• If the patient has a history of taking stimulant medication and how they have reacted to it in the past.

• Genetic and metabolic differences.

• Comorbid conditions such as anxiety or depression.

• If any treatment has been received in the past and how the patient reacted to it.

• The severity of symptoms at present.

It is also possible to increase medication dosage too far, where side effects become extreme, however, the aim for both doctor and patient is to find the right balance of both.

How to Know if Your ADHD Medication is Suitable?

It is first important to make a detailed list of your ADHD symptoms and pick 5 that most affect you and which you can measure once you start medication. It’s possible to see effects from stimulant medication straight away, so if you see your 5 symptoms improve, your doctor may begin to increase the dosage, given that side effects are kept to a minimum. If the increase in dosage does not see further improvement but increases side effects, the previous lower dose will be your “sweet spot”.

For children, it is more difficult to measure their responsiveness to medication as their self-perception is lacking, however standardised medication scales, like the Gonner Global Index Scale, which is designed for children aged 3 to 17, can monitor progress in medication response trials. 

For adults, performance testing is generally used by looking at a single measurement in time of two major areas of impairment, such as distractibility and impulse control. Testing must have been carried out prior to taking medication to set a baseline.

Side Effects to Look Out for When Finding the Right Medication.

The most common side effects caused by ADHD medication are:

• Sight headaches.

• Dehydration.

• Anxiety and depression.

• Increase in pulse rate and blood pressure.

• Insomnia.

• Appetite suppression.

• Nausea and diahorrea. 

• Emotional problems or mood swings.

In order to find the right medication at the right dosage it’s important to log symptom improvement against the level of side effects. Signs that your dose is too high could include severe day-to-day functioning ability, feeling muted or sedated or just feeling very much unlike yourself, also referred to as the ‘zombie effect’. Signs that your dose is too low are that there are very minimal to no symptom improvements and no side effects are experienced.

How a Private ADHD Clinic in Manchester Can Help.

Here at Beyond, we are a private ADHD clinic in Manchester, dedicated to helping our patients manage their ADHD so they can live their lives to their full potential. We offer ADHD assessments for adults and children and a supportive medication care plan where medication therapy is clinically recommended.  

The clinical team at Beyond Clinics has extensive experience and expertise in assessing and diagnosing ADHD. Start your journey today and speak to one of our team here at our private ADHD clinic in Manchester.