Which ADHD Medications Have the Least Side Effects?
Stimulant Drugs for ADHD
Stimulant drugs for ADHD come under a variety of names and in two primary forms, instant release and extended release. The vast majority of these drugs are derivative forms of either methylphenidate or amphetamine. All stimulant ADHD drugs have a similar subset of potential side effects. The extent of the side effects varies slightly among the different medications primarily according to the user. Because of this, it is often necessary for an individual to try different medications sequentially to find the ADHD medication with the least side effects for them. That said some studies have shown a slightly reduced presence of side effects with certain forms of stimulant medications.
The most common side effects for ADHD stimulant drugs are appetite suppression, sleep disturbances– primarily difficulty falling asleep, mood swings, irritability and anxiety, and tic formation. In some cases, where the dosage is not properly adjusted individuals may experience a sense of being overdosed or lethargic. This is easily addressed by reducing the prescribed dosage.
The most commonly prescribed stimulant drugs are Ritalin, Focalin, Concerta, Metadate, Daytrana, Dexedrine, and Adderrall. Some of these drugs come in the instant and extended release forms. Of these stimulant drugs the two which appear to produce the least side effects in the majority of patients with the best outcomes are Focalin (Dextro-methylphenidate) and Daytrana (Methylphenidate transdermal system).
FOCALIN- This drug is a dextro-methylphenidate. This is an isomer form of methylphenidate which isolates the most effective part of the drug molecule. By reducing the molecule in this way, Focalin offers a more direct form of the methylphenidate than drugs such as Ritalin, Metadate, and Concerta. Studies have shown Focalin to have less of an impact on appetite, sleep disturbances and mood swings than other stimulant drugs. This may be due to the fact that Focalin is comprised of only the active part of the methylphenidate isomer. It is possible that the inactive part of the isomer is what contributes to the majority of the undesirable side effects in other methylphenidate drugs.
Focalin comes in both instant release and extended release and many patients have had the best outcomes with the extended release form. Because of the nature of the drug, Focalin XR is often prescribed in much smaller doses than Ritalin, Metadate and Concerta, thus causing it to be less addictive and enabling patients to go off the Focalin XR when they are not in situations that require greater attention or focus.
DAYTRANA- This medication is administered in the form of a transdermal patch. The patch is designed to be worn for nine to twelve hours and then removed. The benefit of this medication is that it puts the patient in control of their medication. While the side effects are typical of stimulant drugs, the benefit of being able to calculate exactly when the medication is administered is unique to Daytrana. Typically the medication wears off within three hours of removing the patch. Daytrana is ideal for individuals who have difficulties swallowing pills or need their medication only for a specific part of the day, as the patch can be removed at any time. Because of the ability to remove the patch, patients on Daytrana often experience less loss of appetite and sleep disturbances because they are able to reduce their medication earlier in the day.
Non-Stimulant Drugs for ADHD
Among the non-stimulant medications which are sometimes used for ADHD, Strattera is the most commonly prescribed. Unlike the stimulant drugs, patients using Strattera do not experience difficulty falling asleep or stimulant-related appetite suppression.
While these side effects are diminished with Strattera, other side effects are possible which can include sleepiness, mood swings, change in appetite and, in rare cases among children, suicidal ideation. It is important to note that these side effects are less common than the typical side effects among stimulant drugs. Strattera is also non-addictive which is often viewed as a plus as compared to other ADHD medications.
Conclusion
While finding the right ADHD medication with the least side effects is challenging, it is possible. Trying one of these options first may be beneficial for some patients, but not all ADHD medications work well for all individuals, so trial and error may be necessary. Just because one medication presents with side effects does not necessarily mean all medications made up of the same active ingredient will present in the same way. Similarly, finding the right dosage is key to getting the best results with the least amount of side effects.
Reference
ADDitude Magazine Online - Say No To Side-Effects
ADHD Medications for Children - Medication, Side Effects, Research
