When you have ADHD, stimulant medications help like nothing else. Many people describe it as putting on glasses for the first time; suddenly everything is so much clearer–less hazy–and you can see straight enough to actually get things done.
They aren’t perfect, but they’re helpful. I guess if we’re keeping with the same analogy, stimulants are like putting on glasses that aren’t quite strong enough for you but are sooooooo much better than what you were used to.
But stimulants often come with side effects that can really suck. When I first started taking medication for my ADHD, the side effects became pretty rough. I was struggling to sleep at night, feeling this weird complicated anxious/dark/moody/sad thing, and at times I was getting dizzy and my heart was beating out of my chest.
I tried a couple different medications, and at first, all of them had some pretty nasty side effects. It was frustrating and honestly at times depressing.
I finally realized one day that I needed to at least try to find a way to control the side effects and that it might take modifying my “usual” in order to feel better but still keep my brain glasses.
And I found things that helped. Thank GOD!
What Are Common Side Effects of ADHD Meds?
This list is far from exhaustive, but here are some of the most common side effects from stimulant meds. Most side effects disappear in the first few weeks.
- Heart palpitations
- Irritability or moodiness
- Low appetite
- Muscle Tension
What is Rebound and How is it Different than Side Effects?
Rebound effects are those that happen as your medication is wearing off. It’s like side effects that primarily happen at the end of the day. If, towards the end of your stimulant effectiveness, you notice that you start feeling crappy–headache, irritable, moody, etc… That’s rebound.
Rebound happens because your medication is wearing off too fast. The variation of medication in your blood levels is causes these nasty side effects. Thankfully some of these strategies help with rebond, too.
Strategies for Maximizing Your Meds but Minimizing Side Effects/Rebound
Start your day with protein.
I first came across this strategy from my doctor. He told me that when you take stimulants with protein, first thing in the morning, it helps reduce overall side effects for the rest of the day. Apparently, protein helps improve the delivery of stimulant medications which help lessen the side effects and make them more effective.
I’ve tried it and I’ll say that I do think it helps. I notice that I have better focus on days that I eat a high protein breakfast with my meds and I seem to be less likely to have palpitations or a headache as well.
This is a fairly easy thing to try. In the morning, when you take your meds make sure you get some bacon, eggs, or whatever high protein breakfast you prefer.
Be careful with your coffee
Some people are able to drink coffee and take stimulants and don’t notice any problems. Unfortuanately, I am not one of them.
Caffeine might be one of the biggest reasons that I had a hard time finding a stimulant that I could tolerate. I didn’t realize the impact even a single cup of coffee was having on me when it was combined with my medication.
On one medication, caffeine made me overheat, become dizzy/lightheaded, and I couldn’t sleep no matter what I tried.
On the other medication, caffeine gave me chest pain and palpitations that were so bad I thought I was having a heart attack. I stopped that medication in less than a week, thinking it was the problem. Once I discovered the problem wit caffeine, I actually came back to try this medication again. And loved it.
With caffeine, I thought I was dying. Without caffeine, it works beautifully for me. It’s the medication I am currently on and my side effects are almost non existent.
If you are having side effects with your stimulants and you are still drinking caffeine, try stopping your caffeine intake. It broke my heart to start drinking decaf coffee (it doesn’t taste as good, I don’t care what anyone says). But I feel So. Much. Better.
Eat Regularly, and Eat More Protein
Eating regularly can help keep your blood sugar stable. I don’t know if you know this, but low blood sugar mimics ADHD symptoms in many ways. So do yourself a favor and make sure that your engine (brain and body?) are getting consistent fuel (food) so that it doesn’t sputter out on the side of the road (collapse on the couch).
Back to the protein thing though, just like eating protein in the morning can help with side effects, eating it in the afternoon can help with rebound. Remember, rebound is when your meds are dropping out of your system too quickly and causing nasty, uncomfortable stuff. Protein seems to help improve the delivery and absorption of the stimulant. I’m guessing is why it helps rebound symptoms.
I have noticed that using this strategy in the afternoon has helped with headaches, tiredness, irritability, etc… and it’s another easy thing to try.
So long as your doctor says you are healthy enough to exercise, it can be a helpful strategy for combating side effects/rebound. Especially the emotional effects in my experience. The first stimulant I tried had a lot of emotional effects.
I called it Vy-xiety ha! You can probably guess which med it was that I was struggling with. (But keep in mind, that was only my experience with it and I’ve known a LOT of people who have done really, really well on that same med).
One of the strategies I used for Vy-xiety was exercise and it did help (not perfectly, but it did help a good bit).
I primarily used exercise two ways when it came to using it for side effects: 1. in the moment when I was feeling that anxious/dark/irritated combo and 2. in the evening to help with rebound.
I mostly went on walks because that’s exercise I don’t mind doing.
Exercise is also one of those things that are known to improve ADHD symptoms in general so if your medication isn’t working as well as you’d like for it to, exercise can help bridge the gap. Check out this article on specific ways to use exercise for your symptoms.
Obviously, anything that involves changing or adding meds is something you’ll have to talk to your doctor about. BUT, if you want ideas for what to bring up, here are some strategies that can be helpful.
To manage side effects, sometimes doctors will add another medication to help lessen the side effects. At first, my doctor added an antidepressant to the mix and it greatly improved my side effects–pretty much all of them. No more trouble sleeping, no lightheaded feeling, no issues with caffeine, or sleeplessness, or anxiety/dark/irritibility….
For other reasons, that combination didn’t work out for me in the long run. But an antidepressant or a nonstimulant can be a good strategy to ask your doctor about. They can often be helpful for both side effects and rebound problems.
For rebound specifically, doctors will sometimes add a “booster.” That’s just a much lower dose, short acting stimulant that you take in the afternoon. When your meds are wearing off, adding a bit of the stimulant back into your system can help smooth out that “wearing off process.”
There are pros and cons to both strategies so it’s important to talk to your doctor about it.
Dealing with Appetite Suppression
In the beginning of stimulant treatment, my appetite was not only non-existent, food made me feel nauseous. It became a problem as this was happening during 100 degree days in the summer and I was getting more and more lightheaded and dizzy.
You may already be underweight and appetite suppression is a big concern. Or, you may notice that if you aren’t eating during the day your medication isn’t as effective as you need it to be.
While some of us may be excited about the idea of something helping us not eat impulsively, having your appetite gone becomes a huge problem.
If you find this being a struggle, there are a few strategies that might help. It’s often recommended to eat breakfast before you take your medication. If you aren’t a breakfast person (I wasn’t) that takes some adjusting, but it can be done.
Personally, for a while my long lasting stimulant seemed to take my appetite even when I didn’t take the medication. I found that drinking protein shakes were a viable solution when I couldn’t stomach the idea of food. Somehow, drinking one doesn’t feel quite so nauseating or hard to do.
When you do eat, prioritize high calorie foods to make sure you’re getting the calories you need. But don’t just rely on milkshakes (as tempting as that can be for me at least). You still need foods with vitamins and minerals in them too.
For a while, I got most of my intake needs from protein shakes and high calorie fruit and vegetable smoothies. It wasn’t ideal but it was better than not eating.
For most people, the appetite suppresent effect reduces over time. It took a few months, but now my appetite is a good bit better than it was and I no longer feel nauseated at the thought of food.
Other Strategies I’ve experimented with and the effects
Drinking More Water
Stimulants may make you more prone to dehydration which can cause a lot of it’s own side effects. Stimulants often raise body temperature, increase metabolism, raise blood pressure, etc… That can translate into needing more water than usual to stay hydrated.
Personally, I tend to forget to drink enough during the day. That was worse before ADHD treatment, but unfortunately still a problem. However, I do notice that one days that I drink plenty of water (and maybe add some electrolytes, too) I tend to feel better, especially with rebound issues.
Toward the end of my medication, if I notice I’m feeling really tired all of a sudden (or moody or have a headache) and I grab more water or gatorade I often notice those rebound symptoms improve some.
Caffeine for Rebound
If you’re remembering to my “be cautious with caffeine” speech above and thinking, “WTF?” let me explain…
I love coffee. I love it so much and apparently I’m a glutton for punishment. Even knowing that it has made me feel awful on stimulants, I sometimes do dumb things and just check to make sure it hasn’t changed. Ridiculous, I know.
But in that process of “checking” I accidentally discovered that caffeine only creates more problems when I take it too close to my stimulant dose. If, instead, I drink a cup of coffee in the afternoon after taking my stimulant in the morning, I don’t notice the same problems. As you can imagine, I was VERY happy to discover that being the coffee fiend that I am.
But I also noticed that, intermittently, drinking coffee in the afternoon seemed to help with rebound effects for me. My theory is that it’s similar to rebound effects of caffeine (which is another stimulant).
If you’ve noticed after drinking a lot of caffeine for a long time that you have a massive headache after cutting back but drinking more coffee fixes it, then you understand my theory behind using caffeine for stimulant rebound.
I don’t have any research on the use of caffeine for stimulant rebound. I’m not suggesting that this is the miracle solution you just have to try. All I’m saying is that when I drink caffeine in the afternoon, it sometimes reduces rebound effects. And it does not seem to add any “extra” side effects like it does earlier in the day.
Do with that as you will.
Vitamin C for Rebound
It’s well known that for many ADHD stimulants, Vitamin C can lower the effectiveness of the medication. It decreases your stimulant absorption making the medication less effective.
Generally,doctors recommend avoiding Vitamin C for amphetamine based medications in the first hour of taking them. It does not seem to have the same effect on methylphenidate.
I ran across a website suggesting that you take vitamin c to help with rebound effects. The thought was that it would help your body get rid of the medication and reduce rebound effects and sleeplessness.
I can’t say that this strategy worked for me at all and I think the “science” is shaky here but others have said they found it helpful. Unless you have an allergy or other medical complication, I can’t think of a downside in trying it.
It didn’t personally work for me, but it’s an easy try. Just drink a glass of OJ or something similar when your meds start wearing off. Who knows, maybe you’ll be one of the lucky ones?
Keep in mind, if the side effects are unbearable, talk to your doctor. If you are trying everything and none of it’s helping, it may indicate that you’ve got the wrong med. No matter what I did, I couldn’t make the first ADHD med work for me.
But when I applied these strategies to the next ADHD medication, the angels sang Hallelujah.
I told you mine, now tell me yours!
Okay all you cool cats and kittens, what side effects have you struggled with and what’s working/not working for you? Let me know in the comments.