I am writing this as a follow-up to a prior entry which compared medications commonly used to treat ADHD. I again begin with the declaration that I am not a physician, but our work with children and adults has brought me into regular contact with ADHD medications and their effects.

As the previous blog explained, there are chemical differences between the common ADHD medications. While chemically different, the medications do share a common set of potential negative side effects. In our experience the most common are: loss of appetite, decreased sleep, and increased irritability or mood changes. Less prevalent but still noted often enough to be considered as potential side effects are: headaches, dizziness, dry mouth, nausea, and tics. These can decrease across time. It is up to the informed consumer to weigh the degree of benefit against the degree of negative side effects relative to their individual situation. The ideal case is, of course, all benefit and no negative side effects, but in our experience most psychotropic medications cause some type and degree of unwanted side effect. There are, of course, common sense ways to try to decrease negative side effects. For example, if loss of appetite is noted, one can plan a good healthy meal for the time of day that the medication effect is wearing off. Also, one can see that healthy snacks are available for whenever the individual in question feels at all hungry.

While the psychostimulants share common potential negative side effects, different medications can have differing effects on any one individual. So, just because you cannot tolerate a methylphenidate does not mean that you would not tolerate an amphetamine salt. This, of course, has led to the “trial and error” method of prescribing a medication. Another note on side effects: What are listed are the “common” side effects. Everyone’s brain is different. Whenever you start taking any medication it is advisable to monitor yourself for any unexpected changes you might experience and to contact the prescribing physician if you notice anything that seems to correspond to when you began to take the medication.

A potential way to decrease the trial and error process is emerging. This is the qEEG (quantitative electroencephalogram), which is described elsewhere in this website. In brief, this is a way to measure the electrical activity in a person’s brain and compare their activity against a normative database. How this can be relevant to ADHD and ADHD medication is as follows. First, for simplicity sake, let us say that brain waves are composed of slow waves and fast waves. The most common form of ADHD in terms of brain waves involves an excessive amount of slow-wave activity in certain areas of the brain. As it turns out, psychostimulant medication is known to decrease slow-wave activity and increase fast-wave activity. This is great if you are dealing with a case of excess slow-wave activity and no other “abnormalities.” But, what if the person also happens to have excess fast-wave activity to begin with. You give them a psychostimulant and now they have even more fast-wave activity, which raises the probability of unwanted side effects emerging. A qEEG can help to guide the safe and effective prescribing of medication. This is an emerging science, so it certainly has its limitations, but it is something to consider based on your situation.