ADHD drug raises concerns about side effects on human health

Attention Deficit Hyperactivity Disorder (ADHD) is a condition that can impact individuals at any stage of life. While medication isn't the only treatment option, it’s often the one that brings the most noticeable improvements for those who struggle with focus, staying still, or controlling impulses.

But once you've found the right medication for yourself or your child, is it something you should continue taking indefinitely? Here's what to keep in mind.

What Are Medications for ADHD?

The primary medications used to treat ADHD are stimulants, such as methylphenidate (commonly known by brand names like Ritalin and Concerta) and dexamfetamine.

Another option is lisdexamfetamine (brand name Vyvanse), which is a “prodrug” of dexamfetamine, meaning it includes an attached protein molecule that. is removed in the body to release the active drug.

Non-stimulant medications, like atomoxetine and guanfacine, are also available, though they are prescribed less frequently. 

While these can be highly effective, they are sometimes prescribed by general practitioners (GPs), but may not always be covered under the Pharmaceutical Benefits Scheme.

How Stimulant Medications Work

Some stimulants prescribed for ADHD are "short-acting," meaning their effects begin within about 20 minutes and last around four hours.

Longer-acting stimulants provide a more extended effect by releasing the medication gradually. The choice between short- or long-acting stimulants depends on whether the individual prefers a once-daily dose or wants to target the medication’s effects for specific tasks or times.

For most stimulants (except possibly lisdexamfetamine), there is little to no carry-over effect into the next day, meaning ADHD symptoms may be more noticeable until the morning dose takes effect. A key goal of treatment is for individuals with ADHD to live their best life and reach their goals. 

For young children, parents weigh the risks and benefits of treatment on their behalf, but as children grow older, they play a larger role in the decision-making process.

What Are the Potential Side Effects?

The most common side effects of stimulant medications for ADHD include appetite suppression, leading to weight loss. In children, this can temporarily slow growth and slightly delay puberty. Stimulants may also increase heart rate and raise blood pressure, and they often cause insomnia.

Most of these effects are reversible once the medication is stopped. However, there is some

 concern that even small increases in blood pressure could speed up the progression of heart disease, potentially causing heart attacks or strokes to occur slightly earlier in life for those on long-term medication.

This doesn’t mean older adults should avoid ADHD treatment. Instead, they should be informed of the risks to make educated decisions and ensure that symptoms like high blood pressure or chest pain are promptly addressed.

Stimulants can also cause stomachaches or headaches, which may improve over time or with a dose reduction. 

Although there have been reports of stimulants being misused by students, there is limited research on the long-term risk of prescription stimulant dependence.

Is Long-Term Medication Necessary?

Although ADHD can impact a person's functioning throughout their life, most individuals discontinue medication within the first two years.

People may stop taking it because they dislike how it affects them or prefer not to rely on medication. Their limited time on medication may have helped them gain a better understanding of themselves and improved their ability to manage their ADHD.

For teenagers, the medication might become less effective as they outgrow their dosage, leading them to stop taking it. This should be distinguished from tolerance, which occurs when a dose becomes less effective, resulting in only temporary improvements even with increased doses.

Tolerance can be managed by taking short breaks from the medication, switching to a different stimulant, 9or opting for a non-stimulant alternative.

Are There Too Many Prescriptions?

ADHD is increasingly recognized, with diagnoses rising among 2–5% of adults and 5–10% of children. 

In Australia, stimulant medications are tightly regulated and primarily prescribed by specialists, such as pediatricians or psychiatrists, although this varies by state. As the number of cases grows for this lifelong condition, there simply aren’t enough specialists to accommodate everyone.

A Senate inquiry report released in November addressed the challenges faced by individuals seeking ADHD assessment and support services, highlighting their urgency for treatment.

In New South Wales, legislative changes are already underway that may allow more general practitioners (GPs) to treat ADHD. Enhanced training could help GPs feel more confident in managing the condition, either through shared-care arrangements or through independent management, similar to a model currently being piloted at Nepean Blue Mountains Local Health District, where GPs receive training in an ADHD clinic (where I serve as a specialist clinician).

While not every individual with ADHD will need or desire medication, it should be more accessible for those who may benefit from it.

In conclusion, while medications for ADHD can significantly improve focus and overall functioning, they also raise valid concerns regarding potential side effects on human health. Issues such as appetite suppression, increased heart rate, and the risk of dependency underscore the importance of careful monitoring and open communication between patients

and healthcare providers. As more individuals are diagnosed with ADHD, it is essential to balance the benefits of medication with awareness of its risks.

 Ultimately, informed decision-making and ongoing evaluation of treatment plans can help ensure that those with ADHD receive the support they need while minimizing adverse effects on their health.