ask your pharmacist

back to: pharmacy | ask your pharmacist

What are the side effects of stimulant drugs used to treat people with attention-deficit hyperactivity disorder?

Stimulant medicines used to treat attention-deficit hyperactivity disorder (ADHD) include methylphenidate (brand name Ritalin or Concerta), amphetamine salts (>Adderall), dextroamphetamine (>Dexedrine), and pemoline (>Cylert). The most commonly reported side effects of these drugs are poor appetite, irritability, trouble sleeping, excess crying, and anxiety. Since people with ADHD can have these same symptoms when not taking stimulant medicines, it’s often hard to tell if the medicine is causing the problem.

In children five to 15 years old, trouble sleeping is slightly more common with dextroamphetamine than with methylphenidate. To lower the chance of trouble sleeping, avoid giving your child medicine in the late afternoon or evening.

Liver damage has occurred in several people taking pemoline. Because of this, it’s no longer the first choice for treating ADHD. People taking pemoline should have blood tests every two weeks to check for liver damage. There aren’t clear differences in side effects between amphetamine salts, methylphenidate, and dextroamphetamine.

Some parents worry that using stimulants for many years may curb a child's growth. Long-term studies about the effects of stimulants in children haven’t been done. Some recent research showed no difference in height and weight in children taking methylphenidate.

Physical and psychological dependence hasn’t been reported in people taking stimulant medications for ADHD as directed by their physicians.

Sources:
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
Spencer, T. "Pharmacotherapy Of Attention-Deficit Hyperactivity Disorder Across The Life-Cycle," The Journal of the American Academy of Child and Adolescent Psychiatry 35 (1996).
Efron, D. "Side Effects Of Methylphenidate And Dexamphetamine In Children With Attention Deficit Hyperactivity Disorder; A Double-blind, Crossover Trial," Pediatrics 100 (1997).
Cylert product information. Abbott Laboratories, 1999.
Kramer, J. "Predictors Of Adult Height And Weight In Boys Treated With Methylphenidate For Childhood Behavior Problems," Journal of the American Academy of Child and Adolescent Psychiatry 39 (2000).
Concerta Product Information, Alza Corporation, July 2000.

This answer prepared 8/7/00.