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How do people with ADHD feel on stimulants?

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Stimulant medications like methylphenidate (Ritalin) and amphetamine-dextroamphetamine (Adderall) are commonly prescribed to treat ADHD. These stimulants work by increasing the brain’s dopamine and norepinephrine levels, which helps improve focus and concentration in people with ADHD.

But how exactly do stimulants make people with ADHD feel? Here’s a look at some of the common experiences and effects.

More focused and clear-headed

One of the main reasons stimulants are prescribed for ADHD is they help increase a person’s ability to focus. About two-thirds of people with ADHD report feeling more focused and clear-headed when taking stimulants.

Stimulants appear to enhance focus and concentration by altering activity in the prefrontal cortex, the part of the brain involved in attention, organization, planning, and impulse control. This allows people with ADHD to hone their attention, avoid distractions, and improve organization and planning.

Improved motivation and drive

In addition to focus, many people with ADHD report feeling more motivated and driven when taking stimulants. This is likely related to the increase in dopamine, which is associated with motivation and task initiation.

By enhancing dopamine signaling, stimulants can help activate the brain’s reward system and pleasure centers. This gives people with ADHD more drive and initiative to complete tasks and achieve goals.

Calmer and less impulsive

Impulsivity is a core characteristic of ADHD. Stimulants can help reduce impulsive behaviors by improving regulation of impulses.

People with ADHD often describe feeling calmer, less jittery, and less erratic when taking stimulants. There tends to be an overall smoothing out of sudden mood changes.

This calming effect likely occurs because stimulants also increase norepinephrine levels. Norepinephrine is thought to play a role in mood regulation.

Reduced hyperactivity

Hyperactivity is another hallmark of ADHD, characterized by excessive movement, restlessness, and fidgeting. Up to 75% of people with ADHD notice a decrease in hyperactive symptoms like fidgeting when taking stimulants.

Stimulants seem to target areas of the brain involved in regulating and controlling movement. This leads to a reduction in excessive motor activity.

Improved working memory

Many people with ADHD struggle with working memory, which is the ability to temporarily store and manipulate information. For example, forgetting instructions easily or losing track of what you’re doing.

Studies show stimulants may improve certain components of working memory. As many as 30-50% of those taking stimulants report better working memory.

Increased wakefulness

Excessive daytime sleepiness affects up to 70% of adults with ADHD. Stimulants can improve wakefulness by increasing activity in arousal centers in the brain.

If lack of energy and sleepiness are an issue associated with your ADHD, stimulants may help you feel more alert and awake during the day.

Improved ability to start and finish tasks

ADHD can make it hard to not only focus on tasks, but start tasks and follow through to completion. The increase in motivation and focus from stimulants also translates to an improved ability to initiate and complete tasks.

Starting projects you’ve been putting off suddenly feels easier. You’re able to sustain focus better to finish up tasks you start.

Decreased negative emotions

Some research shows stimulants may decrease negative emotions in those with ADHD, including irritability and mood swings. There are a few reasons stimulants may improve mood:

  • Increase in dopamine improves reward signaling and motivation.
  • Norepinephrine increases help regulate emotion centers in the brain.
  • Accomplishing more and staying on task reduces frustration.

Common side effects

While stimulants provide benefits for many people with ADHD, they also come with potential side effects including:

  • Loss of appetite – Stimulants may cause decreased appetite and weight loss.
  • Trouble sleeping – Taking stimulants too late in the day can interfere with sleep.
  • Stomach upset – Some experience nausea, vomiting, or stomach pain.
  • Headaches
  • Mood changes – Some report feeling irritable, anxious, or depressed.
  • Fast heart rate and increase in blood pressure.

The benefits of stimulants typically outweigh the risks when taken as prescribed. But it’s important to let your doctor know if side effects are interfering with your daily life.

Effects of stimulants on people without ADHD

Stimulants affect people with ADHD differently than those without ADHD. In people with ADHD, stimulants enhance function of underactive brain areas. In people without ADHD, stimulants may overstimulate normal functioning parts of the brain.

In those without ADHD, stimulants may cause:

  • Euphoria and excessive energy
  • Heightened sense of well-being
  • Improved focus for 4-6 hours
  • Loss of appetite
  • Trouble sleeping
  • Increase in blood pressure and breathing rate

These effects make stimulant drugs more likely to be misused by those without ADHD. Taking high doses can also lead to dangerously high body temperatures and irregular heart rhythms.

Duration of effects

How long stimulant effects last depends on the formulation:

  • Short-acting – Effects last about 4-6 hours. Examples are short-acting Ritalin and Adderall.
  • Intermediate-acting – Effects last about 6-8 hours. Example is Ritalin SR.
  • Long-acting – Effects last about 10-12 hours. Examples include Concerta and Adderall XR.

Stimulants tend to be most effective about 1-2 hours after taking them. The effects diminish as they are cleared from the body.

Getting used to stimulants

The first few days on stimulants may not reflect how you’ll feel in the long-term. It can take 3-4 weeks for the body to get used to stimulants and for the effects to stabilize.

For example, side effects like loss of appetite and trouble sleeping tend to improve within 1-2 weeks. Pay close attention to any side effects, but give your body time to adjust.

Developing tolerance

Over time, some people develop tolerance where they require higher doses to get the same focus-enhancing effects. This doesn’t happen with everyone, but may occur in about one-third of people taking stimulants for ADHD long-term.

If you feel like your medication has stopped working as well, talk to your doctor. They may adjust your dosage or switch you to another stimulant medication.

To reduce tolerance, some people take “drug holidays”, such as skipping their medication 1-2 days per week or month. Check with your doctor before making any changes.

When stimulants may not help

While stimulants are effective for about 70% of people with ADHD, they aren’t right for everyone. You may not experience the desired benefits if you have:

  • A type of ADHD not characterized by inattention and hyperactivity. For example, the predominantly inattentive subtype may respond better to non-stimulants.
  • Certain medical conditions or disorders that are exacerbated by stimulants.
  • An underlying mental health condition like anxiety, depression, or bipolar disorder that requires other medications.

Stimulants should never be used alone to treat ADHD. Behavioral interventions, counseling, and non-stimulant medications should also be incorporated into a comprehensive treatment plan.

Considerations for children

The effects and side effects of stimulants are basically the same in children as adults. But there are extra considerations when giving stimulants to younger kids:

  • Effects like reduced appetite may impact growth and weight gain in children, so their height and weight should be routinely tracked.
  • Stimulants may initially cause children to seem “zoned out”, before the beneficial effects are observed.
  • Paradoxical effects can occur in children like increased activity, irritability, and crying.

Children should start stimulants at much lower doses that are gradually increased. Ongoing monitoring for positive effects and side effects is crucial.

Bottom line

Stimulant medications can provide significant relief to those with ADHD by enhancing focus and concentration, boosting motivation, and reducing hyperactivity, impulsivity, and distractibility.

But stimulants affect everyone differently. Some may experience mild side effects or none at all. For others, bothersome side effects may outweigh the benefits.

Starting stimulants requires close monitoring and open communication with your doctor. Finding the right medication and dose for your ADHD symptoms takes time, patience, and adjustments.