ADHD Medications - Part I - How They Work

The past 10-15 years have witnessed a number of major developments in the medications and delivery systems available for the management of ADHD. Dr. Barkley here discusses the types of medications now available to ADHD management and the various delivery systems developed to extend the effectiveness of the medications across the day. For each medication, he will present the major beneficial effects and side effects. He will also discuss various issues clinicians should consider in selecting particular medications to use with a patient with ADHD, such as those issues related to the social context, the patient’s characteristics, and any comorbid conditions that may exist.
In Part I, I discuss how each of the different types of medication works in the brain.

[@SpecialEdDHD]

42 years old just diagnosed today with ADHD combined type. Going to start meds soon. Here we go. This man is a gift to humanity and a national treasure. He needs to get a statue and Nobel prize for his contributions to ADHD and mankind.

[@russellbarkleyphd2023]

You are incredibly kind. Thank you so much. I am delighted my work here has been of help to you and others. Russ

[@AllThingsConsidered333]

43yo here and just diagnosed yesterday. Was prescribed atomexatine to start. I’m eager to get started and see improvement! My daughter is 15.5yo and should get diagnosed in a few days…

[@Aliibrahim-yx4pl]

​@@AllThingsConsidered333how was your experience on automoxtine if you dont mind me asking?

[@phoebesmith8154]

Additionally, I’d absolutely love a video covering the neuro chemistry of ADHD and medication for those of us with science backgrounds! I love reading studies but I’m definitely a visual/auditory learner and love seeing it explained by a specialist.

[@russellbarkleyphd2023]

thanks!

[@michellepetraitis3156]

I am located in Scranton, Pa. We cannot get Focalin for my daughter and haven’t been able to get it for her since October. I am watching your videos hoping I can find something to help my 20 year old child. I am grateful that you have made these videos and am sad that I did not find them sooner in her formative years.

[@ardibashotaj3148]

This looks really interesting? Do you also have a video on wellbutrin/bupropion for ADHD? And how do you think about bupropion for ADHD?

[@Budike2007]

Great and very informative video! Thank you!!

[@mac101irl]

Absolute fantastic again!! Your videos have been key to helping me through my ADHD journey :) Do we know if there is any drug drug interactions between the stimulants and SSRIs? I know there is a risk of serotonin sydrome but is tgere any evidence that SSRI can reduce the effectiveness of the stimulants becauE of too much serotonin?

[@phoebesmith8154]

This is really helpful and informative! Are you still planning to look into the panorma? It’s having massive effects on people’s access to medication and shared care in the UK. It’s amazing and upsetting to me that GPs that have been through medical school and understand research, can’t see the serious methodological errors and biases in one 30 minute BBC ‘show’.

[@russellbarkleyphd2023]

Thanks but likely not as it's specific to the UK audience. A shame they didn't do a better job of it.

[@geraintwd]

Similar thing happened in the world of HRT and menopause care - millions of women going through menopause without HRT because some "documentary" blew up a tiny increased risk of breast cancer among older patients.

[@Scoop9599]

Appreciate your work, and your presentation style. I would appreciate if the audio could be improved in these videos, something like a rode wireless go lapel mic would really help, in addition to recording in a less echo-y environment.

[@russellbarkleyphd2023]

Thanks, but that recording was done vi Zoom for a Canadian sponsor. They provided me the copy in which it is clear the audio on the microphone was not getting through properly. The other videos should be OK except the Medications related ones.

[@bagawbokup]

Thank you for the great video. I've read an article by Gene-Jack Wang regarding the effect of ADHD medication on dopamine transporters, where the author claims to see a 24% increase in dopamine transporters after a years use of methylphenidate. Are you aware of that study and should a person taking or considering to take ADHD meds be concerned about that? Thank you in advance!

[@RachelGerrard]

Can the under developed brain be improved on stimulants even in adulthood?

[@Handle8844]

Fascinating. I am particularly interested in the 20-30% of ADHD people who derive no benefit from any medication. Do you see any similarities or trends among these “non-responders? For example, are there any age groups, blood types, races, education levels, sexes, severity of symptoms etc that are more highly-represented in the non-responder group?

[@jamiejohnson5748]

It's possible that it was a misdiagnosis with ADHD like symptoms. There are certain behaviours common in ADHD which also overlap with behaviours that are characteristic of depression, anxiety, bipolar, and CDD. Brain trauma can also have ADHD-like symptoms, and there aren't really any medications for that. That's not to say you don't have ADHD if you don't respond to treatment. It could also be due to varying levels of medication adherence, or factors that impact absorption. For example, grapefruits can interfere with different medications, and it's possible that this might apply to a fruits and fruit juices to a lesser extent. There's some evidence that hormonal changes in women regarding their cycles may worsen ADHD symptoms at different times. I don't know if this impacts the medication itself, but it might be the case that women need high doses at certain times of the month to receive the same results.

[@carloscontreras3633]

What year is this presentation from?

[@russellbarkleyphd2023]

2021

[@enigmab8978]

Aren't ADHD stimulant medications neurotoxic,and not neuro-protective?

[@russellbarkleyphd2023]

No,,not at the levels or doses. used for oral treatments for ADHD.

[@enigmab8978]

Thanks!@@russellbarkleyphd2023