Do ADHD medications really work differently in ADHD and non-ADHD people?

There was probably a more concise way to phrase the title, but I couldn’t think of it.

Anyway, I am referring to the amphetamine-type ADHD medications, such as Ritalin, Focalin, etc. I have heard anecdotally that if you administer these medications to someone that does not have ADHD, they will make the person hyperactive, jittery, etc. – basically all the things you would expect from giving someone a dose of speed. But if you give it to someone who genuinely has ADHD, that person will experience an improvement in concentration and focusing abilities. Is this true? It seems like this would be a great diagnostic backup for ADHD - if we give medication and the kid goes completely hyperactive, well, he didn’t have ADHD, no?

I would ask up-front that people stick to the GQ here and avoid debate over whether ADHD is a real disease, whether it is overdiagnosed, etc. I am just interested in the answer to my question about how the medications work on different people’s brains.


Amphetimines can be considered “performance enhancers” for just about everyone. In small doses, they allow most people to sustain attention for more mundane types of tasks, such as studying. I’ve heard that college students sometimes use these drugs to help them “cram”.

So no, there is no difference in effect with the drug between groups identified as ADHD and “normals” although there will likely be a big difference in the behavior of the ADHD child once medicated.

Caffeine is also a stimulant and has the same general effect on people who use it.

I currently take Ritalin for my Chronic Fatigue. It gives me a temporary boost of energy that lasts a few hours.

Before reading your reply I had this statement in mind so don’t take it as a direct reply to yours.

I grew up with what today is called ADHD, and have a grandson who is diagnosed with it.
I can SO identify with his struggles.
Caffeine helps him better than some of the high priced meds that knock the snot out of him.

I was an espresso-holic IYW, however I could not drink it or coffee after dinner or I just couldn’t sleep. Now my son-in-law, unrelated to this grandson can have a double shot of espresso at bedtime and have no problem sleeping. Of course he is a Rara-Avis on many other levels also:dubious:

This is merely anecdotal, but I knew someone with ADD who often had coffee just before bed. It stimulated her brain enough that she could concentrate on sleep. Without it her mind would be racing all over the place. Not she takes ritalin or something like it.

My oldest son was diagnosed ADHD and has been on medication for several years. He is on Concerta which is just another form of drug like Ritalin.
My understanding of how it works is like Kelby said, stimulates the brain to help with focusing but I know it does have a calming effect on him. If he doesn’t have his med he is very fidgety, nervous acting, can’t sit still and can’t stop talking. He bounces from subject to subject in a conversation. Once he takes the med, he is a different person.
As far as caffeine having the same general effect, we were told to limit his caffeine intake because it basicly does work the same way and lots of caffiene along with the medicine will cause over stimulation and your right back to the same problem. But… our doctor did tell us that for some reason we didn’t have his med to give him ( such as an unexpected overnight stay somewhere and not packing the med) we could give him a cup of black coffee and it would work basicly the same way.
As far as “normal” people taking it, yes it does have a different affect on them. I know a guy who has narcolepsy who takes Ritalin as a treatment for that to make him more hyperactive so he can stay awake.

As someone for whom ADD has proven a formidable handicap, here’s how I see it.

The reason that ADD sufferers like me respond well to stimulants is that for us, the process of maintaining focus requires more energy than a “normal person” would need to expend.

An apt simile might be swimming laps in a pool. Contestant A and Contestant B are in comparable physical condition, and both are required to swim the same number of laps per day. But for Contestant B, who suffers from ADD, it’s like having to swim against a current. Even if he’s just as strong a swimmer as Contestant A, completing the same task is simply more difficult. A stimulant such as Ritalin may give Contestant B the extra jolt he needs to fight against the current. Some medications like Concerta work in a different way. Instead of providing an energy boost, they actually serve to slow the current. About 10 years ago I switched to Concerta, and for two glorious weeks, I felt “normal.” Then my body decided to become immune to the medication and it was back to Ritalin.

Yes, ADHD drugs have different affects depending on who takes them. There are a number of drugs that do the same thing.

As an OTC example, I’ve found that ADHD people find Sudafed somewhat relaxing and those who are not find it makes them jittery.

This is not true in my experience. I have known several people who get drowsy after drinking coffee. (Computer Science seems to attract a lot of folk with non-standard wet-ware.) In one case, I suggested seeing a doctor about getting tested/treated for ADD which he did and was greatly pleased with the results. (Note that ADD type conditions are not restricted to children.)

Not everyone has the same biochemistry. Ritalin can actually calm some folk down.

Sure, alcohol too has different apparent effects on people, but it’s still a CNS depressant. The biochemistry is the same and everyone will pass out from it at a certain point.

Ritalin and the other amphetamines (including coffee) are the same. I would venture to say that someone who gets drowsy from drinking coffee already has built up a tolerance to caffeine and need it to feel “normal” just as smokers need nicotine. In small doses, stimulants help subdue behavior and allow the person to focus better, the latter being one of the reasons people enjoy their coffee in the morning and at work.

My main point is that a person’s reaction to stimulant drugs cannot be used as a method to retroactively confirm the diagnosis of ADHD, since the effects are similar for most everybody. Of course, certain folks will have significant side effects to any drug. Most children don’t like taking the medication (it makes them feel strange) and will sometimes avoid taking it when the can.

The research I’m familiar with shows that the use of stimulant drugs for ADHD symptoms does produce desired results for most people in the short term. The same is true for the antidepressants. For many, however, the remarkable brain adapts to the chemical and different dosages or preparations are then required.

I don’t have ADHD, but I have some sub-clinical hyperactivity. Any stimulant makes me sleepy. I have a family member without any hyperactivity. Any stimulant makes her more active. I have a family member with ADHD. Any stimulant makes her calm and able to focus.

If a child is diagnosed with ADD/ADHD/ why in hell don’t they try caffeine first before resorting to the more high powered drugs like Ritalin, etc.?

What about its effects as an appetite suppressant? Do people generally lose a lot of weight and not eat on Ritalin? If someone does lose a lot of weight and barely eats on Ritalin is that indicative of the OP in some way?

>If a child is diagnosed with ADD/ADHD/ why in hell don’t they try caffeine first before resorting to the more high powered drugs like Ritalin, etc.?

Because, generally, caffeine is too weak and self-diagnosing a child is probably a bad idea.

I believe some of the stimulants were prescribed as “pep pills” and diet aids in the 50’s and 60’s. Bad side effects and bad press killed those uses, I guess.

Ritalin does suppress the appetite. Most of the time it is prescribed to be in effect during school hours, which often means one dose in the morning and one in the afternoon. They do have time release preparations that can be taken in the morning only.

The effects usuallywear off by the end of the day, and many kids will make up their caloric needs then. Theoretically, the drugs aren’t meant to be used on weekends, holidays, and in the summers also, to allow the child to regain any blunted growth.

I’ve also heard there are problems with dosing, which makes sense.

I said nothing about self-diagnosing. I said if a child is diagnosed with that condition by a doctor, could the doctor try caffeine first? I see someone else said it is weak (I guess compared to the normal drugs prescribed) but is it even tried , to assess the depth of the child’s condition? It would seem like a no-brainer, but IANAD, so I’m looking for the reason. How could dosing be hard with pharmaceutical grade caffeine, but this isn’t an issue with Ritalin and the others?

My point about dosing was with respect to the parents attempting to treat symptoms of ADHD in their child.

But you raise an interesting question.

I know that Ritalin and its ilk are schedule II drugs and therefore pretty carefully controlled, due to their potential for abuse and dependence. I assume that means they are much more powerful than caffeine.

But I don’t know why caffeine is not tried, if the only reason is drug strength.

Anecdotal data point that I know hyperactive kids who, at least back in the 70s and early 80s, were dosed with a cup of coffee before school instead of Ritalin.

Not remotely factual in the case of the people I knew. You can only build a tolerance if you regularly use coffee. None of them could ever drink coffee in the AM if they wanted to get any work done.

You are making far too sweeping of a generalization.