Treatment of ADHD
ADHD can be treated using medicine or therapy, often a combination of both is best.
Evidence from NICE guidance supports the use of medication as the first line choice for the treatment of ADHD in adults. Untreated ADHD can have a negative impact on a person’s life so medication is recommended when ADHD symptoms are causing significant impairment in everyday life.
Medication for ADHD is designed to help reduce symptoms of hyperactivity, inattentiveness and impulsivity and there are two classes of medicine to choose from. It is important to understand how these medicines work to ensure it is the most appropriate for you and that you are aware of its side effects.
Stimulants are the first line treatment for ADHD, being the most widely used treatment for ADHD. Stimulants work in the part of the brain called the Frontal Cortex whose job includes working memory, organising information, initiating an action, delaying gratification, regulating emotions and reining in our impulses. Stimulants increase dopamine in the frontal cortex and therefore this helps us to pursue our goals and remain committed in their pursuit.
There are many different stimulant medicines to choose from and the choice will depend on working together to find the right medication for you, at the ideal dose and schedule, taking into consideration how often and what time of day you need to take it.
Below are the three different classes of stimulant medication and the difference between the medicines can be determined by their mechanism of action and how long the medication works for, which can range from anywhere between a few hours to over 12 hours.
Methylphenidate – Medikinet, Concerta, Equasym
Dexamphetamine – Dexedrine
Lisdexamfetamine - Elvanse
Evidence shows a clinically important benefit for treatment with stimulants compared with placebo and other medicines. However, where such medication is either not tolerated or symptoms continue to cause impairment a non-stimulant can be considered.
Atomoxetine (also known as Strattera) is a "selective noradrenaline re-uptake inhibitor" which increases the amount of noradrenaline in the brain. This helps increase the amount of messages passed in the brain which in turn increases concentration and helps control impulses.
Non-stimulant ADHD medications are longer lasting, which means they only need to be taken once a day and can be useful for people who also suffer with depression as they have anti-depressive qualities.