For most children, the combination of stimulant medications — like Adderall or Ritalin — with therapy and behavioral modification is safe and effective way to treat attention-deficit/hyperactivity disorder (ADHD). Once your child is diagnosed with ADHD and you fill their prescription, you may have questions about the medication, such as how to maximize its efficacy and if there are things your child should or should not do while they are taking the medication. Children’s National Hospital psychopharmacologist Adelaide Robb, MD, answers some common questions caregivers have about ADHD medications.

Are there differences between generic and brand name medications for ADHD?

Yes. Generic and brand name medications often differ in their delivery systems, or how the medication gets into the bloodstream. Some medications are absorbed in the stomach while others enter through the intestine. There is even a skin patch for one of the methylphenidate formulations. Some are absorbed faster while others are slower. Different people can do better or worse on different delivery systems. This is why some people may feel like their medication is not working as well after switching to a generic version.

My child’s ADHD medication does not seem to be working anymore. What should I do?

There are many reasons a child’s ADHD medication may seem less effective, including:

• The child may have experienced a growth spurt and their previous dose is too low for their new weight. If this is the case, your child’s doctor will raise their dosage.
• The medication may be wearing off too early. This can be fixed with a second dose, an increase in dosage or switching to a longer lasting preparation.
• The pharmacy may have switched your child to a generic version of their medication. Ask your pharmacist if it is possible to switch your child back to their previous medication.

NOTE: Do not change your child’s dosage without consulting with their doctor first!

Do certain foods or medications affect how well my child’s ADHD medication will work?

Yes. Certain medications and foods — such as high fat foods — can alter absorption of ADHD medication. Be sure to read your child’s prescription label to see how the medication should be taken.

What are some other ADHD medication dos and don’ts?

• DO read the label on the prescription bottle and follow instructions for how and when to take the medication.
• DO NOT order medication from random sites on the internet —get a prescription from your child’s doctor and fill it at a reputable pharmacy.
• DO NOT double up or change doses on your own without consulting your child’s doctor first.
• DO NOT take ADHD medication with a lot of caffeine (workout powder, coffee, etc.) or nicotine (cigarettes, vape pens, etc.). Both can speed up the body’s metabolism of the medication and make it less effective.

Is there anything I can do to make my child’s ADHD medication more effective?

Yes! There are several things you can do to maximize the effects of your child’s ADHD medication and set them up for success during the day:

• Make sure your child does high cognitive tasks earlier in the day when their medication levels are at their highest and save low-key maintenance activities for the afternoon.
• Build breaks into the day to make sure your child does not try to power through their work.
• Encourage your child to do exercise at the beginning of the day to get all their energy out.
• If your child drinks coffee or other caffeinated beverages, make sure it is in moderation and earlier in the day, so sleep will not suffer.
• If your child is stuck on a task, suggest switching rooms to give them a change in scenery.
• Use omega 3 supplements to help with sluggishness and concentration.
• Make sure your child’s sleep and wake times are consistent.

What can I do if I cannot get my child’s prescription filled because of the current Adderall and Concerta shortages?

There has been a shortage of Adderall since last October and Concerta this calendar year, and many families are feeling its effects. If you are having a problem getting your child’s Adderall prescription filled, consult their doctor. There are several alternatives to Adderall, such as Vyvanse, which may work for your child. If you do not have access to Adderall alternatives, your doctor may prescribe a methylphenidate product like Ritalin.

Do NOT cut your child’s dosage of Adderall or give it less frequently to make up for the shortage!