Your body's chemistry. As many as 1 in 10 people don't get results from either of the two main types of stimulants prescribed for ADHD because they don't work with their body chemistry. Though experts aren't sure why, sometimes medicines can stop working even though they did in the past.
Ainslie Gray, MD, writes at springboardclinic.com that if you are prescribed a stimulant, and you don't feel any change—or you feel changes at first but then they stop—the dose could be too low. A dose might be too high if you feel uncomfortable, anxious, "wired," or "overstimulated."
There are several reasons for this, such as: The medication is no longer the right dose or type because of physical changes, such as child development. There are new factors that are affecting how the medication works for you. You have new or worsening symptoms that mimic ADHD but are actually caused by something else.
One clinical study showed that 24.7% of patients developed tolerance to stimulants in the time of days to weeks; another showed 2.7% developed tolerance over 10 years. Long term follow-up studies demonstrate that medication response may lessen over longer durations of treatment in a high percentage of patients.
But stimulants “fail” to assist many patients with ADHD, and this presents a clinical challenge. From 10% to 35% of patients do not respond to stimulants, according to best estimates from the American Academy of Child and Adolescent Psychiatry (AACAP) and the Centers for Disease Control and Prevention.
Stimulants are an effective way of managing ADHD symptoms, such as short attention span, impulsive behavior, and hyperactivity. These drugs improve ADHD symptoms in about 70% of adults and 70–80% of children.
Stimulants are believed to work by increasing dopamine levels in the brain. Dopamine is a neurotransmitter associated with motivation, pleasure, attention, and movement. For many people with ADHD, stimulant medications boost concentration and focus while reducing hyperactive and impulsive behaviors.
In people who don't have ADHD, because Adderall produces an excess amount of dopamine, users may experience feelings of euphoria and increased energy levels, as well as possible dangerous physical and emotional side effects.
In the typical dose range of 5 mg to 20 mg, up to perhaps 60 mg total per day, Ritalin does not produce either tolerance or addiction. Ritalin does not accumulate in the bloodstream or elsewhere in the body, and no withdrawal symptoms occur when someone abruptly stops taking the drug, even after years of use.
As you know, one trademark of ADHD is low levels of the neurotransmitter dopamine — a chemical released by nerve cells into the brain. Due to this lack of dopamine, people with ADHD are "chemically wired" to seek more, says John Ratey, M.D., professor of psychiatry at Harvard Medical School in Boston.
The ADHD zombie effect is a drugged, zoned-out feeling where a child is unnaturally quiet. It is one of the side effects of stimulant medications and can indicate that a dose is too high. Some children experience these symptoms even when they are taking an optimal dose.
National guidelines report that the first-line treatment for ADHD is a stimulant medication,2 and stimulants have been shown to have a short-term success rate as high as 68 to 80 percent. Prescriptions for stimulants have increased dramatically over the last two decades.
Signs that a Vyvanse dose is too high or too low
If this dose doesn't work well for you, your doctor may increase your dose. Other reasons why your doctor might increase your Vyvanse dosage include: your kidneys aren't working as well as they should. you experience certain side effects.
Adderall is a stimulant that boosts your levels of serotonin, norepinephrine, and dopamine. These are neurotransmitters in your brain that calm and relax you so you can focus better. They also affect sleep in different ways. That may be the reason the drug causes drowsiness in some but not others.
This is sometimes called the “Concerta crash” or the “Adderall crash,” after common brand names of stimulant medication. Some of the symptoms of this crash include fatigue and trouble focusing. Some people may describe this feeling as “zombie-like.”
How they can cause depression: Stimulant medications increase the level of dopamine in the body. Researchers believe that prolonged exposure to higher levels of dopamine may cause depression.
If your ADHD medication is not working anymore, it could be due to several reasons: the dosage may be incorrect; adherence may be an issue; co-existing disorders may impede the medications effectiveness or the patient may have another medical condition producing ADHD-like symptoms 3,4 (i.e., infection-triggered ...
When the dosage is too high, stimulants can cause children or even adults to seem “spacey” or “zombie-like,” or to be uncharacteristically tearful or irritable (a condition known as emotional lability). In general, the best way to rein in these side effects is simply to lower the dosage.
Daily dosage above 60 mg is not recommended. Adults: Average dosage is 20 to 30 mg daily. Administer orally in divided doses 2 or 3 times daily, preferably 30 to 45 minutes before meals. Maximum total daily dosage is 60 mg.
Problem: ADHD Medication Doesn't Work
The most common reason for this lack of response is an incorrect ADHD diagnosis. Maybe your child's behaviors are caused by an academic problem, such as a learning disability (LD) — maybe you suffer from a mood disorder or an anxiety disorder, not adult ADHD.
The most beneficial advantage that stimulants have over non-stimulants is that it is fast acting and you may see improvement in overall impulsivity and ADHD symptoms within two hours. Short acting meaning medications effectiveness stops working once an individual stops taking them. Reduced side effects.
The following are some common signs that ADHD medication should be adjusted: irritability or increased hyperactivity when the medication is in a child's system. consistent weight loss or problems with appetite.
Stimulant drugs are fast-acting, effective, and the first-line treatment for ADHD. However, these drugs may increase anxiety symptoms, making nonstimulants a suitable option for people with ADHD and anxiety. Examples of stimulants include amphetamines and methylphenidate.
Psychostimulant treatment of the core symptoms of ADHD is often linked to a beneficial effect on emotion dysregulation and should be considered the first line of treatment. Atomoxetine also appears effective for symptoms of ADHD and emotion dysregulation.