Taking medication can seem like a mystifying process, and many people rely exclusively on their doctor to prescribe the right drug and dose. After all, they’re the experts, right? But some doctors may not be well versed in treating adult ADHD, and may get it wrong.
So what can you do?
The key is to educate yourself about medications for adult ADHD. And, fortunately, there are tons of great resources to become a smart consumer.
I recently came across an excellent piece on medication in ADDitude magazine’s Fall 2011 issue by author Gina Pera. Specifically, the article lists 10 erroneous statements doctors may make about ADHD drugs and the facts behind each one. If your doctor mentions any one of these statements, the author suggests giving them a copy of the treatment guidelines from the Canadian Attention Deficit Hyperactivity Disorder Resource Alliance, an organization made up of ADHD experts. Or find a new doctor.
Below, I’ve summarized four facts from the article, some of which might surprise you. Be sure to check out the entire article!
1. There’s no empirical basis for playing favorites.
Stimulant medications are the first line of treatment for ADHD, but there’s no research to suggest that one class is better than the other. In fact, whether a medication works for you is largely a matter of trial and error. (In other words, you won’t know how the medication works until you try it out.)
There are two types of stimulant medications: methylphenidate (such as Ritalin and Concerta), and amphetamine (such as Dexedrine and Adderall). For some people, one class works really well; for others, the same class either offers no improvement or has a negative effect. From the article:
Physician and ADD/ADHD specialist Patricia Quinn, M.D., suggests trying both classes of stimulants (MPH and AMP) before deciding that stimulants won’t work for you and moving on to a nonstimulant medication: “You might even try several meds within the same class before switching to another stimulant class.” For example, Ritalin LA and Concerta are both long-acting medications in the same class (MPH). Due to their different delivery mechanisms, however, each brings different results.
2. There’s no average starting dose.
According to the article, there’s no one-size-fits-all recommended starting point. Doctors must consider many individual factors when prescribing ADHD medications, including whether you’ve taken stimulants in the past, have co-occurring conditions (anxiety and depression are common) and the severity of your ADHD symptoms.
3. Your doctor should take the approach “Start Low, Titrate Slow.”
Right now doctors can’t predict the best medication or dose to begin with. So the best approach they have in finding the right medication for each person is titration, which the article defines as: “carefully increasing the dosage over time, until side effects outweigh benefits, and then dialing down to the previous dosage.”
4. Identifying whether a medication works goes beyond, “So how are you doing?”
Appointments with physicians can feel like a drive-thru. You get asked a few questions, and out you go. But there’s no way to determine a medication’s effectiveness with questions like “How are you feeling?” Doctors need to gather a lot more detail than that.
For instance, before taking any medication, you and your doctor should discuss and record your symptoms. Then, as you start your medication, it’s important to review each symptom and identify how the medication is affecting it and what side effects you’re experiencing. One of the experts suggested using a rating scale to track your progress in all areas of your life.
During this process of trying to find the best medication, experts also suggest communicating with your physician every week along with in-office appointments every three to four weeks. This is when you review symptoms, side effects and your overall health and well-being.
Want to read more tips? Check out Gina Pera’s article, ADHD Medication Mistakes Even Doctors Make, now.