How Do ADHD Agents Work?

Attention deficit hyperactivity disorder (ADHD) agents are medications prescribed to manage ADHD symptoms such as lack of attention, hyperactivity, and impulsive behavior. ADHD medications work on the central nervous system to improve concentration and reduce impulsive and hyperactive behaviors.

ADHD medications work in different ways to improve ADHD symptoms. The main types of ADHD medications include:

• Stimulants: Stimulants increase the levels of two neurohormones (catecholamines) dopamine and norepinephrine in the brain. Catecholamines regulate attention, thinking, pleasure and movement. Increased catecholamine levels enhance brain activity and improve alertness and concentration.
  • Stimulants also increase heart rate, blood pressure, blood glucose, and dilate respiratory tubes. Stimulants are the most commonly used ADHD medications, but they have potential risk for abuse.
• Alpha-2 agonists: Alpha-2 agonists stimulate protein molecules known as alpha-2 receptors in the central and sympathetic nervous system, which reduces the release of norepinephrine. Alpha-2 agonists decrease blood pressure, inhibit pain transmission, and have sedative effects which reduce impulsive behavior and hyperactivity.
• SNRIs: Selective norepinephrine reuptake inhibitors (SNRIs) work similar to stimulants, but increase only norepinephrine levels in the brain by inhibiting their reabsorption (reuptake).

ADHD agents are mostly taken orally as tablets, suspensions, or capsules. ADHD medications are available as skin patches and administered an epidural infusion to treat cancer pain that is not relieved by opioid analgesics.

In addition to treating ADHD, some of the ADHD medications are used to treat the following conditions:

Stimulants

• FDA-approved:
  • Narcolepsy, a sleeping disorder
  • Obesity
  • Binge eating disorder
• Alpha-2 agonists
• FDA-approved:
  • Hypertension
  • Cancer pain
• Orphan designation:
  • Tourette’s syndrome, a nervous system disorder that causes tics and involuntary sounds
  • Fragile X syndrome, a genetic condition that affects brain development
• Off-label uses:
  • Alcohol withdrawal
  • Smoking cessation
  • Heroin withdrawal
  • Opioid withdrawal
  • Migraine prophylaxis
  • Restless leg syndrome
  • Tourette’s syndrome
  • Cyclosporine nephrotoxicity
  • Menopausal flushing
  • Dysmenorrhea
  • Postherpetic neuralgia
  • Psychosis
  • Pheochromocytoma diagnosis

Side effects of ADHD agents may include the following:

• Anorexia (loss of appetite)
• Infections
• Abdominal pain
• Xerostomia (dry mouth)
• Headache
• Insomnia
• Fatigue
• Irritability
• Emotional lability (mood swings)
• Agitation
• Anxiety
• Dizziness
• Nervousness
• Anger and aggression
• Depression
• Euphoria
• Hyperactivity
• Dysphoria (unease)
• Dermatillomania (skin picking)
• Dyskinesia (involuntary movements)
• Logorrhea (excessive talking)
• Paresthesia (prickling or crawling sensation)
• Hypesthesia (numbness)
• Exacerbation of Tourette’s syndrome
• Bruxism (teeth grinding)
• Tremor
• Vertigo
• Asthenia (weakness)
• Somnolence (drowsiness)
• Hypokinesia (slow movements)
• Sedation
• Confusion
• Hallucination
• Nightmares
• Seizure
• Accidental injury
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Dyspepsia (indigestion)
• Dysgeusia (taste disorder)
• Angina (chest pain)
• Ventricular hypertrophy (thickening of ventricular walls)
• Palpitations
• Hypertension (high blood pressure)
• Tachycardia (rapid heartbeat)
• Cardiomyopathy (heart muscle disease) with chronic use
• Myocardial infarction (heart attack)
• Cardiac arrhythmia (irregular heartbeat)
• Changes in pulse rate
• Hypotension (low blood pressure)
• Postural hypotension (drop in blood pressure when standing up from sitting or lying down)
• Atrioventricular block
• Bradycardia (slow heartbeat)
• Rebound hypertension
• Hypertensive encephalopathy (brain dysfunction due to high blood pressure)
• Syncope (fainting)
• Cerebrovascular accident
• Cerebral arteritis (inflammation of cerebral arteries)
• Cerebral occlusion (block)
• Cerebral hemorrhage
• Vasculitis (inflammation of blood vessels)
• Sudden death (rare)
• Nasal congestion
• Epistaxis (nasal bleeding)
• Allergic rhinitis (inflammation of the nasal passage)
• Sinusitis (inflammation of the sinuses)
• Throat pain
• Nasopharyngitis (inflammation of nasal passage and pharynx)
• Streptococcal pharyngitis (inflammation of pharynx from bacterial infection)
• Cough
• Dyspnea (shortness of breath)
• Upper respiratory tract infection
• Weight loss with stimulants
• Weight gain with alpha-2 agonists
• Hyperhidrosis (excessive sweating)
• Hot flashes
• Hypersensitive reactions such as:
  • Rash
  • Urticaria (hives)
  • Pruritus (itching)
  • Dermatitis
  • Angioedema (swelling in the tissue under the skin or mucous membranes)
  • Anaphylaxis (severe allergic reaction)
  • Erythema multiforme (round lesions like a bullseye)
  • Exfoliative dermatitis (redness and peeling of the skin)
  • Stevens-Johnson syndrome (a rare medical emergency with flu-like symptoms and a painful rash)
  • Toxic epidermal necrolysis (a severe skin condition with widespread redness, skin cell death, and exfoliation which can lead to sepsis)
• Alopecia (hair loss)
• Exfoliation
• Blurred vision
• Diplopia (double vision)
• Difficulty focusing
• Mydriasis (dilated pupils)
• Reduced blood count conditions such as:
  • Pancytopenia (decrease in all types of blood cells)
  • Thrombocytopenia (decrease in platelet count)
  • Thrombocytopenic purpura (easy bruising and bleeding due to thrombocytopenia)
• Back pain
• Leg cramps and pain
• Fever
• Malaise
• Pallor
• Edema
• Impotence
• Changes in libido
• Frequent/prolonged erections
• Erectile dysfunction
• Pelvic pain
• Menstrual disorder
• Urinary tract infection
• Urinary retention
• Urinary incontinence
• Frequent urination
• Nocturia (frequent urination at night)
• Raynaud phenomenon (a disorder that causes reduced blood flow to the extremities)
• Arthralgia (joint pain)
• Myalgia (muscle pain)
• Muscle tightness and cramps
• Muscle twitching
• Rhabdomyolysis (breakdown of skeletal muscle cells)
• Serotonin syndrome
• Abnormal liver function
• Elevated liver enzymes
• Liver damage and failure
• Eosinophilic hepatitis
• Problems with growth and development in pediatric patients

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of ADHD drugs include:

• Adderall XR
• Adhansia XR
• Adzenys ER
• Adzenys XR-ODT
• amphetamine
• amphetamine/dextroamphetamine
• Aptensio XR
• atomoxetine
• Azstarys
• Catapres
• Catapres-TTS
• clonidine
• Concerta
• Cotempla XR-ODT
• Daytrana
• Dexedrine
• dexmethylphenidate
• dextroamphetamine
• Duraclon
• Dyanavel XR
• Evekeo
• Evekeo ODT
• Focalin
• Focalin XR
• guanfacine
• Intuniv
• Jornay PM
• Kapvay
• lisdexamfetamine
• Metadate
• Metadate CD
• Metadate ER
• Methylin
• methylphenidate
• Mydayis
• Qelbree
• QuilliChew ER
• Quillivant XR
• Ritalin
• Ritalin LA
• Ritalin SR
• serdexmethylphenidate/methylphenidate
• Strattera
• viloxazine
• Vyvanse