Unlocking ADHD Writer, Hana Cheng, takes a look at the different types of ADHD medication and the issues involved in making a decision on taking medication.
Medication is one of the most common ways to manage ADHD. It can only be prescribed by psychiatrists, pediatricians and general practitioners, and not by psychologists. Most of the ADHD medications are controlled substances and thus, are strictly regulated.
Some people may be uncomfortable at the thought of having to take medication to manage ADHD. Medication is just one of several options available, but is nevertheless the most widely used, efficient and effective. Often, medication is combined with other treatments such as coaching, Cognitive Behavioural Therapy, and mindfulness. These form a comprehensive approach to ADHD management.
A useful analogy when it comes to medication is to think of it like wearing a pair of glasses. While someone with myopia may still be able to see without glasses, learning and working are so much more efficient with glasses. Being able to focus enables students to learn better. Adults can also carry out their responsibilities at work more effectively and efficiently.
However, medication is not a miracle remedy and one would still need to put in the required effort of studying in order to achieve the desired results.
Types of ADHD Medication
ADHD medication generally falls into two broad categories:
- Stimulants, and
Stimulant medications are considered the first line treatment for ADHD. A widely used stimulant is methylphenidate. They are generally effective for most people and they work almost immediately. They can also be taken on a daily basis, or when necessary. However, the effects do not last the whole day and there is potential for abuse.
Some of the commonly prescribed ADHD stimulant medications in Singapore include:
- Ritalin (methylphenidate)
- Concerta (methylphenidate)
- Medikinet (methylphenidate)
- Strattera (atomoxetine hydrochloride); and
- Vyvanse (lisdexamfetamine dimesylate)
These stimulant medications are available in short-acting (about 4 to 6 hours) and long-acting (more than 8 hours) forms. Children who have been prescribed medication tend to take the short-acting stimulants while older children and adults take the long-acting stimulants as they would be required to stay focused on academics or work for an extended period of time.
Non-stimulants are sometimes prescribed for those who do not tolerate stimulant medication well (up to 30% of people). Examples of non-stimulant medication include guanfacine and clonidine. Non-stimulants can be taken on their own, or used in conjunction with stimulant medication. These types of medication have to be taken on a daily basis and one can only see the effects after a period of a week or longer. The advantages of non-stimulant medication is that they last 24 hours and there is less potential for abuse.
Antidepressants are sometimes used for treating ADHD. However, as there is a smaller body of research about the use of antidepressants to manage ADHD symptoms, this is usually the third line of treatment after stimulants and non-stimulants.
Supplements which contain Omega-3 fatty acids are also used to help control ADHD symptoms. They can also be used to complement stimulant medication. While Omega-3 supplements are natural and non-addictive, they are less effective than the other types of medication above.
How do I know which type of ADHD Medication is the most suitable for me?
Your doctor would be the best person to advise on the most appropriate type of medication for you. What may work for another may not necessarily work in your situation.
Do be aware that adjustments may be needed in the initial period to find the most suitable dosage or combination of medications. Each individual may experience different reactions and/or side effects. It would be helpful to keep a medication diary to record the effect of the medication, such as how long it takes to kick in, how long it lasts, the side effects (if any), the impact on your attention, etc. so that you can discuss this with your doctor at the next appointment.
Another factor to bear in mind is logistics. Some people may find it difficult to remember to take their medication twice daily (usually for short-acting forms) and thus, have better medication compliance for longer-acting forms which are taken once a day.
Medication has been used to treat ADHD for several decades with good results. It does, however, take time and a process of adjustments to find the optimum dosage. Both the ADHDer and the healthcare professional should be aware of this, and work together to arrive at a dosage that enables the best result.