6 Things To Know About Stimulant Medications For ADHD

Stimulant medications are considered the first-line treatment for ADHD for some very good reasons. Here are 6 things to know about stimulant medications in ADHD.

Attention Deficit Hyperactivity Disorder (ADHD) is a highly genetic neurodevelopmental condition that leads to different wiring in the brain. This differently wired brain becomes capable of thought patterns with distinct advantages such as in creativity, problem-solving and idea generation. The ADHD brain also comes with real challenges in the brain’s ability to regulate emotions, attention, and behavior. The most consistent feature of the ADHD brain is inconsistency, and the highs and low that come with that can be hard to live with. Stimulant medications are useful for their ability to help with the core symptoms of ADHD.

Stimulant Medications May Be Neuroprotective

Emerging research evidence suggests that stimulant medications are neuroprotective in the developing brains of kids and teens with ADHD. Stimulants appear to preserve brain structure and volume in areas associated with cognitive function. Using stimulants appropriately in kids with ADHD can actually support their brain development and protect their brain cells. ADHD researcher and expert Russell Barkley calls this effect neuropromotion and discusses it in this YouTube video:

Stimulant Medications Work Like Coffee, But Better

Many of us drink coffee because caffeine enhances our cognitive functions. Caffeine stimulates the prefrontal cortex of the brain, the executive function area where our ability to organize, choose where to direct attention, and a host of other important functions happen. (Lin 2023) In fact, it’s well known among doctors that many adults with undiagnosed ADHD have managed it by ‘self-medicating’ with large amounts of caffeine. Just like caffeine, stimulant medications work on the prefrontal cortex and can help brains with ADHD regulate themselves. (Berridge 2010) But stimulant medications work a lot more efficiently than caffeine.

Stimulant medications are thought to work for ADHD by regulating key neurotransmitters in the brain. Stimulants normalize levels of dopamine and norephinephrine, which are involved in attention, task motivation, and the reward pathways. This allows people with ADHD to do what can be almost impossible without medication: pay attention to and perform tasks that they find boring. Modern life, work and education all require us to do things we find tedious or dull. Stimulant medications allow people with ADHD to get these tasks done, helping them perform better in school, at work, or managing the stuff of life, like grocery shopping and paying taxes.

Stimulants Are The First-Line Treatment for ADHD

Stimulant medications are the first-line treatment for ADHD, based on decades of research evidence and clinical experience. (Stutzman 2024) When prescribed with skill, individuals with ADHD find stimulants reduce their struggles with impulsivity and attention reduced while enhancing their strengths.

As a pediatrician many parents have expressed fears to me that the medication might turn their child into a zombie. Side effects are usually mild and the upsides are often notable, but it can take some trial and error to find the right medication for each individual. Less common side effects like flattening of personality, excess anxiety or irritability, or rarely heart palpitations, should all lead to prompt adjustments by the treating provider. The key to a good experience with these medications (as with any prescription drug) is working with a prescribing doctor who listens to and collaborates with their patients.

Stimulants Work Best In Combination With Other Therapies

Stimulant medications may be the first-line treatment for ADHD, but they work best in combination with other therapies. Once on a medication that helps with some of the symptoms that get in the way of learning, people with ADHD can benefit from learning strategies from executive function coaches, improve self-image with a therapist, or sensory based self-regulation strategies from a pediatric occupational therapist. Parents often prefer to try these therapies before starting medication, and usually find their child does not benefit due to distractibility. Once on a stimulant, the child can focus enough to learn from what the therapist has to offer.

Stimulants May Prevent Mental Health Problems

Life with ADHD can be hard, especially as a kid. Because of their natural wiggliness, impulsivity, forgetfulness, and/or distractibility, kids are constantly criticized. Psychiatrist and author William W. Dodson, MD, estimates that by age 12, children with ADHD receive 20,000 more negative messages from parents, teachers, and other adults than their peers without ADHD. People with ADHD often carry a lot of shame, and are more likely to develop anxiety disorders or depression than others. However, when ADHD is treated with stimulant medications, people are less likely to develop mental health disorders like anxiety or depression. (Biederman 2009)

Stimulant Medications May Prevent Addiction

People with ADHD have a higher risk of developing addictions. First, use of addictive substances often begins as a way of self-medicating to manage the unpleasant symptoms of ADHD. Second, addictive substances work on the dopamine reward pathway in the brain, which happens to be more vulnerable in brain with ADHD.

Since stimulant medications are controlled substances regulated by the DEA, which makes patients wonder if they are risking addiction by taking them. But in ADHD, stimulant medications actually help prevent addiction. It turns out that when used appropriately, these medications meet people’s needs and make them less vulnerable to trying risky substances. (Biederman 2009)

You Do Not Have To Take Stimulants Forever

Making decisions about how to best support yourself or your child with ADHD can be stressful. Unfortunately, stimulant medications have been associated with some negative myths. Knowing these 6 things about stimulant medications for ADHD can bring some reassurance. Still, as a pediatrician, I’ve often found that people feel a lot better about trying these medications if they understand that this is not a lifetime commitment. There may be seasons of life when stimulant medications help and other times when they are not needed. The goal is a thriving life with ADHD and to know that the support it out there.