ADDitude.com

Authors: ADDitude.com

Should my child take a stimulant medication like Concerta or Adderall? Or a non-stimulant like Strattera or Intuniv? Why is Vyvanse so popular? Is Evekeo gaining traction? How can I weigh all of our ADHD medication options effectively?

We hear these questions — and others like them — often from parents who are wrestling with the decision to medicate or working with a physician to monitor and adjust a treatment plan for side effects. For many of them, our answer is the same: Every child is different and there is no ‘right’ answer; the best medication for your child will be revealed only through trial and error.

We saw this trial and error in living color when ADDitudesurveyed 4,425 readers in August 2017 to learn more about the most common and effective forms of ADHD treatment today. In that survey, we learned that:

  • The most common age of diagnosis is 7 (nearly 8) years old
  • Most of our survey respondents said their child was diagnosed 3-4 years earlier
  • 83.48% of children had tried at least one medication since diagnosis
  • Of those, each child had tried 2.2 medications, on average

We asked respondents to tell us which medication(s) their child had ever used to address symptoms of attention deficit disorder, and learned that Concerta is the most used ADHD medication for children, by far, followed by Adderall, Ritalin, and Vyvanse.

Of course, the data below reflects a long time window; one-third of survey respondents had a child diagnosed more than five years earlier. Among patients diagnosed within the previous year, Concerta, Adderall, and Vyvanse were in a dead heat with a new class of generics that have recently hit the market.

MOST COMMONLY USED ADHD MEDICATIONS EVER USED BY CHILDREN

MedicationClass% Who Have Used It
ConcertaMethylphenidate42.28%
AdderallAmphetamine37.54%
RitalinMethylphenidate32.37%
VyvanseLisdexamfetamine32.22%
FocalinDexmethylphenidate21.63%
StratteraAtomoxetine18.58%
DexedrineDextroamphetamine3.73%
EvekeoAmphetamine Sulfate0.97%
Other meds29.37%

We also asked survey respondents to rate the efficacy of these top ADHD medications — specifically, we asked: “Overall, how effective would you say each medication was at managing ADHD symptoms?”

Below, we see that the medication used by the fewest households surveyed — Evekeo — was rated extremely or very effective by the greatest percentage of caregivers. The second most effective, according to our readers, were ‘other medications,’ which primarily included Intuniv, guanfacine, Quillivant/Quillichew, and Biphentin. (We were not able to assign specific efficacy ratings to each of those ‘Other’ medications in this particular survey.) Following closely behind was Vyvanse, which is also one of the most commonly used.

It’s also worth noting that the medication rated most effective was also ranked the second least effective, right after Strattera. This may be due to the small sample size of caregivers who have administered Evekeo — just 20, compared to the 874 who have tried Concerta or the 666 who have tried Vyvanse. Here, again, ‘other meds’ emerges a clear winner that deserves more study and analysis.

As the comments below suggest, a medication’s effectiveness is tied very closely to its side effects — or lack thereof. So we asked survey respondents to report the the prevalence of three common side effects — irritability, sleep disturbances, and dampened personality — with each of the following medications. The chart below shows the percentage of individuals who reported experiencing these side effects while on the each medication.

MOST AND LEAST EFFECTIVE ADHD MEDICATIONS ACCORDING TO CAREGIVERS

MedicationExtremely or Very EffectiveNot Very or Not At All EffectiveIrritability or MoodinessSleep DisturbancesDampened Personality
Evekeo55.56%27.78%5.56%16.67%5.56%
Vyvanse46.25%26.38%39.26%27.07%21.32%
Concerta44.65%22.52%34.10%32.69%22.48%
Focalin43.38%25.73%35.64%25.99%25.99%
Ritalin38.87%21.77%36.18%28.31%23.79%
Adderall38.09%26.25%43.79%31.53%23.54%
Dexedrine37.68%23.18%38.46%29.23%24.62%
Strattera14.66%50.15%32.12%20.61%18.48%
Other meds46.92%13.95%16.70%20.45%10.32%

COMMENTS ON EVEKEO

“Evekeo doesn’t seem to have side effects and it helps some with his focus.”

“Evekeo had same effects as Adderall. She began to lose weight and became irritable due to low blood sugar from not eating. Stopped it at beginning of summer but didn’t see an increase in ADHD symptoms.”

“Evekeo worked well on hyperactivity. No appetite. Increased irritability due to low blood sugar from not eating. Lost weight.”

COMMENTS ON VYVANSE

“Vyvanse has worked very well at the lower dosages with minimal side effects. [My son] has some loss of appetite, but not as much as with the Adderall. Although we’re on the long-acting Vyvanse, as he is getting older (he’s 12 now), it doesn’t seem to be lasting as long.”

“Vyvanse was effective immediately in minimizing impulsive/hyperactive behavior. However, he started complaining of feeling sick after about one week, so our pediatrician lowered the dose from 30mg to 20mg. This stopped the nausea. Also I prefer to say that, rather than lessening his appetite, the medication delays his appetite. He eats little during the day but is hungry from about 7:30 through to 9 at night.”

“The initial side effects of Vyvanse 20mg were lack of appetite and mild stomachs discomfort, however, both have subsided with time. At home the effects of being on the medication were subtle. The meds didn’t change [her personality], but seemed to help her to know when to reign things in before crossing over from funny to irritating.”

COMMENTS ON CONCERTA

“Concerta works well helping my child to control his impulsive behavior it also does the job in helping him to focus. He still gets some headaches now and then and he still had some appetite loss but it works better than the previous medication that we tried before.”

“[My son] is on 27mg of Concerta. He is well behaved at school. He is happy overall and doing better about completing homework. But he becomes overwhelmed easily with school work. He has no appetite during the day. He has trouble settling down for the night. He is grinding his teeth terribly in his sleep. We haven’t been giving it to him on weekends so he will eat. It’s nearly impossible to get him to do homework on weekends.”

“Concerta seems to be helping with impulse control and attention in school. She’s had a slight decrease in appetite, but only for lunch. She still eats a decent breakfast and dinner. No sleep issues on this medication.”

COMMENTS ON FOCALIN

“Focalin started helping the first day she took it. Mainly, it helps her focus to complete tasks. It decreased her appetite for a month, but then that symptom faded significantly. She has some rebound effect when it wears off. It works for about 6 hours every day.”

“Focalin worked well at a low dose with minimal side effects. As he grew, we again had to increase the dosage to achieve the needed behavior control. As the dosage increased, he became more irritable and angry, and this resulted in an increase in physical aggression, so we switched to Vyvanse.”

“Focalin managed the ADHD well with very minimal side effects. It also lasted entire day without needing a booster dose until he became a teen.”

COMMENTS ON RITALIN

“Ritalin has helped considerably with his ability to focus in school, and occasionally with impulsivity, but not with his ability to control his reactions if someone makes him mad. In addition, we are starting to feel that the loss of appetite caused by the medication is hindering that side of things, as when he’s hungry he’s far less able to control his reactions.”

“Ritalin helped my son immediately, as he was better able to focus and retain information. Unfortunately, he also becomes extremely withdrawn and meek when on this medication (not his typical personality!) So, many years later a new doctor that we met with added Sertraline to his regimen, and this made a HUGE difference! My son now has his ‘normal’ personality, but still has the benefits of increased focus and attention when taking Ritalin!”

“My daughter had extreme stomach upset and wouldn’t eat all day on Ritalin, even after being on the medication for several months. She had a hard time sleeping, and would sleep very little once on it. She also lost her ‘spunk’ and personality. She seemed very muted, and lacking emotion.”

COMMENTS ON ADDERALL

“Adderall has helped control my child’s ADHD symptoms, which in turn allowed him to be able to focus on learning and listening. It also allowed him to be able to recognize when he should calm down while not on his medication because he doesn’t take it during the summer. My son used to take 3 hours to do one page of homework, get in trouble for classroom disruptiveness, and be behind in reading. With the medication, and behavioral therapy, he is now in the gifted program at school, reads far above his grade level, doesn’t feel like his teachers are out to get him, and always gets his homework done promptly after getting out of school.”

“Adderall caused mild loss of appetite and mild increase in focus, but only at a higher dosage of 15mg. The higher dose caused increased irritability, mood swings, tantrums, more tics, and negative self thoughts, such as ‘Why am I such a bad person? Why can’t I be like everyone else?'”

“Adderall allowed her to be able to sit and focus on schoolwork. It did ruin her appetite though and she started losing weight. We would take breaks so she could eat more. It even changed her desire for some foods. After a while this subsided. When we upped the dosage, she developed a vocal tic so we lowered again and that went away after a while.”

COMMENTS ON DEXEDRINE

“Dexedrine has worked more effectively following a fair bit of experimentation with dosage to get the best effect. Too high a dose caused irritability.”

“Dexedrine really affected his appetite — lots of weight loss and changed personality.”

“On Dexedrine, my child was argumentative about everything.”

COMMENTS ON STRATTERA

“Strattera was overall effective in managing some symptoms, mainly some of the ODD, but didn’t specifically manage the ADHD symptoms that were hindering him at school.”

“Strattera made her very organized but stoic and somber…no emotion, more depressed.”

“Strattera worked well for about 6 months then we needed to add Intuniv. It is a gradual alleviating of ADHD issues but not the dramatic change you see with stimulants. Takes enough of the edge off so other therapies can work.”


Does this data help to predict a clear winner for your child? No. Should you adjust your child’s treatment plan based on these comments? Definitely not. But can they help overwhelmed parents better understand how other ADHD families are managing symptoms? Almost certainly.

Would you like to share your experience with an ADHD medication? Please find the medication here and submit a review that other readers can easily find.

Read more https://www.additudemag.com/adhd-medications-strattera-concerta-adderall-vyvanse-evekeo-ritalin-focalin-dexedrine/