If you have a common cold, it's easy to tell which medicine will work and how much of it to take. The dosage for an over-the-counter drug store medication is often determined roughly by weight or age. For example, the label might say simply, "Adults, 2 tablets; Children under 13, 1 tablet." When it's difficult to tell which medicine will work or how much to take, you need professional supervision.

A doctor may start with the lowest dose and watch for signs that both the medication and the dosage are safe and effective for you. The process of checking, little by little, exactly how much ADHD medication is right for a person is called titration.

"This seems like just trial and error. I don't want my child to be a guinea pig."

"Trial and error" is a random process. A laboratory may test, by trial and error, thousands of plants from the world's jungles to see if any might have medicinal properties. Testing chemicals for developing new medicines is medical research.

Titration is not random. You are is receiving medicines that have been studied and approved already. For many disorders, there may be only a few options to consider, not thousands. Titrating is normal in medical practice.

When you go to an eye clinic, the optometrist doesn't talk to you for a while and then reach in a drawer to hand you the right pair of glasses. The optometrist figures out a few lenses that might work. Then you try out samples: "Is it clearer this way — or that way?" "Is it better this way — or that way?" That's not "trial and error". That's good medical practice.

Every person is unique: this is true not only of an individual's talents and personality, but also of their body's cells and biological systems. A prescription medication may affect you differently than it affects others. This means doctors have to find the right medication in the right amount for each patient. It is a process and it may take time. It's standard medical practice to treat an ADHD patient’s specific needs.

Types of Medication for ADHD

The symptoms of ADHD are inattention, hyperactivity, and impulsivity. Persons with ADHD may have trouble focusing, trouble sitting still and trouble keeping themselves from interrupting.

Attention and behaviour are controlled by signals that move through the brain, from one cell to another.

To carry signals from one cell to another, the brain makes various kinds of chemicals. These are natural chemicals. With enough natural chemicals in the right places, brain cells communicate.

Scientists believe when the brain fills the spaces between cells with natural chemicals, it's like building a bridge for information to pass smoothly. ADHD medicines, both stimulants and non-stimulants, are thought to keep these natural chemicals in the spaces between the brain cells, making a better bridge for the information. That may be a surprise: stimulants and non-stimulants are not opposites. They are similar in that:

Both stimulant and non-stimulant ADHD medications are thought to keep these natural chemicals in the spaces between the brain cells.
Stimulant medications are thought to have an effect on the amount of natural chemicals called dopamine and norepinephrine, which can both be found in spaces between the brain cells. Non-stimulant medication is thought to have a specific effect on one of these natural chemicals, norepinephrine.

As with all medications, there are some side effects associated with ADHD medications. Both stimulant and non-stimulant medications can lead to serious side effects. In children and adolescents with heart-related problems and heart defects, increased blood pressure and heart rate and sudden death may occur. Mental (psychiatric) problems such as hearing voices, believing things that are not true and being suspicious may also develop in some patients, as well as new manic symptoms.

In addition, abuse of stimulant medications may lead to dependence. With stimulant medications, the most common side effects include headache, dizziness, decreased or loss of appetite, stomach pain or discomfort, nausea, vomiting, weight loss, sleep difficulties, irritability, nervousness and dry mouth. Other side effects may include tics, as well as stroke in adults. People taking a stimulant medication should not take monoamine oxidase (MOA) inhibitors at the same time to avoid hypertensive crisis. Other serious side effects include seizures, eyesight changes, slowing of growth in children, new or worsening behaviour or thought problems, new or worsening bipolar illness and new or worsening aggressive behaviour or hostility.

With use of non-stimulant medications, there is a higher chance compared to placebo of suicidal thoughts and actions in children and teenagers, as well as severe liver damage. With non-stimulant medications, most common side effects include upset stomach, decreased appetite, nausea or vomiting, dizziness, tiredness, constipation and low blood pressure. Other side effects include new or worsened emotional or behavioural problems such as agitation, hostility or anxiety.

Talk to your doctor if you have any concerns or questions on side effects.