Alleviating Any Adverse Effects

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Adverse effects of stimulants include some responses that are common and transient or easily adjusted for, such as slight stomachache, headache, and (especially for the first few days on longer-acting agents) extended delay in getting to sleep. Many patients taking stimulants also find that their appetite is diminished while the medication is most active; they may not feel very hungry until the medication has worn off, which is sometimes not until almost bedtime.

Stomachaches and headaches, if experienced, are usually not severe and often go away within a few days, after the person's body has become more accustomed to the medication. Stomachache is less likely if the patient can eat some food, even just a piece of toast or a glass of milk, before taking the medication. And diminished appetite is often simply delayed appetite. Many patients taking stimulants eat very little during the day

DROP-OFF

Figure 8 Stimulant time frames and "rebound." Unpleasant reactions may occur while the stimulant medication is at full strength or as it wears off. If the reaction is limited primarily to when the medication is active, the dose may be too high, whereas if the reaction occurs only later, as the medication is wearing off, the problem is more likely one of "rebound," an excessively quick drop-off of medication effect. Each of these problems requires a different intervention.

Figure 8 Stimulant time frames and "rebound." Unpleasant reactions may occur while the stimulant medication is at full strength or as it wears off. If the reaction is limited primarily to when the medication is active, the dose may be too high, whereas if the reaction occurs only later, as the medication is wearing off, the problem is more likely one of "rebound," an excessively quick drop-off of medication effect. Each of these problems requires a different intervention.

while the medication is most active, feel slightly hungry for dinner in early evening, and then become quite hungry later in the evening. If they are encouraged to eat when they feel hungry, possibly having a second dinner shortly before bedtime, appetite difficulties usually become less problematic. In fact, many patients report that their appetite returns to a more normal schedule after they have been on stimulant medications for at least a couple of months.

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