A disorder that can impact people at any stage of life is attention deficit hyperactivity disorder, or ADHD. While medication is not the sole form of treatment, it is frequently the one that can have the biggest impact on a person who struggles with attention span issues, staying motionless, or impulse control.
What are ADHD medications?
Stimulants are the cornerstone of ADHD medicine. These include dexamfetamine and methylphenidate (marketed under the names Ritalin and Concerta). Additionally, lisdexamfetamine, also known by the brand name Vyvanse, is a "prodrug" of dexamfetamine; in order for the body to release dexamfetamine, a protein molecule connected to it must be removed.
Additionally, there are non-stimulants, such as guanfacine and atomoxetine, which are less frequently used but can still be quite helpful. GPs can prescribe non-stimulants, although the cost and coverage of these medications may vary and may not always be provided by the Pharmaceutical Benefits Scheme.
How stimulants work
A few "short acting" stimulants are prescribed for ADHD. This indicates that the effect starts about 20 minutes in advance and lasts for about 4 hours.
Longer-acting stimulants typically release their medication more slowly, which results in a longer-lasting effect. Whether the patient wants to take their medication once a day or chooses to limit its effects to certain times or tasks will determine which option is best for them.
With the probable exception of lisdexamfetamine, there is very no carry-over effect for the following day with stimulants. This implies that until the first dose of the morning takes action, the symptoms of ADHD may be highly noticeable.
The person with ADHD should live their best life and accomplish their goals, and this is one of the key goals of treatment. When it comes to young children, it is the parents' responsibility to weigh the advantages and disadvantages on their behalf. Children play a bigger part in making decisions as they get older.
What about side effects?
The stimulants' most frequent side effect is appetite suppression, which leads to weight loss. This is linked to a brief slowdown in a child's growth rate and maybe a small delay in pubertal development. They may also elevate blood pressure and quicken the heartbeat. Often, stimulants lead to sleeplessness.
When taking medication no longer, these alterations are mostly reversible. People who take medicine over time may experience heart attacks or strokes slightly sooner than they otherwise would have, as there is fear that minor increases in blood pressure could hasten the onset of heart disease.
This does not imply that treating ADHD in older persons is not appropriate. Instead, kids ought to be aware of the possible dangers so they may decide wisely. Additionally, they must ensure that episodes of chest discomfort and elevated blood pressure are handled seriously.
It is possible for stimulants to cause headaches or stomachaches. With time or a lower dose, these symptoms might become less pronounced. Research on the dangers of long-term prescription stimulant use is sparse, despite reports of students abusing stimulants.
Will medication be needed long term?
Despite the fact that ADHD can impair a person's functioning at any stage of life, the majority of patients cease using medication after the first two years.
Individuals who dislike taking medication may quit taking it because they don't like how it makes them feel. It's possible that their brief drug experience improved their self-awareness and taught them effective self-management techniques for their ADHD.
When teenagers outgrow their prescribed dosage and quit taking the medicine, the medication may no longer be effective. However, this needs to be distinguished from tolerance, which occurs when an increase in dose only produces transient gains and the medication loses its effectiveness.
Using non-stimulants, alternating between stimulants, or taking brief pauses from medicine can all help control tolerance.
Too many prescriptions?
The recognition of ADHD is growing, as more people—between 2 and 5% of adults and between 5 and 10% of children—are receiving diagnoses. Although this varies from state to state, stimulants are strictly regulated in Australia and are typically recommended by experts (psychiatrists or pediatricians). There just aren't enough professionals to handle the increasing caseloads for this lifelong condition.
A Senate inquiry report on ADHD screening and support services in November brought attention to the desperation felt by those pursuing treatment.
New South Wales has already made modifications to its laws that would allow more general practitioners to treat ADHD. Additional training may boost general practitioners' confidence in managing ADHD. This might take the form of a shared-care plan or the autonomous management of ADHD by general practitioners (GPs), similar to a model being tested at Nepean Blue Mountains Local Health District, where GPs receive training within an ADHD clinic (in which I work as a specialist clinician).
Not every ADHD sufferer will require or desire to take medicine. Still, it ought to be more accessible for people who might benefit from it.
