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Stimulants have effect on the way the brain controls impulses and regulates behavior and attention. They influence the availability of certain chemicals, called neurotransmitters, in the brain.
Stimulants are given to people suffering moderate to severe from ADHD condition, who have difficulty in at least two different environments, such as school and home. Most stimulant medications used for the treatment of ADHD are approved by the U.S. Food and Drug Administration (FDA) to treat both children and adults with ADHD since the age of three.
Methylphenidate ( Ritalin or Concerta ) is preferred for treating ADHD because it has fewer side effects than other medications and generally works well behavioral control.
Pemoline is hardly ever prescribed to treat ADHD because, in rare cases, it can damage the liver. Pemoline is given to very few people with ADHD who do not get better with methylphenidate, dextroamphetamine, or Adderall. If this medication is used, blood tests to monitor liver function are often needed.
The dextroamphetamine and amphetamine combination medication (Adderall) is used when the combination of medications may be more beneficial or when other stimulants have not improved symptoms. The long-acting form of dextroamphetamine controls behavior for a longer period of time, so less doses are required during the day.
Mood disorders, like depression, can also be treated with stimulants. The age is the first factor taken into consideration for ADHD treatment. If for children stimulants are used as a first treatment, for adults, antidepressants take its place and stimulants will be used only after they fail or even a combination of the 2 medications.
The most common side effects, encountered in about 50% of the cases of stimulants are most of the times related to the dose and disappear after 2 or 3 weeks on the medication. Persistent side effects can usually be relieved by changing the dosage level, changing when the medication is given, or trying a different stimulant and include:
- Decreased appetite in about 80% of the cases. The appetite is usually least during the daytime, increasing in the evening. If the medication is given after meals and the diet will also include snacks, it may help improve the child's appetite and prevent loss of weight.
- Difficulty in falling asleep.
Other side effects are also usually temporary or go away with dosage adjustment: stomachache, headache, increased blood pressure (in black males)
Although short-term studies have shown the safety of stimulant medications, long-term effects have not been studied yet. In a recent 2-year study, children who took stimulant medication grew almost 0.5 in. (1.3 cm) per year slower than those that didn't take medication. The study followed 540 youngsters with ADHD, who were aged 7 to 9 at the outset of the study. However, more studies are required in order to determine whether growth is affected at other ages and whether children taking these medications might catch up later. As with any other medication, a parent should put into balance the benefits and the potential risks their child might receive from taking these medications.