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Treating ADHD with Stimulant Drugs

Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.

Before we discuss single, specific, stimulant drugs, it is important to remember that most people will take some combination of medications. Furthermore, medication requirements may change over time. Each person must arrive at the right combination in conjunction with their healthcare professional. This list is intended for educational purposes only.

It may seem contradictory to give stimulant medication to a hyperactive person. As described previously, ADHD is actually a result of insufficient brain functioning. Stimulant medication makes up for this insufficiency. Once the insufficiency is corrected, attention and impulse control improve.

pillsStimulants are the most commonly prescribed medication for ADHD (Cherney, 2014). Stimulants affect dopamine levels. Stimulants block dopamine reabsorption (reuptake) so dopamine remains active longer. These medications may also block some of the metabolic enzymes that function to weaken dopamine's effect. This process allows dopamine to have more time to do its job in the brain. This additional time improves the efficiency of signal transmission between nerves. This in turn reduces ADHD symptoms.

Multiple studies of stimulant use for ADHD indicate improvement rates ranging from 70%-85%. For instance, the 1999 Multimodal Treatment Study of ADHD found an 80% positive response rateMore recently Molina (2009) conducted a follow-up to the 1999 Multimodal Treatment Study of ADHD (MTA Study, 2009)). This study found that treatment effectiveness faded over time. More research is needed to clarify our understanding of medication response across time.

In the United States, stimulants are considered Class II medications. This means they have a potential for abuse. Therefore, stimulant use is monitored by the Drug Enforcement Agency (DEA). Physicians who prescribe these medications must follow special regulations. For example, prescriptions must be handwritten rather than phoned in. Only a one-month supply can be distributed at a time. Despite the DEA's extra precautions, research indicates that stimulants at such low dosages are not habit forming. Therefore, experts estimate that the risk of developing a drug addiction problem is quite low.

There are different types of stimulant drugs. Therefore, if one medication is not effective, there is a 25% chance that another stimulant medication will be. Unfortunately, discovering which medication is best for each person must be determined by trial-and-error. New research is uncovering certain brain conditions that might predict which type of medication will be most effective. More research is needed to fully understand this connection. Until then, medications must be tried, evaluated, and discarded until an effective medication regime is found.