Are there non-stimulant options for ADHD at 35?

Question

Hello doctor,

I am 35 and just recently diagnosed with ADHD after struggling my whole life. Always thought I was just lazy or not trying hard enough. The psychiatrist put me on Methylphenidate extended release 36 mg, but I am having terrible side effects.

My heart races, I can not sleep at night, have lost my appetite completely, and have dropped 12 pounds in three weeks. The ADHD medication does help me focus at work, but the side effects are unbearable. Also makes my anxiety worse, which I already take Sertraline for. Tried lowering the dose to 18 mg, but then I can not concentrate well enough to do my job.

My periods have become irregular since starting ADHD medication- used to be like clockwork. Wondering if it is related or just a coincidence. I have two kids who also might have ADHD based on their behavior.

My daughter especially struggles in school, like I did. Are there non-stimulant options for ADHD that might work better for me? Really need help with focus, but can not handle these side effects, affecting my health and sleep too much.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

These are common side effects of stimulants, and if unbearable, you can switch or augment them with Clonidine.

Clonidine is an A2 agonist and not only manages ADHD (attention deficit hyperactivity disorder) symptoms but also improves sleep. If Methylphenidate is improving your symptoms, you can also augment it with Clonidine. If possible, try to continue it, as it is the most effective medicine.

You need to make a few changes with Methylphenidate, such as a drug holiday, and avoid taking it during weekends. If totally unbearable, take only Clonidine or Guanfacine.

You should not solely rely on medicines; combine them with behavioral therapies, and divide tasks into short, manageable acts. For example, if concentration is required, you should divide a one-hour task into three to four intervals. Sleep hygiene also improves sleep; follow it. Avoid taking caffeine, as it can interfere with anxiety, sleep, and ADHD symptoms.

Generalized anxiety disorder is common with ADHD and should be effectively managed, as their relationship is bidirectional. If you feel unknown fear or physical symptoms all the time, it is usually due to GAD. Augmenting the capsule Pregabalin and your anxiety symptoms will improve much. It will improve your focus and hyperactivity as well.

If you experience anxiety symptoms or want to discuss more, feel free to arrange a follow-up meeting.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.