This post was developed in collaboration with Adlon Therapeutics L.P, a subsidiary of Purdue Pharma L.P. Personal opinions expressed within this post are my own.
How to Take your Medication
Isn’t it interesting that we read so much about the different medications you can take for your ADHD but little- if anything- about how to take them? In fact, my daughter- just the other day- asked me about the antibiotics she was prescribed: “Mom, it says three times a day. Does that mean I have to wake up at 3am to take my last dosage?” (she gets up late in the morning these days, which means she has a late start with her medications).
Seriously: it’s extremely important to take your medications exactly as prescribed. Yet, few of us take the time to learn exactly how to do just that.
Some ADHD medications are short acting, leaving your system quickly, requiring a second (or more) dose during the day. Other medications are long-acting.
Some medications need to build up in your system, requiring you to take them consistently in order to be effective, but more importantly, some medications, if stopped abruptly, can lead to uncomfortable and even serious side effects.[1] It can all be very confusing.
These are just a few of the things you need to be aware of when taking your prescribed ADHD medications (or supervising your child’s medications), because if you are careless, it can lead to serious consequences. For example, stimulant medications are the most widely used ADHD medications.[2] Yet, it’s important to remember that this type of medication is a Schedule II controlled substance, which means that even when used as prescribed, stimulant medications have a high potential for abuse. Other risks associated with prescription stimulant medications can include misuse, diversion, severe psychological dependence and heart attack or mental health issues.[3],[4],[5],[6],[7]
The main thing to remember is, follow the instructions on the bottle to a “T” and if you’re unsure about any of the instructions, call your doctor!
Read the Bottle!
Let’s talk a bit more about how to take your ADHD medications safely and properly.
Most of us read just the one main line on the bottle that tells you how many pills to take, when to take them, and how often. Generally, it looks something like this:
Take one tablet daily in the morning.
How many of you read the fine lines on the label or study the insert that pharmacies are required to give you when you pick up your medications? Ok, put your hands down now and let’s go over why it’s important to take a more serious look at your bottle.
Medications can interact with other medications you’re taking, so it’s important to read those seemingly “boring” instructions that you typically toss in the garbage without a glance. No judgement! I do it myself! In fact, while writing this article, I looked at one of my own bottles and was shocked to read that I was taking my bedtime pill wrong- I’d been taking my thyroid medications at night instead of in the morning, meaning, they weren’t as effective in managing my condition. And I’d been doing this wrong for many years!
There’s lots of other information we all need to be aware of. For example, what are the potential side effects? Are there serious interactions with other medications you’re taking?
Also check to see if your medication has a black box warning. Prescription stimulants carry a boxed warning, and these should not be taken lightly, as they come directly from the Food and Drug Administration (FDA) and are some of the most important precautions we need to be aware of.
Another thing to look out for is if your current pills look different from the ones the pharmacy gave you just the month before- even if the name of the med is the same. Look more closely at the bottle. If the medication name is now different, it’s possible that:
- Your pharmacy switched you from a name brand to a generic (or vice versa), or
- Your pharmacy is purchasing your medication from a different manufacturer (generally this happens with generics).
This change could also be due to your medication insurance plan. At times, they will insist that you take a generic form of your medication. Either way, this could explain why your current pills might look different from your last prescription. If you’re unsure as to whether you’ve received the proper med, call your pharmacist directly with your concerns.
You can also check in with your doctor, especially if the name of the medication or the dosage information has changed. Let’s say your doctor has decided to change out your ADHD prescription to an entirely different medication. Or perhaps it’s the same medication but a different dosage or formulation (i.e. short-acting vs long-acting). It may be confusing to know if you should be taking it the same way as your last prescription. Instead of deciding yourself which way to go with this, it’s imperative that you call your prescriber or your pharmacist to make sure you’re taking your medication correctly.
Other Things to Consider
Since most ADHD medications are Schedule II controlled substances, refills are not allowed. They require a new prescription to be issued.[8]
Another common problem may be: not paying attention to when you are running low on your medication. If you don’t talk with your doctor in time to get a new prescription, you’re shocked to see that you’ve run out, which is another reason to keep your eye on the bottle: to see when you are running low on pills.
And here’s one I hear all the time: forgetting to even take your medications. Why? Because you (or your teen/young adult, if that’s the case) have… ADHD. Adults, children, and teens with ADHD typically have trouble focusing or get distracted and simply forget to take medicine. [9]
For more information on how to read your medication bottle and take your prescription responsibly, check out this helpful digital course and interactive videos.
Doctor, Doctor: Why So Many Appointments?
Let’s take a step back for a minute. After you’ve been evaluated, diagnosed with ADHD, and referred to a prescriber who feels you’d benefit from taking medication and has started you on one, your doctor needs to assess a number of things:
- Are you having any potential issues with side effects?
- Is your medication effectively treating your symptoms?
It’s imperative to stay in close contact with your doctor during these early months, to make sure that you’re not taking too little or too much of your medication.
In order for your doctor to help you manage your treatment plan, you may be asked to be seen every few weeks at first. Then every few months. Generally, once you’re stabilized with your medications and things are going well, your doctor may see you every three months and maybe finally stretching that out to every six months or so.
The frequency will vary from doctor to doctor. Some doctors may want to see or speak with you every month. The National Institute on Drug Abuse recommends that healthcare professionals should monitor patients over time to see if any changes need to be made to a prescription or if a prescription stimulant should be discontinued.10 A doctor should work with you to make sure the dose and frequency of your prescribed medication is the right fit for you.2
Tips on Paying Attention to your Medications
Keep a medication diary. Write down how you feel on your medication: are you having any side effects? Do you feel an improvement in focus, attention? Are you getting your schoolwork done on time? Work projects?
If your medications or dosage has changed, jot down any changes you are experiencing, both positive and negative.
Bring your notes to your appointments so you can assess whether further changes are needed.
Remember, it can take quite a while to get it all straight. Be patient and observant. Interestingly, many adults tell me that they don’t know if their medications are helping. Since adults with ADHD often are not the best of self-observers, ask those around you – your parents, friends, teachers – if they notice a difference. Children, parents and teachers often can tell if there have been improvements.
For some – around 10-30% – ADHD medications just aren’t effective, in which case, your doctor can discuss other ways to manage your symptoms.11 Even for those who are prescribed a medication, your doctor may recommend additional approaches in conjunction with your medication, like behavioral therapy.3
The good news is that, in many cases, medication can be life-altering – in a good way – especially when you know how to take your medication as intended by following the medication label and your doctor’s instructions.
[1] American Academy of Child & Adolescent Psychiatry and American Psychiatric Association. ADHD Parents Medication Guide. https://www.aacap.org/App_Themes/AACAP/Docs/resource_centers/adhd/adhd_parents_medication_guide_201305.pdf. Accessed November 2020.
[2] U.S. Centers for Disease Control and Prevention. Treatment of ADHD. https://www.cdc.gov/ncbddd/adhd/treatment.html. Accessed November 2020.
[3] National Institute on Drug Abuse. Drug Facts: Stimulant ADHD Medications: Methylphenidate and Amphetamines 2014. https://www.drugabuse.gov/sites/default/files/drugfacts_stimulantadhd_1.pdf. Accessed November 2020.
[4] Drug Enforcement Administration. Controlled Substance Schedules. https://www.deadiversion.usdoj.gov/schedules/. Accessed November 2020.
[5] Kolar D, Keller A, Golfinopiulos M. Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatric Disease and Treatment 200;4(2): 389–403. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518387/pdf/ndt-0402-389.pdf. Accessed November 2020.
[6] National Institute on Drug Abuse. Drug Facts: Prescription Stimulants. https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants. Updated June 2018. Accessed November 2020.
[7] Cottler LB, Striley CW, Lasopa SO. Assessing prescription stimulant use, misuse and diversion among youth 10 to 18 years of age. Curr Opin Psychiatry. 2013 September; 26(5): 511–519. Accessed November 2020.
[8] Centers for Disease Control and Prevention, My Child Has Been Diagnosed with ADHD – Now What? https://www.cdc.gov/ncbddd/adhd/treatment.html. Accessed November 2020.
[9] Roselló, B., Berenguer, C., Baixauli, I. et al. Empirical examination of executive functioning, ADHD associated behaviors, and functional impairments in adults with persistent ADHD, remittent ADHD, and without ADHD. BMC Psychiatry 20, 134 (2020). https://doi.org/10.1186/s12888-020-02542-y. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092442/#Par26:~:text=ADHD%2DP%20group%20shows%20significantly%20worse%20performance,attention%2Dvigilance%20%5B15%5D%2C%20or%20set%20shifting%20%5B. Accessed November 2020.
[10] National Institute on Drug Abuse. Misuse of prescription drugs 2018. Retrieved from https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/2609-misuse-of-prescription-drugs.pdf. Accessed on November 2020.
[11] Kolar, D., Keller, A., Golfinopoulos, M., Cumyn, L., Syer, C., & Hechtman, L. (2008). Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatric disease and treatment, 4(2), 389–403. https://doi.org/10.2147/ndt.s6985. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518387/#__p58:~:text=However%2C%2010%25%E2%80%9330%25%20of%20patients%20do%20not,treatment%20or%20have%20intolerable%20side%20effects. Accessed November 2020.
