Side Effects of ADHD Medications
Side effects resulting from drugs taken for attention deficit hyperactivity disorder (ADHD) are unfortunately quite common. As with any condition, these unwanted effects can be severe enough to cause ADHD patients to discontinue their treatment.
It is important for physicians to be aware of side effects from real world experience as well as information supplied by drug companies. A team from Quintiles Inc., the drug company consultants based in Falls Church, Va., looked at patient-reported side effects of ADHD drugs. The drugs covered were amphetamine and dextroamphetamine (Dexedrine); atomoxetine (Strattera); dexmethylphenidate (Focalin); lisdexamfetamine (Vyvanse); and methylphenidate (Concerta, Ritalin).
Results showed that 48 percent of the 325 patients surveyed reported at least one side effect, most often loss of appetite, sleep problems, and mood swings. Differences between the drugs in terms of side effects were thought to be minor. About a fifth (21 percent) of the side effects were considered “very bothersome” or “extremely bothersome,” but only 20 percent of patients mentioned the side effects to their physicians.
The rate of side effects appeared similar for drugs that stimulate the central nervous system and nonstimulant drugs. However, mood disturbances were more common on stimulants, whereas nausea and gastrointestinal problems were more common on nonstimulants.
Researcher Dr. Sharon B. Wigal commented that drug treatment of ADHD typically brings significant therapeutic benefits. But “also evident is the associated pattern of relatively common adverse events that may impact, and even impair, short- and long-term outcomes.”
She explains that side effects can vary by the age of the patient, with preschoolers often having stronger side effects. Most side effects settle down in a couple of weeks, or with a reduction in dose or change in timing. In fact, many are dose-dependent, she says. Nevertheless, they are often the reason why patients stop treatment.
A 2003 investigation into physicians’ perceptions of ADHD drugs found that “the stimulant drug side effects of decreased appetite or weight loss, sleep disruption, and exacerbation of anxiety were a concern for 32 percent, 50 percent, and 22 per of physicians, respectively.”
About 38 percent of the 365 physicians who completed the survey said they would prefer to prescribe a nonstimulant than a stimulant medication. The researchers state, “While many physicians consider the side effects of the stimulants easily managed, others are concerned about prescribing stimulants because of their side effects.” They add that, “The majority of physicians would prefer to prescribe a noncontrolled medication without abuse potential instead of a controlled medication to treat children or adolescents with ADHD.”