The Low Down on ADHD Medication Effectiveness

On average, some treatments are more effective than others.  This post provides specific details.

Getting good treatment for ADHD is a process of experimenting with the different treatment options, as different individuals respond quite differently to the different treatments options.  Some, like my daughter, find that stimulant medications work well for them.  Some, like my husband, cannot tolerate stimulants at all (he takes an anti-depressant to manage his ADHD symptoms.)

Most adults (50-65%) will eventually find a medication that can significantly improve their ADHD symptoms without significant side effects, with another 20-30% able to find medications that will help them somewhat.  So even if you don't like the first (or second) medication you try, keep experimenting, as chances are that you will find something that will help.  Of course some people (Dr. Hallowell is one of them) never do find an ADHD medication that they can tolerate.  They have to use other methods of managing ADHD.  (Did you know that one reason Dr. Hallowell writes so many books is that the process of doing so helps him manage his ADHD symptoms?  How's that for an interesting treatment?!)

As important as the kind of medication you take is the dose.  Research suggests that stimulant medications at the dose optimized for that particular patient are more than twice as effective as stimulants given at just a "standard" dose.  That's a big deal?  Why the disparity?  Metabolism, stress, and gut health all play a role in how quickly and efficiently you ingest a medication.  In addition, different medications have different release schedules, so there is a lot of variation between the options.

Treatment effectiveness is measured in "effect size," and you can get a good overview of the effectiveness of many ADHD treatment options at this link.  These numbers show quite clearly that on average, some treatments are more likely to help you than others.  However, remember that these are averages.  Some people really respond much better or worse than average to a specific treatment.

Further, a research study is about to be published about the combination of different levels of medication combined with different levels of behavioral therapy.  The study shows that the combination of medication and behavioral therapy is better than any individual therapy (another way of saying "pills don't teach skills" and acknowledging it's really hard to stay on task when you don't have the assistance of incremental dopamine that medications provide.)  Interestingly, it also suggests that the combination of lower levels of medication combined with behavioral therapy may be the most effective of all.

As part of the introduction to my new book, I am about to put an online treatment guide for ADHD on this website (should be up before April 15).  This treatment guide will provide what I think is the most relevant information about treatment of ADHD for couples.