ADHD medication: types, side effects and risks

Summary: ADHD medication can make a real difference to a child's focus, impulse control and day-to-day life. There are two main types: stimulants and non-stimulants. You and your child's clinician will work out which is likely to suit them best. As with any medication, there are risks and side effects – and we'll keep a close eye on these throughout treatment. 

• ADHD medication: introduction

• Types of ADHD medication

• Risks and side effects

• FAQs 

This article applies if your child's been diagnosed with ADHD, or ADHD together with another condition like autism – where treatment often looks different.  

ADHD medication affects neurotransmitters like dopamine and noradrenaline, which can support a child’s attention, impulse control and activity levels. 

For lots of families, this can be life-changing. That said, medication affects every child differently, and it's just one part of treatment – alongside things like the practical strategies included in your child's outcome report. If medication looks like the right option, we'll help find the right type and dose through titration. 

Explore our Help Centre for information on the titration process and how to manage medication and prescriptions. 

There are two types of ADHD medication: stimulants and non-stimulants. NICE guidance recommends starting with a stimulant called methylphenidate, unless there's a clinical reason to consider something else first. As your child goes through titration, their clinician will recommend the best fit, based on their medical history and any preferences you and your child have. 

• Stimulant medications 

Stimulants are the most commonly prescribed medication for ADHD. They’re usually the first option we try. They work by increasing levels of dopamine and noradrenaline in the brain. This helps to improve attention and self-control. Available stimulants include: 

• Methylphenidate (e.g. Concerta) 
  This is often the first medication we prescribe for ADHD. It comes in two types: short-acting, which lasts a few hours, and long-acting, which releases slowly throughout the day. 

• Dexamfetamine (Amfexa) 
  We often try this if methylphenidate hasn't worked. Dexamfetamine is also short-acting and usually starts to work within a few hours. 

• Lisdexamfetamine (Elvanse) 
  A widely used long-acting ADHD medication. Your child's body converts it into dextroamphetamine, a stimulant that acts on the central nervous system. 

• Non-stimulant medications 
  We recommend non-stimulants when stimulants aren't the best choice for your child – for example, if they've experienced unwanted side effects. Available non-stimulants include: 

• Atomoxetine (Strattera) 
  This helps improve focus and reduce impulsivity. It's non-addictive and tends to work well for children who don't get on with stimulants. 

• Guanfacine (Intuniv) 
  Guanfacine can help with impulse control and hyperactivity. It's licensed in the UK specifically for those under 18, and is sometimes considered if stimulants haven't been the right fit for your child.
  
  Shared Care arrangements for guanfacine vary by area – some ICBs will accept it for children and young people, so we'll always check what's possible locally. It's worth knowing that Guanfacine isn't available under Shared Care for adults, so this may need revisiting if your child transitions to adult services in future.  

ADHD medication is safe and effective for most children, but like all medications, there are potential side effects, and every child's experience is different. 

It's worth keeping a note of how your child's getting on with their medication, and bringing any questions or concerns to appointments. Their clinician will help manage any issues, while making sure your child's getting the most out of their treatment. 

• Weight loss 
  ADHD medication can reduce appetite, which can sometimes lead to weight loss. It helps for your child to eat a good meal before taking their medication. We'll also keep an eye on their weight at appointments. 

• Trouble sleeping 
  Stimulant medications can interfere with sleep if they're taken late in the day. Giving the medication in the morning or early afternoon should help with this. If sleep continues to be a problem, your child's clinician may also consider melatonin, alongside good sleep habits and routines, if that seems appropriate.

• Increased blood pressure and pulse rate 
  Some medications can cause a slight increase in blood pressure and heart rate. We'll check your child's readings at appointments and adjust treatment if needed.

• Mental health changes 
  In rare cases, ADHD medication can affect mood or anxiety levels. If you notice anything significant in your child, we recommend stopping the medication immediately and contacting us or their GP. If the changes aren't significant, and it's safe to wait, your child can stay on their medication, and you can raise this at the next appointment. 

We're not a crisis service, but if your child is struggling, there are ways to get help today. If your child is in crisis, or you're worried they may be at risk of harming themselves, please call 999 or go to your nearest A&E. 

• Heart problems 
  Although rare, stimulant medications can increase the risk of heart-related issues – particularly if your child has a pre-existing condition. We'll review their full medical history before treatment begins, and might request a heart scan (ECG) or other tests if needed. 

• Serotonin syndrome 
  Serotonin syndrome is a rare but serious condition. It’s caused by excess serotonin in the brain. The risk from ADHD medication is low, but rises when combined with other medications or substances like antidepressants, pain medications or recreational drugs. Symptoms tend to come on within hours and can include: 

  • Confusion or agitation 

  • Rapid heart rate 

  • Muscle twitching 

  • Sweating or nausea 

  • Severe symptoms – like high fever, seizures or loss of consciousness – need immediate medical attention. Call 999 or go to A&E. 

Your child's clinician will review any medication they're already taking to make sure it's safe alongside ADHD medication. If your child is prescribed anything new after starting treatment – by their GP, a dentist, or another specialist – please check with their GP, pharmacist, or ADHD clinician first. 

For a full list of medications and substances that increase the risk, see taking ADHD medication safely.

Dependency or misuse 

Stimulant medications can be habit-forming, but this risk is low if taken as prescribed. Always follow the clinician's advice on how and when your child should take their medication. 

If your child experiences severe side effects – like chest pain, shortness of breath, or a sudden change in mood – stop the medication straight away. Go to your nearest hospital or contact their GP.

How will my child's clinician decide which medication is right for them? 
Their clinician will consider your child's medical history, any other health conditions, and how they respond to treatment. It may take a few adjustments to find the right fit – that's what titration is for. 

What if the first medication my child tries doesn't work? 
This is common. If a medication or dose isn't right for your child, their clinician will adjust treatment. They may try a different dose, or switch to a different medication. 

Can my child take ADHD medication if they have another health condition? 
Their clinician will review your child's full medical history before prescribing, and will factor in any other conditions when recommending a medication.