Most people with ADHD eventually find a stimulant medication
that works for them, however, there are some people who are unable to take
stimulants due to side effects or ineffectiveness. There are a few steps to take when this is
the case.
1) Optimize standard nonmedical treatments. Have you gotten off of your regular
schedule? Have you started cheating or
ignoring your diet? Are you putting in
too much screen time too close to bedtime?
Have you been skipping your supplements?
Have you been missing appointments with your coach or therapist? Are you not getting enough sleep, or are you
waking up not feeling rested? Its time
to get back with the program.
2) Have your iron checked. Iron supplementation has a funny place in the
treatment of ADHD. Most experts agree
that treating everyone with ADHD is not a good idea because of the risk of iron
overdose. However, some people do benefit
from a little extra iron, especially those who are both iron deficient and taking
medication. So, if medication after
medication is failing, ask your doctor to check your iron level to see if a
little supplement might not help you.
3) Get enough protein. Most North Americans get enough protein in
their diet. However, if you have been on
stimulants for a few months and your appetite has taken a big hit, you might
not be getting enough. Especially at
breakfast time, make sure that you get a good amount of protein, so that your
brain can make the neurotransmitters it needs to function. If you've run out of ideas for high protein
breakfasts, you can check out my article on High
Protein Breakfasts.
4) Look in to nonstandard nonmedical treatments. A full examination of this topic is presented
in the article Natural Treatments for ADHD: What to Try After Medications Have Failed.
5) Consider second, or third line medications. Second line medications include things like guanfacine,
clonidine, or atomoxetine. These medications can be given alone or in
combination with a stimulant. Third line
medications include bupropion and desipramine.
6) Consider treating side effects with a
second medication. While it seems
excessive to treat a side effect with another medication, when you can't find
anything else that works, sometimes that's what is needed. For insomnia, clonidine or melatonin are
commonly tried. For appetite suppression,
mirtazapine can be used.
7) Consider combining medications. Sometimes taking two medications which are
marginally effective by themselves can give an adequate effect when taken
together. Generally combining
medications from different classes (a stimulant and nonstimulant) is advisable
to minimize side effects.
8) Reconsider the diagnosis. Sometimes what initially looked like ADHD isn't what it seemed to be. This is especially important if medications don't work at all or only make things worse. Sit down with your doctor or therapist and go over your medications (including over the counter and supplements), the time when the symptoms first started, and any unusual symptoms you may have.
8) Reconsider the diagnosis. Sometimes what initially looked like ADHD isn't what it seemed to be. This is especially important if medications don't work at all or only make things worse. Sit down with your doctor or therapist and go over your medications (including over the counter and supplements), the time when the symptoms first started, and any unusual symptoms you may have.
Most people with ADHD can find a stimulant that will work
for them, but for those who cannot, there are many options.
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