About taking any kind of medicine, not just ADD ADHD
I wanted to write about the non-stimulant ADHD ADHD medications, but thought this should come first.
Generics
Always ask about the generic. They should always be much cheaper (should). Not all the generics are as good as the brand name but most are. Also, the generic brands are not always equivalent to each other, but most are.
Expense
If the medicine comes in a pill and it’s not timed or delayed release, you usually can cut the expense by getting the biggest dose they make and cutting the pills. (Pill cutters are inexpensive.)
Dose
I recommend starting with a very low dose and gradually increasing it. This minimizes the chance of getting side effects. Increase until either you do get side effects or you have no symptoms (unlikely) or the increase doesn’t add any benefit. Then either stay at that dose or drop back one dose.
Possible Side Effects
If you do get side effects they usually go away in about a week if you stay on that dose. I usually suggest not reading the list of possible side effects – doing so seems to increase the frequency of getting them. Just pay attention to anything that you think might be a side effect and ask your doctor.
That list was written by the company’s lawyers to protect them and includes any symptom that anybody anywhere at any dose ever had that might possibly have had anything to do with the medicine. The list can be useful when it gives the percentages of people who actually got that side effect, but those are hard to find.
Almost all side effects are reversible if you just stop the medicine. It is very rare that anyone should need to put up with any significant side effects.
Very Important Bonus Tip
Always check for interactions with other medicines or other substances you are taking. Your doctors should do this but I can’t promise they will.
Coming very very soon:
Non-stimulant ADD ADHD medicines!
doug
Just being normal active boys misdiagnosed as ADD ADHD
ADDadultstrategies 
Hi Doug,
I fully agree with you re the danger of suggestion creating expectation of side effects. This effect has just got bigger and bigger since i qualified as a doctor in 1985.
However with free access to the Internet and to user forums there is plenty of unqualified advice out there so if we do not broach the subject the patient is likely to pick up some half baked nonsense from a support group website AND be angry at us for not telling them.
I prefer to have a frank discusssion with the patients and to emphasise that the risk of unmanageable side effects is very low and that the patent should come back for review if having a problem.
Ritalin and dexamphetamine are really special cases though because their short half life makes it exceptionally easy to withdraw medications if side effects are an issue then re-challenge with a slower dose increase. (The bottom line is these things clear our bodies very fast so they are soon flushed out if problematic.
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Dr Kinsella- my practice has been to tell the patients that I would prefer not to tell them about side effects or have them read about them, but if they want me to, I will be happy to. Some do and some don’t. I explain why. I say, please call me if you notice anything unusual.
thank you for providing expert commentary and I hope you will continue especially as I go through this medication series
best wishes
Doug
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Hi, Doug
I’m allways very surprised at the differences in medication between the States and Europe. You mention that a list of side-effects with a percentage is very rare, while in Europe, I don’t recall seeing a list of side-effects without a percentage. Side-effects are allways listed by probability of occurence, from the most probably to the less likely. Although it is true that reading the lists sometimes worsens side-effects or simply just puts some people in a state of unnecessary panic. I do like to read about what I’m taking, though. Looking forward for more!
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RAM –
thanks for the information. It’s getting harder and harder for me to find the percentages, and I think that is critical information.
I’m torn between the dangers of suggesting symptoms to people versus my belief that knowledge is power. It’s a dilemma.
As always, thank you for commenting.
Doug
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