Adult ADHD Medication: Types, Side Effects, & Risks

What Is Adult ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that contributes to symptoms of inattention, hyperactivity, and/or impulsivity. Adults with ADHD often present different symptoms than children, with many experiencing restlessness rather than hyperactivity and inattentiveness.¹

FDA-Approved ADHD Medications for Adults

The most common ADHD medications for adults are stimulants. Patients who respond poorly to stimulants or take other medications may consider non-stimulants instead. A provider will work with individuals to determine if stimulants or non-stimulants better suit their needs and goals for treatment.

Stimulant Medications for Adult ADHD

Stimulants are a first-line treatment for adult ADHD that works by increasing norepinephrine and dopamine levels in the central nervous system.² Stimulants for ADHD in adults can help individuals manage their symptoms of ADHD by improving focus, impulsivity, and hyperactive behavior.

Professionals often recommend stimulants for adults with ADHD, but not every patient benefits from these medications. Stimulants carry the risk of dependence and misuse, so some individuals with histories of substance use may seek alternatives. Additionally, those with high blood pressure, tic, psychotic, or heart conditions should use stimulants with caution due to the risk of adverse effects.

Side Effects of Adult ADHD Medications

Adverse effects of adult ADHD medications vary depending on the type. Individual factors, such as age, weight, and gender, may also affect these reactions. A doctor will inform you of the risk of adverse effects to help you choose a suitable medication.

Side Effects of Stimulants

While stimulants can help improve focus, they also carry the risk of adverse effects. Common side effects of stimulant medications include appetite suppression, insomnia, headache, and initial feelings of restlessness. Some individuals may also experience mood changes, dizziness, or lightheadedness. Work closely with a healthcare provider as they can adjust the medication or dosage to minimize these side effects.

Common side effects of stimulants in adults include:

• Increased heart rate and blood pressure
• Loss of appetite or decreased appetite
• Insomnia or difficulty sleeping
• Headache
• Nervousness or restlessness
• Stomachache or abdominal discomfort
• Dry mouth
• Dizziness or lightheadedness
• Mood changes, such as irritability or anxiety
• Increased sweating
• Tremors or shaking
• Blurred vision
• Nausea or vomiting

Side Effects of Non-Stimulants

As with other medications for adult ADHD, non-stimulants may result in unwanted effects. Common side effects of non-stimulant medications include fatigue, dizziness, upset stomach, dry mouth, headache, and decreased appetite. More severe side effects are rare but may result in allergic reactions, high blood pressure, and abnormal liver function.

Common side effects of non-stimulants in adults include:

• Drowsiness or fatigue
• Upset stomach or gastrointestinal discomfort
• Headache
• Dizziness or lightheadedness
• Dry mouth
• Decreased appetite or weight loss
• Nausea or vomiting
• Diarrhea or constipation
• Insomnia or changes in sleep patterns
• Mood changes, such as irritability or anxiety
• Muscle weakness or aches
• Sexual dysfunction, such as decreased libido or difficulty reaching orgasm
• Sweating or increased perspiration

Risks of ADHD Medications for Adults

Individuals should only take ADHD medications for adults as recommended by their doctor, as specific populations may be at a higher risk of experiencing severe side effects. For example, individuals with pre-existing cardiovascular conditions may experience elevated heart rate or blood pressure while taking stimulant medications. Individuals with these conditions should work closely with their healthcare provider to monitor their cardiovascular health and adjust medication dosage if necessary.

Additionally, those with a history of substance abuse may be at a higher risk of misusing or abusing stimulant medications, which can lead to addiction or other adverse effects. Close monitoring and communication with a healthcare provider are essential in managing and reducing these risks for individuals with a history of substance use disorder.

Risks of ADHD medications for adults may include:

Stimulants

• High blood pressure: Stimulant medications can sometimes increase blood pressure, which can be of concern for individuals with pre-existing hypertension or cardiovascular conditions.
• Heart problems: Stimulants carry the risk of heart-related issues like irregular heartbeat, palpitations, or more serious cardiac events. These risks are relatively rare.
• Seizures: Stimulant medications may lower the seizure threshold, meaning they can increase the risk of seizures, especially in individuals with histories of seizures or epilepsy.
• Psychiatric effects: Stimulant medications can occasionally worsen pre-existing psychiatric conditions or even contribute to the development of new psychiatric symptoms, including mood swings, anxiety, irritability, or aggression.
• Addiction or substance abuse: Stimulants carry a risk of misuse, addiction, or substance abuse, particularly in individuals with a history of substance use disorder.
• Sleep problems: Stimulant medications can interfere with sleep patterns and disrupt the normal sleep-wake cycle, leading to insomnia or difficulty falling asleep.
• Appetite suppression and weight loss: Stimulant medications can suppress appetite, resulting in decreased food intake and potential weight loss, which may be undesirable for individuals with low body weight or eating disorders.

Non-stimulants

• Suicidal ideation: Individuals taking non-stimulant medications for adult ADHD may experience increased suicidal thoughts or behaviors. While rare, close monitoring is necessary, especially in individuals with a history of depression or suicidal tendencies.
• Allergic reactions: Non-stimulant medications can potentially cause allergic reactions in some individuals. Symptoms may include skin rash, itching, swelling, or difficulty breathing. Immediate medical attention is required if an allergic reaction is suspected.
• Cardiovascular effects: Some non-stimulant medications, such as atomoxetine, may have a small risk of increasing blood pressure or causing changes in heart rate.
• Gastrointestinal issues: Non-stimulant medications can occasionally cause gastrointestinal side effects like upset stomach, nausea, vomiting, or loss of appetite. These effects are usually mild and resolve on their own.
• Impaired liver function: In rare cases, non-stimulant medications may affect liver function and lead to liver damage. Routine monitoring of liver function is recommended, especially for individuals with liver disease or a history of liver problems.
• Priapism: Priapism, a prolonged and often painful erection, is a potential but rare side effect of certain non-stimulant medications. Immediate medical attention is necessary if this side effect occurs.

Antidepressants

• Sexual side effects: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can cause sexual side effects such as decreased libido, difficulty achieving orgasm, or erectile dysfunction.
• Suicidal ideation: Antidepressants may increase suicidal thoughts or behaviors, especially in young adults. Close monitoring and regular follow-up are important.
• Serotonin syndrome: Although rare, serotonin syndrome can occur when combining multiple serotonergic medications. This potentially life-threatening condition results in symptoms like agitation, confusion, rapid heart rate, dilated pupils, high blood pressure, and tremors.
• Activation and agitation: Some individuals may experience increased restlessness, jitteriness, or difficulty sleeping when starting or adjusting the dose of certain antidepressants, particularly those with stimulating effects.
• Weight gain or weight loss: Antidepressants can affect weight in various ways. Some individuals may experience appetite changes leading to weight gain, while others may report a loss of appetite and subsequent weight loss.
• Heart disease and blood pressure: Certain antidepressants may have a slight impact on heart function or blood pressure, particularly in individuals with pre-existing cardiovascular conditions.
• Withdrawal symptoms: Abruptly stopping antidepressants may result in withdrawal symptoms such as mood changes, dizziness, or gastrointestinal disturbances. Tapering the medication under medical supervision is generally recommended.

ADHD Medications & Pregnancy

Carefully consider the risks and benefits of adult ADHD medications when pregnant. Some ADHD medications, particularly stimulants, can slightly increase the risk of fetal abnormalities. Studies show conflicting results, so individuals should discuss medication, dosage, and potential risks with a healthcare provider.

Untreated ADHD during pregnancy can also pose risks to both the mother and the baby. Poorly managed ADHD symptoms may lead to increased stress, negative impact on maternal mental health, and difficulties in daily functioning. Expectant mothers should weigh these benefits against the potential adverse effects. Ultimately, pregnant women should consult their prescriber to determine whether adult ADHD medications suit their situation.

Interactions With ADHD Medications for Adults

ADHD medications for adults can interact with other SSRIs or stimulants. Combining these medications can potentially increase the risk of serotonin syndrome. Additionally, using different stimulant medications can increase heart rate, blood pressure, or overstimulation. Close monitoring and cautious adjustment of dosages may be necessary when using these medications together.

Adult ADHD Medications & Alcohol

Physicians generally advise against consuming alcohol while taking adult ADHD medications. Alcohol can enhance the sedative effects of certain ADHD medications, leading to increased drowsiness, dizziness, and impaired coordination. This combination can be dangerous, especially when driving or operating machinery. In addition, both ADHD medications and alcohol can individually impair judgment and decision-making abilities.

What Is the Best Medication for Adult ADHD?

The best adult ADHD medication is whichever prescription suits individual needs and treatment goals. While everyone responds to medication differently, some drugs show better efficacy in clinical trials.

As mentioned, stimulants receive the most support from prescribing professionals, but some individuals opt for alternatives that do not carry the same risks. Consult your doctor and health team about the possible adverse effects of every medication before starting.

Other Treatment Options for Adult ADHD

Other potential treatment options for adult ADHD include lifestyle modifications, stress management techniques, and accommodations in the workplace or educational settings. A comprehensive approach combining various treatment modalities can be most effective in managing adult ADHD. Finding a neurodiversity-affirming therapist is a positive first step toward overall well-being.

Below are alternatives to medications for adult ADHD:

• Cognitive-behavioral therapy (CBT): CBT for ADHD focuses on identifying and modifying negative thought patterns and behaviors associated with ADHD. This approach helps individuals develop practical strategies to manage symptoms, improve time management, and enhance organizational skills.
• Psychoeducation: Psychoeducation about ADHD can help individuals understand their condition, develop coping mechanisms, and explore tips for improving relationships and overall well-being.
• Coaching: Coaching involves working with a professional trained in ADHD who can provide support, guidance, and accountability. Coaches help individuals set goals, establish routines, and implement strategies to manage ADHD-related challenges in their daily lives.
• Mindfulness and meditation: Mindfulness practices and meditation for ADHD can improve focus, attention, and emotional regulation. These techniques involve training the mind to be present, reducing distractions, and developing self-awareness.
• Exercise and physical activity: Regular physical exercise can improve ADHD symptoms by increasing dopamine levels in the brain. Engaging in aerobic exercises, yoga, or martial arts can help reduce hyperactivity, improve self-regulation, and enhance overall well-being.
• Support groups: Joining ADHD support groups can provide a sense of community and a platform to share experiences, challenges, and successes with others who understand the impact of ADHD. Members receive emotional support, information, and practical tips for managing daily life.

Questions to Ask Your Health Team About ADHD Meds for Adults

You should feel comfortable with your treatment plan before starting medication for adult ADHD. Consult your prescriber about the appropriate dosage, when to take your medication, and what to do if you experience adverse effects. You can always request additional reading materials to educate yourself about alternatives.

Below are questions to ask your doctor about medications for adult ADHD:

• How does this medication work?
• How can I tell if this medication is working?
• What are the common side effects of this medication?
• What are the high-risk side effects that require immediate attention?
• What dose should I take, and when should I take it?
• Can I use discounts or coupons for Qelbree to help cut costs on my prescription?