ADHD Medication Side Effects: Everything You Need to Know

What Is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a neurological condition that affects both children and adults, resulting in difficulty focusing, impulsivity, and/or hyperactivity. Depending on the type of ADHD and individual, symptoms of ADHD can significantly impact various aspects of life, including academic performance, relationships, and overall functioning.

The types of ADHD include:

• Inattentive ADHD: Inattentive ADHD refers to difficulties sustaining focus, being easily distracted, and struggling with organization.
• Hyperactive/impulsive ADHD: Hyperactive/impulsive ADHD can lead to excessive motor activity, restlessness, impulsivity, and difficulty with self-control. Individuals with this type of ADHD may have a hard time sitting still and often act before thinking.
• Combined ADHD: Combined ADHD refers to a mix of both inattentive and hyperactive/impulsive symptoms. People with combined ADHD experience challenges with attention, hyperactivity, and impulsivity to varying degrees.

What Are ADHD Medications?

ADHD medications can help reduce and treat symptoms of ADHD. Medications for ADHD vary greatly, producing different results depending on the person. Regardless, these pharmaceutical options aim to improve attention, organization, impulse control, and decision-making skills.¹

Stimulants

Stimulants are a class of medications commonly prescribed for the treatment of ADHD. These medications increase specific neurotransmitters in the brain, such as dopamine and norepinephrine, to help improve attention, reduce hyperactivity, and enhance impulse control. Stimulants are available in different forms, including short-acting and long-acting formulations.

Common stimulant medications for ADHD include:²*

• Adderall XR (amphetamine)
• Concerta (methylphenidate)
• Dexedrine (amphetamine)
• Focalin XR (dexmethylphenidate)
• Jornay PM (dexmethylphenidate)
• Quillivant XR (methylphenidate)
• Ritalin (methylphenidate)
• Vyvanse (lisdexamfetamine dimesylate)

*These medications have a black box warning, the most serious kind of warning from the FDA for a risk of medication misuse or abuse.

Non-Stimulants

Non-stimulant medications are an alternative treatment option for individuals with ADHD who may not tolerate or respond well to stimulants. Non-stimulants work differently than stimulants by targeting norepinephrine levels. However, they can also reduce unwanted symptoms of ADHD, such as impulsivity, poor focus, and hyperactivity.

Non-stimulant medications for ADHD may take longer to show noticeable effects compared to stimulants, and the specific medication used will depend on individual needs and medical history.

Common non-stimulant ADHD medications include:³

• Strattera (atomoxetine)*
• Wellbutrin (bupropion)*
• Intuniv (guanfacine)*
• Kapvay (clonidine)

*These medications have a black box warning, the most serious kind of warning from the FDA for a risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.

ADHD Medication Side Effects

ADHD medications can cause various side effects in different populations. Some individuals may react negatively to a specific prescription, while others experience symptom improvement taking the same medication. A prescribing doctor will help you understand the risk of adverse effects based on your situation and treatment goals.

Side effects of ADHD medication may include:

Personality Changes

Although rare, personality changes are potential side effects of ADHD medication. These changes may include mood swings, irritability, aggression, or even the emergence of new or worsening behavioral issues. Not everyone experiences these effects, and most individuals return to normal as their bodies adjust to the medication.

Sexual Problems

Some people who use ADHD medications will note an unwanted impact on their sexual health. One concern is Adderall side effects in men, as some experience erectile dysfunction when taking the medication. Women may experience other forms of sexual problems affecting functioning or desire.³

Height & Weight Changes

About 80% of people who use stimulant medications for ADHD will experience a reduced appetite.² Some may view these changes as positive, but poor appetite can lead to physical implications.

Children need proper nutrition to maintain their normal development. When taking stimulants, they may struggle to achieve height and weight expectations, especially if treatment continues for extended periods.

Underweight adults or those with histories of eating disorders may want to avoid certain stimulants to preserve safety. Taking the medication after eating and changing diet to include more protein and frequent, small snacks can help lessen these ADHD medication side effects.²

Sleep Issues

Sleep problems are another common side effect of ADHD medication. For stimulants, many people report sleeplessness and insomnia, often struggling to fall and stay asleep.^2,4 Other medications may leave individuals feeling drowsy during the day, even after sleeping a full recommended amount.^1,3

Experimenting with dosages and timing can help mitigate ADHD medication side effects, like poor sleep quality. Like other sleep and energy issues, proper diet and physical activity levels can promote desired energy during the day and healthy, restorative sleep at night. Always consult a doctor before adjusting your medication regime.

Mood Changes

Mood changes can occur as a side effect of ADHD medication, particularly with stimulant medications. Some individuals may experience increased irritability, mood swings, or symptoms of depression or anxiety.

Mood changes are typically temporary, but prescribers may recommend alternative medications if the effects are disruptive or uncomfortable. Closely monitor and report any adverse effects to a healthcare professional to ensure appropriate management of ADHD symptoms and discomfort.

Stomach Distress & Headaches

Stomach distress and headaches are common side effects of ADHD medication. Some individuals may experience stomach pain, nausea, or loss of appetite. These side effects are usually temporary and subside as the body adjusts to the medication.

Tics

Tics, including motor tics (sudden, repetitive movements) or vocal tics (sudden, repetitive sounds or vocalizations), can occur as a side effect of stimulant medication for ADHD. This side effect is more common in individuals with a pre-existing or family history of tic disorders.

As with other side effects, tics are mild and temporary, improving as the medication wears off or after a dosage adjustment. However, consult your healthcare professional if tics become severe or bothersome.

“Rebound” Symptoms

“Rebound” symptoms, specifically Adderall rebound, refer to the recurrence or intensification of ADHD symptoms as medications wear off in the body. This phenomenon can worsen attention difficulties, hyperactivity, or impulsivity. Sometimes, adjusting the dosage or changing when you take a medication can help alleviate these rebound symptoms.

ADHD Medication Side Effects in Different Populations

ADHD medication side effects can vary across different ages and genders. Children may experience appetite suppression and sleep disturbances, while adults may have dry mouth, increased heart rate, and elevated blood pressure. However, the severity and frequency of adverse effects depend on numerous factors, so individuals should work closely with their healthcare providers to ensure safety when taking medications for ADHD.

ADHD Medication Side Effects in Children

Children may experience uncomfortable ADHD medication side effects, so parents and caregivers should be aware of the risks. Some may struggle to fall or stay asleep. Others may experience physical symptoms, including headaches or stomachaches. Changes in appetite may contribute to slower growth rates. However, these effects are generally temporary and minor. Working with a pediatrician or prescribing physician can ensure children stay healthy and safe when taking medications for ADHD.

Side effects of ADHD medication in children may include:

• Decreased appetite: Stimulant medications commonly used to treat ADHD can suppress appetite, leading to weight loss or slower weight gain in some children.
• Sleep disturbances: Stimulant medications can interfere with sleep patterns and cause difficulties falling or staying asleep, especially when taken later in the morning or afternoon.
• Stomachaches and headaches: Some children may experience stomachaches or headaches as a side effect of ADHD medication. These symptoms are usually mild and improve over time.
• Mood changes: Some children may appear irritable or moody when taking ADHD medications. These effects are generally short-lived and lessen over time.
• Increased blood pressure and heart rate: Stimulants can cause a temporary increase in blood pressure and heart rate. Regular monitoring by a healthcare provider is important to ensure safety.

ADHD Medication Side Effects in Teens

Teens and adolescents may experience unique ADHD medication side effects. Those taking non-stimulants or antidepressants could face a higher risk of teen anxiety, aggression, and mood changes. In the worst situations, these side effects could escalate toward suicidality.

Side effects of ADHD medication in teens may include:^1,2,3

• Moodiness
• Irritability
• Worsening tics
• Sleep problems

ADHD Medication Side Effects in Women

While limited research is available regarding side effects exclusively in women, considering potential side effects that can occur in both genders is important. Common adverse effects of ADHD medications in women may include decreased appetite, sleep problems, headaches, dry mouth, and increased heart rate.

Side effects of ADHD medications in women may include⁵:

• Decreased appetite
• Sleep problems
• Headaches
• Dry mouth
• Increased heart rate
• Increased blood pressure
• Anxiety
• Mood changes
• Drowsiness
• Dizziness
• Gastrointestinal issues
• Changes in blood pressure

ADHD Medication Side Effects in Men

Research shows men experience similar side effects to women when taking ADHD medications.⁶ However, men may be more likely to report sexual changes, such as premature ejaculation or low libido, when taking stimulants like Adderall. Consult a physician if you notice these effects, as they can recommend a medication alternative or adjust your dose.

Side effects of ADHD medications in men may include:⁶

• Decreased appetite
• Sleep disturbances
• Headaches
• Dry mouth
• Increased heart rate
• Increased blood pressure
• Anxiety
• Mood changes
• Nervousness or restlessness
• Gastrointestinal issues, such as stomach pain or nausea
• Drowsiness or fatigue
• Dizziness
• Changes in blood pressure
• Sexual changes
• Increased irritability

ADHD Medication Side Effects in Pregnant & Breastfeeding Women

Those currently nursing, pregnant, or planning a pregnancy should discuss their treatment options with a medical professional. Some medications are safe to start or continue when pregnant. However, others carry the risk of complications, such as gastroschisis, omphalocele, or traverse limb deficiency.⁷ While rare, women should consult their doctor about the possibility of these risks.

Side Effects of Mixing ADHD Medications & Alcohol

Physicians advise against consuming alcohol with stimulants and non-stimulants. Firstly, combining ADHD medications and alcohol enhances their sedative effects on the central nervous system, thus increasing drowsiness and cognitive and motor function impairments. Doing so can also impact heart rate and blood pressure.

Below are possible side effects of mixing medications for ADHD with alcohol:

• Increased drowsiness and sedation: Both ADHD medications and alcohol have sedative effects. When combined, they can intensify drowsiness and impair cognitive and motor function.
• Impaired judgment and decision-making: Alcohol can further impair judgment and decision-making, which may already be affected by ADHD medications.
• Increased risk of cardiovascular side effects: Mixing ADHD medications with alcohol can heighten the risk of cardiovascular effects, such as increased heart rate and blood pressure.
• Interference with medication effectiveness: Alcohol can potentially interact with certain ADHD medications, affecting their absorption, metabolism, and overall effectiveness.
• Worsened side effects and symptoms: Alcohol can worsen existing side effects of ADHD medications, such as gastrointestinal issues, dizziness, and mood changes.
• Risk of dependency and addiction: Mixing ADHD medications with alcohol may increase the risk of developing dependence or addiction to either substance.

Long-Term Side Effects of ADHD Medication

The long-term side effects of ADHD medications are generally minimal. The benefits of improved symptoms and functioning typically outweigh these risks. Some potential long-term side effects include decreased appetite and growth suppression in children. However, parents and prescribers can manage these changes by monitoring growth and adjusting medication dosages if necessary.

Other possible long-term effects, such as changes in blood pressure or heart rate, may affect those with pre-existing physical health conditions. Individuals taking ADHD medications should have regular check-ups with their healthcare providers to assess any potential long-term effects and ensure the medication remains beneficial and safe.

Rare but long-term ADHD medication side effects include:⁸

• Hallucinations
• Delusions
• Increased risk of aggression
• Sleep disorders
• Prolonged QT interval (a heart rhythm disorder that can increase the risk of heart arrhythmias and sudden cardiac death)
• Tics (new-onset or worsening of pre-existing tics)
• Withdrawal symptoms
• Mania or hypomania
• Development of suicidal thoughts or behaviors

Risks of Taking ADHD Medication

Individuals with ADHD who experience co-occurring medical or mental health issues should seriously consider the risks of taking certain ADHD medications. Some prescriptions for treating other conditions can interact with stimulants or non-stimulants, possibly leading to severe side effects. Always inform your doctor or prescribing physician about your medical and mental health history.

Conditions that may limit the use of ADHD medications include:^2,3

• Anxiety: Individuals with anxiety disorders should take ADHD medications with caution, as stimulant medications can potentially worsen anxiety symptoms.
• Depression: Some medications can potentially worsen depressive symptoms.
• Psychosis: Individuals with a history of psychosis are generally advised against using ADHD medications, as they can potentially exacerbate symptoms.
• Glaucoma: Some ADHD medications can potentially increase eye pressure in those with Glaucoma.
• Tourette’s syndrome: Tourette’s syndrome, a neurological disorder resulting in repetitive, involuntary movements and vocalizations, can influence the use of ADHD medications. Some stimulant medications may exacerbate tics, so consult a doctor if you have a history of this condition.
• Thyroid issues: Some ADHD medications can potentially affect thyroid function.
• Cardiac concerns: Those with a history of cardiac issues, such as heart rhythm abnormalities or structural heart defects, should take ADHD medications with caution.
• Substance use disorders: Individuals with substance use disorders may need special consideration when using ADHD medications due to the risk of dependence.
• Liver problems: Liver problems can affect the metabolism and elimination of medications from the body, potentially impacting the use of ADHD medications. Adjustments to the medication dosage may be necessary for individuals with liver conditions.
• Seizure disorder: ADHD medications can potentially lower the seizure threshold and increase the risk of seizures. Individuals with a history of seizure disorders should discuss this with their healthcare professional before using ADHD medications.