Treatment Options: Prescription Meds

Medical Treatment
Written By Mira K. Cohen

I firmly believe that everyone has the right to understand their treatment options and work with their care team to do their best at work, at school, and in relationships without not feeling like themselves or dealing with distracting side effects. And that looks different for everyone. A specialist might mention some of these common prescription medications.

In general, always do your own research and ask your doctor when and how to take your medications.

Make sure you discuss all other prescription medications and supplements you’re also taking. I also recommend keeping track of how different medications make you feel, especially when you first start them, and sharing your observations with your doctor. Here’s a great med side effect tracker I’ve used created by Understood.

Stimulants for ADHD

How they work

They directly increase the levels of two neurotransmitters - hormones in your brain - that individuals with ADHD naturally don’t make as much of norepinephrine (noradrenaline) and dopamine. Increasing the levels of these hormones increases activity in the central nervous system, just like coffee, which calms down someone with ADHD, reducing symptoms.

Type of Stimulants

The two main classes of stimulant medications are amphetamines and methylphenidate.

Many people respond better to one than the other.

Both short-acting and long-acting versions of medications are available.

  • You usually take the long-acting earlier in the morning so it doesn’t disrupt your sleep.

  • Many teens and adults to take a dose of the short-acting version of their medication in the afternoon after their long-acting one wears off to help with school, work, paperwork, chores, or social stuff. Because ADHD doesn’t stop after 5 PM.

Here are some examples of medicines in each class you may recognize:

  • Amphetamines

    • Adderall (short-acting or long-acting)

    • Dexedrine (short-acting or long-acting)

    • Vyvanse (long-acting)

  • Methylphenidate

    • Ritalin (short-acting or long-acting)

    • Focalin (short-acting or long-acting)

    • Concerta (long-acting)

Note on Stimulant Medication Interactions: You’d be surprised how many people don’t know this - several medications are more effective if you don’t eat or drink anything acidic an hour before or after, or take Vitamin C supplements. This is true for:

  • All short-acting meds

  • Long-acting meds other than Vyvanse

Busting Myths about Stimulants

  • For most people, it is safe to take most antidepressants with stimulant ADHD medication. As long as your doctor says it’s OK, you’re good to go. It’s a very common combination because it’s important to treat ADHD with anxiety and depression.

  • It’s also usually safe to take stimulant and non-stimulant ADHD medication. They are actually often prescribed together.

  • It does not raise the risk of heart problems later on if you don’t have a condition that prevents you from safely taking them in the first place.

  • Taking stimulant medications as prescribed actually decreases the risk of substance abuse because both substance abuse and ADHD are related to your brain not naturally making enough dopamine.

Non-stimulants for ADHD

A doctor often prescribes these when someone has unpleasant side effects from stimulants, wants an alternative, or cannot take stimulants for a medical reason. Unlike stimulants, these medications do not wear off, and it takes a few weeks to see the full effect. Common ones include:

  • Straterra (atomoxetine), which slows down the brain’s reabsorption of norepinephrine

  • Extended-release Wellbutrin (bupropion), which slows down the reabsorption of norepinephrine and dopamine. Bupropion is also an antidepressant.

  • Extended-release Intruniv (guanfacine) and Catapres (clonidine). Both are also medications for hypertension. They work by strengthening connections in the brain and are more effective at reducing hyperactivity and emotional symptoms of ADHD. Both can be sedating, so you take them at night.

Antidepressants

All antidepressants take several weeks to see the full effect.

Selective Serotonin Reuptake Inhibitors (SSRIs): This class of antidepressants is the one most commonly prescribed.

  • What they treat: Anxiety, depression, and OCD

  • How they work: Slowing the brain’s reabsorption of serotonin, a neurotransmitter that increases pleasure.

  • Examples: Prozac (fluoxetine), Lexapro (escitalopram), and Zoloft (sertraline).

Selective Serotonin Norepinephrine Reuptake Inhibits (SNRIs)

  • What they treat: Depression, Anxiety, and OCD

  • How they work: They slow the brain’s reabsorption of both serotonin and norepinephrine.

  • Examples: Effexor (venlafaxine) and Cymbalta (duloxetine). Effexor might also help ADHD symptoms.

Examples of Other Antidepressants

  • Desyrl (trazodone) and Remeron (mirtzapine)

  • Both are sedating

Anti-Anxiety Medications

Benzodiazepines

How they work: These short-acting medications decrease anxiety by increasing the amount of GABA, a neurotransmitter that reduces activity in the central nervous system.

Examples: Xanax (alprazolam), Klonopin (clonazepam), and Valium (diazepam).

Safety Information

  • Because the body needs higher doses over time to get the same effect, and they have significant side effects, doctors usually prescribe them for a short period when someone experiences intense anxiety during panic attacks or to help with sleep.

  • Benzodiazepines are also sometimes prescribed for epilepsy. It is very dangerous to take benzodiazepines while drinking alcohol or taking opioids.

Other Anti-Anxiety Medications

  • BuSpar (buspirone) increases the activity of serotonin and reduces the activity of dopamine over time.

  • Inderal (propranolol). Inderal is a hypertension medication that quickly decreases norepinephrine activity. Propranolol can be sedating, and unlike BuSpar, it can be taken as needed.

Mood stabilizers

These medications mostly fall into two categories: antipsychotics and anticonvulsants.

  • Antipsychotics like Abilify (aripiprazole) and Risperdal (risperidone) indirectly decrease dopamine and serotonin. They are used for very severe mood and anxiety disorders, are very sedating, and can have severe side effects.

  • Anticonvulsants, also used to treat epilepsy, indirectly increase GABA and decrease glutamate (another neurotransmitter that stimulates the central nervous system). Doctors prescribe them for different mood and anxiety disorders that cause problems with emotional regulation. Ones sometimes used for anxiety include Lamictal (lamotrigine) and Neurotonin (gabapentin).

Those Pesky Hormones

Female hormones: A female hormone, estrogen, influences your levels of dopamine. The more estrogen you have, the more dopamine you have. Many neurodivergent girls and women find that their mood, executive functioning, and social symptoms are worse during times when their estrogen is lower. If you find yourself really suffering, you shouldn’t hesitate to talk to your doctor about medications that could help regulate your female hormones, such as birth control pills. Many conditions that cause female hormones to be dysregulated can also have lots of mood symptoms and are more common in neurodivergent girls and women.

Thyroid hormones: Symptoms of thyroid hormone deficiency can often mimic mood disorders, so it’s worth discussing with your doctor, especially if you are experiencing a lot more fatigue than normal.

References

Mira K. Cohen https://www.bybcoaching.net
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