From the Guidelines
Stimulants have a calming and focusing effect on individuals with ADHD, whereas they tend to cause stimulation and excitation in neurotypical individuals, due to the differences in baseline neurotransmitter levels and brain activity patterns between the two groups. In individuals with ADHD, stimulant medications like methylphenidate and amphetamine-based medications work by increasing dopamine and norepinephrine levels in the brain, particularly in the prefrontal cortex, which is often underactive in ADHD 1. This helps improve attention, reduce impulsivity, and enhance executive functioning. The medications essentially normalize brain function in ADHD rather than enhancing it beyond normal levels as they do in neurotypical individuals.
Some key points to consider when prescribing stimulants for ADHD include:
- Typical therapeutic doses range from 5-60mg for methylphenidate and 5-70mg for amphetamine-based medications, usually taken daily, with effects lasting 4-12 hours depending on the formulation 1
- Common adverse effects include decreased appetite, sleep disturbances, increased blood pressure and pulse, headaches, irritability, and stomach pain 1
- Stimulants are associated with statistically significant increases in blood pressure and heart rate, which may be clinically relevant for a small subgroup of patients, especially those with preexisting cardiovascular diseases 1
- Findings from longitudinal studies indicate that treatment with psychostimulants is associated with a statistically significant reduction in height and weight gain, which can be clinically relevant in subgroups and require careful monitoring 1
It is essential to weigh the benefits and risks of stimulant medication and to monitor patients regularly for potential adverse effects, particularly changes in cardiovascular parameters and growth velocity 1. The decision to prescribe stimulants should be based on a comprehensive evaluation of the individual's symptoms, medical history, and potential risks, with careful consideration of the potential benefits and drawbacks of treatment.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Effects of Stimulants on ADHD Individuals Compared to Neurotypical People
- Stimulants, such as methylphenidate and amphetamines, are the recommended first-line treatment for individuals with Attention Deficit Hyperactivity Disorder (ADHD) 2, 3, 4.
- These medications work by increasing the levels of certain neurotransmitters, such as dopamine and norepinephrine, in the brain, which helps to improve attention and reduce impulsivity and hyperactivity 3, 5.
- In individuals with ADHD, stimulants have been shown to be effective in reducing symptoms of inattention and hyperactivity 3, 5, 6.
- However, the effects of stimulants on neurotypical individuals are different, as they can produce feelings of euphoria and increased energy, which can lead to misuse and dependence 5.
- Studies have also shown that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and that characteristics such as sex, race, and academic performance are associated with misuse of stimulant medications 5.
Comparison of Stimulant Effects
- The effects of stimulants on ADHD individuals and neurotypical people can be compared in terms of their impact on cognitive and behavioral functioning:
- In ADHD individuals, stimulants improve attention, reduce impulsivity and hyperactivity, and enhance cognitive functioning 2, 3, 4.
- In neurotypical individuals, stimulants can produce feelings of euphoria, increase energy and alertness, and enhance cognitive functioning, but can also lead to misuse and dependence 5.
- The differences in effects between ADHD individuals and neurotypical people highlight the importance of careful diagnosis and treatment planning, as well as monitoring for potential side effects and misuse 2, 3, 5, 4.
Important Considerations
- When prescribing stimulants for ADHD, it is essential to consider the potential risks and benefits, as well as the individual's medical history, comorbidities, and lifestyle 2, 3, 4.
- Regular monitoring and follow-up are crucial to ensure that the medication is effective and to minimize the risk of side effects and misuse 2, 3, 5, 4.
- Non-stimulant medications, such as atomoxetine, may be considered as alternative treatment options for individuals with ADHD who do not respond to stimulants or experience significant side effects 3, 6.