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How Effective Is Methylphenidate for ADHD?

Sandi Johnson
Sandi Johnson

Attention-deficit hyperactivity disorder (ADHD) is most often diagnosed in school-aged children who show a marked inability to concentrate, coupled with a lack in behavioral impulse control. Traditional treatments involve the use of stimulant medications to manage symptoms, combined with various psycho-therapeutic approaches to learn better coping mechanisms. As one of the most commonly prescribed stimulant medications, the effective use of methylphenidate for ADHD is well documented. Forms of methylphenidate include short and long-acting medications.

The primary symptoms of ADHD include lack of focus and the inability to sit still, as well as poor control over behavior and actions. For decades, methylphenidate has been the first medication of choice for addressing such symptoms. Studies have shown that patients using methylphenidate for ADHD symptom management demonstrated increased levels of dopamine in the brain. Dopamine, like many brain chemicals, is not completely understood by modern medicine, although researchers know increased dopamine in young children can have a calming effect.

A child with ADHD playing.
A child with ADHD playing.

Short-acting methylphenidate for ADHD symptom control is typically administered in four-hour intervals, with the final dose administered in the early evening. Depending on patient specifics, some professionals recommend a smaller dose in the early evening to prevent interference with normal sleep patterns. Compared to long-acting forms of methylphenidate, short-acting forms have a higher occurrence of a phenomenon known as “peaks and valleys.” Peaks and valleys refer to the tendency for therapeutic medication levels in the blood to rise and fall over the course of a day.

Soon after administration, generally less than 45 minutes, levels of methylphenidate concentrate in the bloodstream, with symptoms appearing well controlled. Before it is time for the next dose, therapeutic blood levels fall, with symptoms becoming more evident and difficult to manage. Children often have more trouble consistently focusing on lessons and controlling negative behaviors when treated with short-acting methylphenidate for ADHD, due to varying blood concentrations.

Alternatively, long-acting methylphenidate for ADHD eliminates the “peaks and valleys” associated with short-acting dosages. Long-acting pills gradually release medication throughout the day, providing more consistent symptom control. In public, school settings, long-acting medication also eliminates the need for school personnel to administer medication during school hours. Some patients, depending on a variety of factors, experience more effective symptom management using long-acting methylphenidate for ADHD.

While methylphenidate for ADHD, both in short and long-acting forms, is effective for treating ADHD symptoms, there are side effects. Decreased appetite and difficulty sleeping are the primary complaints associated with using stimulant medications like methylphenidate. Side effects can vary in terms of severity, but most are considered mild compared to uncontrolled symptoms. Most patients and caregivers find the side effects mild enough not to discontinue treatments.

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    • A child with ADHD playing.
      By: Elena Stepanova
      A child with ADHD playing.