Stimulant Medication

Stimulant drugs  such as methylphenidate (Ritalin for example) and amphetamine’s, (Adderall for example), are the most commonly used treatment for the relief of ADHD symptoms, and has been found to be very effective among some patients, but to truly understand what stimulants are doing to the brain, it is better to first understand what happens in a brain which has ADHD.

Although it is not 100% proven in all cases, the cause of ADHD tends to be genetically passed on when born, and the brain doesn’t fully develop certain parts of the brain which are required in order to send the neurotransmitters dopamine and norepinephrine. In fact the frontal part of the brain tend to be slightly smaller than someone without the disorder at around 3-10% less. This does not mean a person is any less intelligent, as the parts which store memory are not effected. What is effected is areas in the brain which recall those memories. It is the areas which tell your brain and body to do function, which is why this is called the executive function of the brain.

The dopamine signals are used for controlling the movement parts of the brain, by sending neurotransmitters across to other nerve cells which could be movement, memories, and general thought processes. With a person that has ADHD the receptors do not send out as much dopamine, but the part of the brain which absorbs excess dopamine continues like normal, thus a person who has ADHD will have reduced dopamine levels. This reduction of dopamine means that the natural chemical feeling of reward is reduced. Now that reward feeling is what makes you feel good for accomplishing a goal, that good job feeling is either little or not at all, so getting motivated internally to get tasks done, especially if it is a task which isn’t interesting (such as housework as an example), it becomes very difficult to get said task done. If a distraction happens then it is likely that a person with ADHD will become more focused in the distraction than the task at hand.

Norepinephrine is a hormone which controls parts of the body which are related to your alertness, arousal and reaction times, it is part what is commonly known as the fight or flight reaction. When norepinephrine is disrupted it effects the mood, making a person with ADHD have low mood swings, and with a wave of depression it of course brings immense difficulty to concentrate. Fight or flight reaction with ADHD can happen much more commonly, with norepinephrine being unbalanced. Because of this unbalance it triggers a form of fight or flight in the pre-frontal cortex. It is not the same as the real thing when your life is on the line, instead what it does it makes you feel anxious. That anxiety starts to work against you, making you loose focus on other matters, and generally makes working on a task far more difficult when you being constantly distracted by an uncontrolled thought process.

The purpose behind stimulants is to balance out the chemicals in the brain. It does this by increasing the dopamine and norepinephrine within the frontal cortex, and reducing the ability of your brain to absorb these chemicals. So with dopamine and norepinephrine increased at a level higher than what a person without ADHD would have it balances out the reductions so concentration can be possible. This is the main purpose behind stimulants to allow cognitive functioning in the brain without it drifting easily by distraction and being able to get more things done. Although it does have this benefit, it can also bring negative side effects.

If the stimulants though are given at too high a dosage it can suppress the limbic system of the brain, which has a part of the emotion control’s in your brain. With a dosage given too high there is a possibility that you loose the ability to have an emotion. It makes you almost like a robot, cold and calculated without any emotional abilities. This is why medical professionals are using Stimulants at low doses, and mixing them with non stimulants like atomoxetine, which activates the executive functions in the frontal cortex which manages the emotions in the brain, which is the part which is effected by ADHD. Another non stimulant is intuitive which are used to regulate the alpha 2 ports, by fine tune frontal nerve cells so the signals are sent cleaner and more pure. If you want to know more about the non stimulant medications, this is covered in their own articles on this site.

Other side effects vary, depending on what you are using and how high a dosage but I will cover them below.

Moodiness: Ironically a side effect that stimulants can bring is an emotional imbalance rather than no emotion at all. The stimulants can make you more cranky and find it more difficult to deal with stress. This can fade as your body gets used to the medication, however if it not something you can cope with, or your family then contact your doctor in regards to this to change dosages or changing the medication altogether.

Disrupted sleep: Stimulant medication does as the name suggest stimulate your brain, giving it a boost. Coffee has similar effects to stimulant medication and it is common knowledge to not take coffee before bed and so obviously you do not want to take stimulant medication anywhere near to when you want to sleep.

Nausea: If you are going to experience this it is something that will happen near the start of  taking medication. This typically happens if you take medication without food, so a good routine is to take your medication with your breakfast. This will certainly reduce the chance of getting nausea.

Loss of appetite: Something that can lead to the nausea though is a loss of appetite. Certain types of medication can make you feel like you just don’t want to eat, it is important though that you do not skip meals. If you do skip any meals not only could you run the risk of nausea, but having less food can lead to low blood sugar, and if the sugar in your blood is low it will make focusing harder, as the brain needs blood sugar in order to function properly.

Headaches: One final issue with taking stimulants on an empty stomach is headaches, although this can also happen when your dehydrated. The time when a headache can occur can be after you taken them, but it can also happen when the medication runs out in your body, otherwise known as withdraw symptoms. If this starts to become a problem then speak to your doctor, to see about changing dosages or type of medication.

So as you have read there are a range of side effects that can happen with taking stimulants, but I want to close this on a positive. As although some people may believe that stimulants are absolutely dangerous and should not be used (like some people thing vaccinations are dangerous), I would like to make a point to the contrary. Stimulants have been used for over 40 years to treat the symptoms of ADHD, along with hundreds of publications from research to the effects of stimulants. They are safe if used properly, the key thing is to watch for any side effects you may experience and let your doctor know, so that it can be checked and reviewed constantly. Dr Russell Barkley even mentioned that stimulants can protect the brain, while it is developing.

Although this of course refers more to children rather then adults, I think it is an interesting thing to know about, especially if you have children which end up having ADHD, check out the clip below.