ADHD, or attention deficit hyperactivity disorder, is a neurodevelopmental disorder that affects both children and adults. It is not curable as a congenital disorder, but that does not mean that the level of difficulties experienced is constant over time (sometimes a year, a month, or even a week).
In many cases, drug treatment is possible, using a range of medications, depending also on co-occurring disorders. Medications for ADHD, however, are most often stimulants – the often demonized Adderall or Ritalin are available abroad. In Poland, there are currently three drugs available under the names Medikinet, Concert, and Atenza.* It’s worth remembering, however, that while these medications can provide significant short-term relief, research clearly demonstrates the effectiveness of therapy (Rajeh et al., 2017), psychoeducation (Oliveira, 2018), and mindfulness training (Hoxhaj et al., 2018). Sometimes, of course, it is the case that the introduction of medication is necessary to start deeper therapeutic work. Therefore, it is worth thinking of the pharmacological and therapeutic pathways not as interchangeable but rather as complementary methods of working with ADHD symptoms.
*I’m writing this in November 2024.
Why are Stimulants Prescribed for ADHD?
At first, it may seem counterintuitive. Stimulants? For people experiencing attention deficit hyperactivity disorder? After all, people with ADHD need to calm down, not get additionally stimulated!
Stimulants are stimulant drugs with specific effects on the central nervous system, which are used to treat disorders such as ADHD but also narcolepsy, for example. The name stimulants itself comes from the English word stimulant and refers to their ability to stimulate or increase the activity of the nervous system, which at the cellular level means increasing the production and availability of key neurotransmitters such as dopamine and norepinephrine.
In other words, stimulants do indeed stimulate, but not the person with ADHD, but rather those brain centers that work too slowly!
Medikinet
Medikinet is a drug based on methylphenidate – a substance that stimulates activity in certain brain areas and is responsible for controlling attention and movement. Unlike many antidepressants, which require constant and long-term use to have an effect (and sometimes even get worse first before improvement occurs), the effects of the stimulants taken can be felt immediately.
Medikinet comes in two types: immediate-release and extended-release. Depending on its form, the drug’s effect can last several hours.
Medikinet has different dosages (5, 10, 20, 30, or 40mg).
Your doctor or physician will decide what dose is best for you, but don’t be afraid to talk to them if you think the drug is working too strongly or too weakly!
Concerta
Concerta is also based on methylphenidate, but it is an extended-release drug, meaning that it works for a longer period (about 12 hours) after taking a single tablet. Thanks to this formula, the drug provides a stable effect throughout the day, which is convenient, especially for those who are studying or working. Concerta is often chosen as a first-line medication for older children and adults with ADHD, as it does not require frequent dosing, and its effects may be perceived as a bit milder.
Concerta comes in doses of 18mg or 36mg. In adults, it is not recommended to exceed 72mg per day.
Atenza
Atenza is the newest drug on the Polish market, issued as a replacement for Concerta (although, at the time of writing this post, I have not yet seen it in pharmacies).
This drug is based on a long-acting form of lisdexamphetamine), which is another type of stimulant used to treat ADHD. Atenza, like Concerta, is characterized by its prolonged action – it works for about 12 hours, making it easier for patients to function throughout the day without additional doses. It works a little differently than methylphenidate – Atenza stimulates the release of dopamine and norepinephrine more intensively, translating into a longer effect and reducing the likelihood of feeling downhill from the drug’s effects during the day.
Availability Problems
Well, you have a diagnosis, you get a prescription from the psychiatrist (or, preferably, prescriptions—ask the doctor to write you separate prescriptions for each box, because there are continuous problems with their availability. Otherwise, your prescription will be kept at the pharmacy you made a purchase at, and you would have to wait until the medication shows up there again), you go to the pharmacy… and the pharmacist shrugs her shoulders and says that the meds are not available. You then check online, for example the gdziepolek.pl website (which I highly recommend!), and there you see that Concerta is available in three pharmacies… in Poland.
Why is it so hard to get ADHD medications if so many people get a diagnosis of ADHD?
On the one hand, stimulant drugs such as methylphenidate and amphetamine are controlled substances. For fear of their abuse, strict regulations are in place for the production, distribution, and sale of these drugs. Secondly, global demand for these substances is increasing, causing difficulties in accessing raw materials and leading to delays in production.
My own observations also show that the biggest deficits in pharmacies occur around Christmas and school holidays.
Happy hunting!
Sources:
Hoxhaj, E., Sadohara, C., Borel, P., D’Amelio, R., Sobanski, E., Müller, H., … & Philipsen, A. (2018). Mindfulness vs psychoeducation in adult ADHD: a randomized controlled trial. European archives of psychiatry and clinical neuroscience, 268, 321-335.
Oliveira, C. T. D., & Dias, A. C. G. (2018). Psychoeducation for attention deficit/hyperactivity disorder: what, how and who shall we inform?. Trends in Psychology, 26, 243-261.
Rajeh, A., Amanullah, S., Shivakumar, K., & Cole, J. (2017). Interventions in ADHD: A comparative review of stimulant medications and behavioral therapies. Asian journal of psychiatry, 25, 131-135.
