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Stimulants
Many studies have shown the effectiveness of stimulants in treating children, adolescents and adults diagnosed with ADHD. Generally, stimulants effectively decrease inattention, distractibility, over activity and impulsivity in three quarters of individuals with this disorder.
The stimulant medications work by increasing the release of or blocking the reabsorption of dopamine and norepinephrine, two neurotransmitters in the brain. Each stimulant medication alters the levels of these two neurotransmitters in slightly different ways, making some medications more effective for certain individuals.
Stimulant medications are also prescribed in addition to antidepressants medication in cases where the patient fails to respond to antidepressants alone.
Clinical experience suggests that in psychotic children, administration of stimulant medications may increase or induce symptoms of behavior disturbance and thought disorder.
Stimulants have a high potential for abuse and addiction, especially in adults. Treatment with these medications for extended periods of time may lead to drug tolerance and dependence.
Some of the stimulants commonly prescribed are listed below:
Dexedrine (Dextroamphetamine Sulfate):
For use in children 3 years and older. Common side effects may include palpitations, tachycardia, elevation of blood pressure, overstimulation, restlessness, dizziness, dryness of the mouth, unpleasant taste, diarrhea, constipation, anorexia, insomnia, euphoria, dyskinesia, dysphoria, tremor, headache, and exacerbation of motor and phonic tics and Tourette's syndrome.
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Desoxyn (Methamphetamine):
For use in children 6 years and older. Common side effects may include nausea, diarrhea, loss of appetite, difficulty sleeping or weight loss, elevation of blood pressure, tachycardia, palpitation, dizziness, dysphoria, overstimulation, and euphoria.
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Adderall (Amphetamine Mixed Salts):
Once daily dosing - extended release formula.
For use in children 3 years and older. Common side effects may include palpitations, tachycardia, elevation of blood pressure, psychotic episodes, overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia, dysphoria, tremor, headache, exacerbation of motor and phonictics, dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbance, anorexia and weight loss.
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Ritalin (Methylphenidate):
For use in children 6 years and older. Less potent than amphetamines. Common side effects may include nervousness, insomnia, loss of appetite, dizziness, headaches, muscle cramps, blurred vision, nausea, palpitations, tachycardia, angina, cardiac arrhythmias, rash, and weight loss.
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Concerta (Methylphenidate):
For use in children 6 years and older. Extended release formula - lasts 12 hours. Side effects are similar to those for Ritalin and may include twitching, nervousness, hostility, insomnia, loss of appetite, dizziness, headaches, muscle cramps, blurred vision, nausea, palpitations, tachycardia, angina, cardiac arrhythmias, rash, and weight loss.
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Metadate CD (Methylphenidate HCl, USP):
For use in children 6 years and older. Extended release formula. Common side effects may include rash, dizziness, headache, abdominal pain, nausea, loss of appetite, insomnia, palpitations, drowsiness, and blood pressure and pulse changes.
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Focalin (Dexmethylphenidate HCl):
For use in children 6 years and older. Side effects and profile similar to that for other drugs in this class such as Ritalin.
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Cylert (Pemoline):
Pemoline is structurally dissimilar to the amphetamines and methylphenidate.
Common side effects may include nausea, loss of appetite, difficulty sleeping or weight loss. Because of its association with life threatening hepatic failure, Cylert should not ordinarily be considered as first line drug therapy for ADHD. Liver function tests should be performed prior to and periodically during therapy with this medication, and treatment should be initiated only in individual without liver disease and with normal baseline liver function tests.
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Strattera (Atomoxetine HCl):
This medication is a selective norepinephrine reuptake inhibitor.
Strattera can be administered with or without food.
Common side effects may include abdominal pain, vomiting, decreased appetite, headache, irritability, cough, dry mouth, nausea and erectile disturbance.
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