• Medication
  • What to expect
    • Honeymoon phase
  • Common Concerns
    • I have a friend who turned into a zombie on Adderall
    • It’s going to wreck my creativity
    • Taking stimulants feels like cheating at school/work
    • I heard it’s addictive
  • What to talk about at a meds check-in
  • Side effects
    • Temporary mild side effects are normal
    • What makes a side effect mild?
    • Signs that a dose might be too high for you
  • What “meds are dialed in” means

Medication

What to expect

• improved self-control of attention/behaviour/movement that’s stable over time
• temporary mood/energy changes that tend to fade over time
  • do not confuse mood/energy changes for adhd symptom effectiveness
• pills don’t build skills, but do give a more solid foundation to start on
  • extra split second to decide to do the right thing
  • may find it easier to put good ideas into practice, even if you’ve e.g. failed to consistently use a planner before
• not a replacement for food, water and sleep
  • medication does not work as well when hungry, dehydrated and/or underslept
  • may help you make these things a more consistent part of your life!
• medication doesn’t fix stress directly, and stress makes it hard to concentrate

Longer term, you may find that you’ve made enough progress on the ADHD that it becomes clear that there’s something else (like anxiety, trauma, or not knowing how to study) that’s causing difficulty, too. That’s ok, too!

Honeymoon phase

• some people feel a mood boost the first time they try meds
  • “I feel so great OMG I can do anything I’m so calm!!!”
  • “I feel new hope that I can turn my life around!”
• some people don’t. That’s perfectly normal too
• are you experiencing it?
  • enjoy it!
  • work on habits that will continue to serve you once getting things done is no longer novel and interesting

Common Concerns

I have a friend who turned into a zombie on Adderall

Sounds like it was a bad medication/dose combo for them. Keep in mind that not a lot of people post their success stories on the internet, and how hard it might be for a parent and child to navigate dosing. Most of the people with these stories were diagnosed and medicated as children. Adults are better equipped to articulate “this isn’t right, doctor. I think something needs to change.”

It’s going to wreck my creativity

• some people do experience this
• others found their creativity unaffected and were better able to execute on their ideas when medicated
• if you’re getting this side effect, and loss of creativity is unacceptable in your life, you can talk to your prescriber about trying something else (possibly a different kind of medication or a different dose)

Taking stimulants feels like cheating at school/work

You’ll still need to put in the effort to learn study skills and Do The Things. Do you know anybody who needs glasses? Are they cheating? ADHD is nearsightedness to the future.

I heard it’s addictive

Personally, I would be sad if I lost access to prescription glasses. I would struggle more and grieve the loss of something that helped me navigate the world, but I wouldn’t lie or cheat or steal or break the law to get another pair. I feel the same way about my glasses as I do my stimulant medication.

That being said, even though statistically, ADHD medication does not increase the risk of substance use disorders, I do know people with stimulant abuse problems. If you have a history that suggests that stimulant abuse is a realistic concern for you, it would be good to have a conversation about that with your provider. There are other options (including non-stimulant ADHD meds like Strattera). The cure isn’t supposed to be worse than what you’re trying to fix.

What to talk about at a meds check-in

Make it easy to jot things down right when you notice them. Keep all your notes in one place. Bring the notes with you!

1. What new good things have you noticed?
   • At what time of day?
2. What new bad things have you noticed?
   • At what time of day?
3. What time of day do you take meds? How consistently?
4. When is the medication effective? Does that work with your schedule?

Side effects

Temporary mild side effects are normal

• not necessarily a sign that the medication won’t be right for you
• often go away after ~2 weeks (appetite changes may take longer; ~4 weeks)
• what makes a side effect mild?
  • you can work around it
  • you can tolerate it until your next check-in
  • it’s not making a big negative impact on your life

What makes a side effect mild?

Your mileage may vary, but these are some examples of things I would tolerate and things I wouldn’t.

• increased heart rate
  • mild: like you went for a brisk walk
  • concerning: feels like your heart is going to beat out of your chest
• cold feet/hands
  • mild: you put on socks and it was fine
  • concerning: they’re turning blue
• dry mouth
  • mild: you have to remind yourself to drink more water
  • concerning: you’re so dehydrated you can’t think clearly
• decreased appetite.
  • mild: much less snacking, and you had to set alarm reminders, but you’re still eating meals
  • concerning: you have no energy to do things and you’re going into anxious spirals from the hunger. You lost weight you couldn’t afford to lose.
• sleep changes
  • mild: it’s a little harder to fall asleep at night
  • concerning: the sleep deprivation is impacting your ability to work/study/take care of yourself

Signs that a dose might be too high for you

Don’t wait until your appointment! Contact prescriber early (call or text) about these side effects.

• more irritable and short-tempered to the point your friends and family notice
  • and, for people who menstruate, not explainable by PMS
• feeling wired and tired at the same time; unable to rest to fix the tiredness
• feeling like a zombie with blunted feelings
• your memory is somehow worse than it is off adhd meds
• vomiting
• any other unpleasant side effects that you could not put up with for 1-3 weeks or your next medication check-in (whichever is sooner)

What “meds are dialed in” means

• improvement in symptoms and general life functioning
  • did you come in because you couldn’t handle school? Can you handle school now?
  • are you able to work on building good habits and learn coping skills, even if your symptoms aren’t totally gone?
• going up in dose would make things worse. For example:
  • same amount of symptom relief, more side effects
  • more symptom relief, unbearable side effects

If lower doses weren’t helpful, the current dose is too high, and you’re still not getting good effects, consider asking to switch to a different medication.