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* a non-stimulant medication

**Usually start at .5 mg/kg/day and then increase to 1.5 mg/kg/day.  FDA recommends maximum of 80 mg/day, then after one month may increase to 100 mg/day.

The traditional medications and most effective medications for Attention Deficit Hyperactivity Disorder are stimulants.

The general theory behind stimulants assisting with problems of attention is that a part of the brain may not have enough brain chemicals to make the connections work well.  Stimulants appear to help with blood flow and activity to the parts of the brain implicated in ADHD, most noticeably the pre-frontal cortex. The exact mechanism of action of the stimulants to help with ADHD is unknown. It is believed that they impact the dopamine, norepinephrine and perhaps the serotonin systems.

The patient advisory leaflet for Metadate states that: Methylphenidate is thought to block the reuptake of norepinephrine and dopamine into the presynaptic synapse neuron and increase the release of these into the extraneuronal space.

The stimulants are Schedule II drugs, meaning that they are highly restricted and have severe abuse potential. For this reason, the physician can not call in a prescription to the pharmacy. Usually the prescription has to be picked up at the physician’s office each month. Most physicians will not write a prescription for more than one month at a time, although it appears to be legal for the physician to write several prescriptions by post-dating them.

Abuse Potential

The fear of abuse potential for ADHD is not well founded. Most studies show almost no addiction with the stimulants for people prescribed. The greatest problem for children and teenagers with ADHD is getting the child to remember to take the medication. This is not the way that most addictions function. When is the last time you had to remind a cigarette smoker that it was time to light up?

The greatest danger of abuse is family members who have access to it. There are also some reports of teenagers who don't like taking the medication then selling their medication to others. And sometimes the medication is kept in less than secure situations in the home or at school. The stimulants can be abused by taking in high doses or by turning them into a power and snorting for an immediate high.

There are some critics of drug treatment for ADHD who point out that children who took Ritalin in elementary school have a high risk of abusing drugs later. There is a correlation between a diagnosis with ADHD and later drug abuse. However, it is the untreated adolescent and adult who is at high risk of later abusing drugs.

The reason for this is that almost all of the illegal drugs impact the dopamine system in the brain, the same system impacted by the psychostimulants. Thus it is believed that many of the people with ADHD who abuse drugs are actually attempting to self-medicate their disorder.

To put the danger of the stimulants in perspective, the most dangerous part of taking a stimulant medication may be the drive in your car to pick up the prescription from your physician!  The car ride has greater dangers than the medication.  So drive carefully!!