They are drugs that are used to improve the symptoms of attention deficit disorder with / without hyperactivity (ADHD): lack of attention, difficulty to be still and quiet and to control impulses.
The most important are four: the methylphenidate, the Lisdexamfetamine, the atomoxetine and guanfacine. All act on certain substances that are in the brain, called neurotransmitters. These are needed in adequate quantities for the proper functioning of it.
The Methylphenidate and Lisdexamfetamine are stimulants of the central nervous system (CNS) and increase levels of dopamine.
How are they used?
The Methylphenidate is started at low doses and will gradually increase every week until the desired effects. You can start with immediate-release tablets, whose effect lasts about 4 hours, and are given 2-3 times a day, with or after meals. Once the effect has been gained, it is continued with that dose or it can be changed to a long-acting preparation, to be given only once a day (in the morning). The different possibilities for sale are:
- “Prolonged” release capsules or “modified”. The first ones are taken with breakfast or later, and the second ones before. Its effect lasts about 8-10 hours.
- Prolonged-release tablets. They can be taken with or without food. Its effect lasts about 12 hours.
Prolonged-release tablets must be swallowed whole, without splitting or chewing. The extended-release capsules can be opened and pour the powder into yogurt. The immediate release tablets can be broken. It’s good to drink water later.
The Lisdexamfetamine also starts at low dose and is increased each week, until the desired effects. It is taken once a day, in the morning, with or without food.
The Atomoxetine is given from the beginning to the dosage but the desired effects may take 4 to 8 weeks to be. They are capsules that are swallowed whole, once a day and their action is maintained up to 24 hours.
The Guanfacine is started at low dosages and may be increased each week, until the desired effects. It is taken once a day, in the morning or at night. It can be taken with or without food, but it can not be chewed, crushed or broken before swallowing.
What problems can they produce?
– Methylphenidate and Lisdexamfetamine: The most frequent side effects are mild and, almost always, transient. Among them are: bad appetite, weight loss and abdominal discomfort, headache, dizziness, difficulty sleeping, irritability, agitation and mood swings.
There are other more serious but very rare, such as allergic reactions, joint pain, blurred vision, chest pain and palpitations, tics and seizures. Methylphenidate and lisdexamfetamine can be habit-forming and should not be given if there is a history of substance abuse.
– Atomoxetine: the most frequent side effects are mild and usually disappear. Among them are: dizziness, headache, difficulty sleeping, dry mouth and constipation, poor appetite, weight loss and abdominal discomfort.
There are other more serious and also very rare, such as allergic reactions, depression, behavior disorders, chest pain and palpitations … It is necessary to watch closely if there are suicidal ideas (desire to hurt oneself).
– Guanfacine: the most frequent side effects are mild and usually disappear. Among them are: drowsiness, sedation, dry mouth, hypotension and weight gain.
What precautions should I have?
Before starting treatment, you must inform the doctor of the child’s and your family’s previous illnesses, because with some of them it is better not to take these drugs: heart disease, glaucoma, hypertension, hyperthyroidism and psychiatric problems.
During the treatment, follow-up visits are used to check the beneficial effects of the drug and if it has had undesirable effects. Above all, weight and height, blood pressure and heart rate will be monitored.
The drug should always be taken at the same time and not interrupt abruptly its administration.