ADHD Treatment Options – Beyond Adderall and Ritalin

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Medications like Adderall are so well-known that they’re almost synonymous with ADHD treatment. But not everyone needs controlled substances (the ones you’re probably familiar with) to manage their ADHD. Some alternatives can have fewer side effects and be less habit-forming.

Together, you and your provider can use these strategies to help you manage your ADHD, often without addictive substances.

The Big Picture of ADHD: What is it You’re Treating?

Inattention is a cognitive deficit, just like poor memory. Inattention can have several different psychiatric sources like worry, paranoia, and even depression. It can also be affected by medical issues. Hyperactivity is another area, and sometimes you can have both inattention and hyperactivity. In order to treat ADHD properly, your provider needs to be able to identify the source of your attention issues.

Conversations with Your Doctor

Factoring in Your Health and Family History

Is there cardiac disease in your personal or family history? If you have a relative who had a heart attack in their forties, you may want to be cautious with medication.

Your provider might ask you to do an annual or bi-annual EKG, or at least get a one-time EKG and a note from your doctor or cardiologist saying you’re safe to start on stimulants. If you have a family history of seizures, they might also ask you to get a neurologic clearance from a neurologist.

Cardiologists and neurologists are very used to this; it’s coming up more and more, so it’s usually not a big deal for them to do. And it’s an important precaution to protect yourself.

Your provider might also ask you to get a urine toxicology screen to make sure you don’t have any other stimulants like marijuana, cocaine, or methamphetamine in your system. If you’re currently self-medicating with marijuana or using other pharmaceuticals, be open with your provider to prevent dangerous drug interactions. This is important so you can get the most effective treatment possible for your ADHD while minimizing any risks to your physical or mental health.

Managing Your Blood Pressure

Your provider may ask you to purchase a blood pressure cuff like the ones your doctor uses to take your blood pressure (easily available on Amazon) and teach you how to get an accurate reading. You’ll want to take a baseline blood pressure measurement, and then check an hour after you take your medication.

Check your blood pressure regularly as your prescriber changes your medications and dosages. You can track these measurements by writing them down in a notebook or using your phone’s note-taking app. If you notice a significant change in your blood pressure measurements, bring this up to your prescriber. Working as a team, you can use your blood pressure to gauge how your body is responding to your medication and what blend of medications may be right for you.

Keep in mind that just because ADHD is a mental disorder doesn’t mean treatment is purely mental. Any medication you take, whether for mental or physical symptoms, affects how your body works. ADHD medication is no different. Tracking your blood pressure is an excellent way to determine how the medication is affecting your body’s normal processes, even while you monitor your mental symptoms.

Finding the Right Medication

Together, you and your provider will look at your symptoms and treatment history to determine the severity of your ADHD symptoms. People with mild and medium symptoms are most likely to benefit from using non-addictive medications for ADHD. People with multiple mental illnesses to manage can also benefit from this approach.

If You Only Have ADHD, Your Doctor Might Prescribe:

  • Wellbutrin (bupropion)
  • Strattera (atomoxetine)
  • Intuniv (guanfacine)
  • Quelbree (Viloxazine)

Your doctor will generally start you on one of these medications, increasing the dosage slowly over time. They may add additional medications from this list if a single medication can’t get your symptoms under control. Your prescriber may determine that using a combination of medications can do the best job of managing your ADHD symptoms while minimizing side effects – the best of both worlds.

Make sure to check your blood pressure regularly as you do this. You can expect your blood pressure to increase slightly with your dosage, but it should stay in a safe range. Remember to follow your prescriber’s instructions for tracking your blood pressure closely. Have your measurements ready each time you talk to your prescriber so you two can make decisions about your medication using all the information available to you.

If You Have a History of Anxiety or Depression, Your Doctor Might Prescribe:

  • Effexor (venlafaxine)
  • Pristiq (desvenlafaxine)
  • Cymbalta (duloxetine)

A combination of these medications is often effective for treating depression, anxiety, and ADHD (which can all feed into each other). This can be a great way to manage multiple mental health conditions without having to rely on and keep track of a long list of medications.

The Long-Term View

People can often rely on these medications instead of habit-forming ones to control their ADHD. In cases where non-habit-forming medications are helpful but not sufficient to completely control ADHD symptoms on their own, they can be used to support habit-forming medications while relying on a smaller dosage of them.

Since ADHD is one of the few psychiatric issues that gets better with time, your provider may keep you on habit-forming medications for now but decrease the dosage over time as your need for them decreases.

Additional Options

Sometimes, people who have tried non-addictive pathways still find that those treatment options aren’t enough to rein in their ADHD symptoms. In those cases, your provider may prescribe you:

  • Vyvanse (lisdexamfetamine)
  • Concerta (methylphenidate)

These medications are safer and have lower addiction potential. This is an effective way to limit amphetamine use.

Things to Watch for When Taking ADHD Medication 

ADHD medications, like any other medicine, can come with side effects. Watch out for these symptoms while taking your medication:

  • Chest pain or discomfort
  • Headaches you’re not used to having
  • Seizures 
  • Heightened blood pressure
  • Twitches or uncontrolled movements

If you experience any of these side effects while taking ADHD medication, do the following:

  • Stop taking the medicine
  • Drink lots of water
  • Take 25-50mg of Benadryl every 4-6 hours until the symptoms subside

Your symptoms should get better as the drug exits your system. If your symptoms get worse after discontinuing the medication, go to the emergency room. These complications are rare but can be serious.

Treating ADHD isn’t a one-size-fits-all endeavor. Everyone’s treatment plan looks a little bit different. If your prescriber recommends non-habit-forming medications to treat your ADHD, your first response might be to ask for the more obvious option (in the form of amphetamines and stimulants).  But knowing all your options and being open to thinking outside the box when it comes to medications is the first step to finding relief.

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