Should I adjust my Attention Deficit Hyperactivity Disorder (ADHD) medication dosage during Premenstrual Syndrome (PMS) to manage heightened symptoms?

Managing ADHD Symptoms During PMS

For worsening ADHD symptoms during your premenstrual period, it is appropriate to temporarily increase your medication dose by the 5mg you mentioned, with your doctor's knowledge. 1

Evidence for Hormonal Effects on ADHD Symptoms

• Women with ADHD commonly experience worsening of symptoms during the premenstrual period due to fluctuations in reproductive hormones 1, 2
• Research shows that premenstrual inattention, irritability, and energy levels can be significantly affected in women with ADHD 1
• The prevalence of premenstrual dysphoric disorder (PMDD) symptoms is higher in women with ADHD compared to the general population 2

Medication Adjustment Approach

• A recent study demonstrated that increasing psychostimulant dosage during the premenstrual period improved both ADHD and mood symptoms with minimal adverse events 1
• All nine women in this study experienced improved symptom control with premenstrual dose elevation and chose to continue this approach 1
• The American Academy of Child and Adolescent Psychiatry supports titrating stimulant doses based on clinical response and presence of side effects 3

Implementation Guidelines

• Since you already have a prescribed "boost" of 5mg, using this during your premenstrual period is a reasonable approach 1
• Document your symptom changes throughout your menstrual cycle to better understand your pattern and medication needs 4
• Be aware that you may need different medication doses at different times of your cycle 3, 1

Important Considerations

• While you can make this temporary adjustment within your prescribed parameters, inform your doctor about this pattern at your next appointment 5
• Monitor for any side effects such as increased blood pressure, sleep disturbances, or appetite changes 3
• The American Academy of Child and Adolescent Psychiatry recommends regular monitoring of symptoms when adjusting medication dosages 5

Pitfalls to Avoid

• Don't exceed your maximum prescribed daily dose without consulting your doctor 5
• Avoid making multiple medication changes simultaneously, as this makes it difficult to determine what's effective 5
• Remember that hormonal contraceptives may affect ADHD symptoms and medication effectiveness, so inform your doctor if you use these 2

This approach of temporary dose adjustment during your premenstrual period is supported by emerging research and falls within standard practice for managing fluctuating ADHD symptoms 1, 4.