Risks of Long-Term Use of ADHD Medications: A Patient's Perspective

ADHD-related issues

What are the risks of long-term use of Concerta 36mg and Sertraline 10mg? I feel that the side effects include some restlessness and discomfort, as well as increased numbness in my legs.
When the medication wears off, I experience some confusion and a tendency towards addiction, but I can still manage.
As for the issue of inattention, I think it's not too bad; I just feel a bit lethargic and unmotivated.
However, my doctor must have genuinely believed I needed these medications, otherwise, they wouldn't take the risk of prescribing such medications to an adult, right? Should I take the medication based on the diagnosis to address any potential physiological weaknesses compared to others?

Sui Gui, 30~39 year old female. Ask Date: 2023/08/10

Dr. Wu Enliang reply Psychiatry

Hello, I would like to ask about the long-term risks of taking 36mg of Concerta and 10mg of Sertraline.
A: If taken as prescribed by a physician, long-term use should generally be fine, and there shouldn't be significant long-term risks.
I think the side effects might include some restlessness and discomfort, as well as increased susceptibility to leg numbness.
When the medication wears off, one might experience a bit of confusion and a tendency towards dependence, but it's manageable.
As for the issue of attention deficit, I feel it's not too severe; it's just that I tend to be less motivated and less inclined to engage in activities.
However, the doctor must have genuinely believed I had a condition, otherwise, they wouldn't take the risk of prescribing such medication to an adult, right? Should I take the medication based on the diagnosis to eliminate the possibility of being physiologically weaker than average? A: This question should be directed to your physician.
Dr.
Wu Enliang.

Reply Date: 2023/08/10

More Info

Long-term use of ADHD medications, such as Concerta (methylphenidate) and Strattera (atomoxetine), can raise several concerns, particularly regarding potential side effects and the risk of dependency. It's important to understand that while these medications can be effective in managing ADHD symptoms, they also come with risks that should be carefully considered.

Potential Risks and Side Effects
1. Cardiovascular Effects: Stimulant medications like Concerta can increase heart rate and blood pressure. For individuals with pre-existing heart conditions, this can pose significant risks. Regular monitoring by a healthcare provider is essential to ensure that these parameters remain within a safe range.

2. Psychiatric Effects: Some patients may experience increased anxiety, irritability, or mood swings. In rare cases, stimulants can exacerbate underlying psychiatric conditions or lead to new ones, such as increased aggression or psychosis. If you notice significant changes in mood or behavior, it’s crucial to discuss these with your doctor.

3. Dependency and Withdrawal: As you mentioned, there can be a tendency towards dependency with stimulant medications. While not everyone will develop a dependency, some individuals may find themselves relying on the medication to function normally. Withdrawal symptoms can occur when the medication is reduced or stopped, leading to feelings of confusion or agitation.

4. Physical Side Effects: Common side effects of ADHD medications include insomnia, decreased appetite, and gastrointestinal issues. You mentioned experiencing restlessness and numbness in your legs, which can be side effects of these medications. It's important to communicate these symptoms to your healthcare provider, as they may need to adjust your dosage or consider alternative treatments.

5. Cognitive Effects: While ADHD medications are intended to improve focus and attention, some individuals report feeling "zoned out" or less motivated when the medication wears off. This can lead to a cycle of reliance on the medication to maintain focus, which may not be sustainable in the long term.

The Importance of Diagnosis and Treatment
Regarding your question about whether you should take medication based on your diagnosis, it's essential to weigh the benefits against the risks. ADHD can significantly impact various aspects of life, including academic performance, work productivity, and interpersonal relationships. If your symptoms are severe enough to warrant medication, your healthcare provider likely believes that the benefits of treatment outweigh the potential risks.

However, medication is not the only option. Behavioral therapies, lifestyle changes, and coping strategies can also play a crucial role in managing ADHD symptoms. Cognitive-behavioral therapy (CBT) has been shown to be effective in helping individuals develop skills to manage their symptoms without solely relying on medication.

Recommendations
1. Regular Follow-ups: Maintain regular appointments with your healthcare provider to monitor your response to the medication and any side effects you may experience. This will help ensure that your treatment plan remains effective and safe.

2. Open Communication: Be honest with your doctor about your experiences with the medication, including any side effects or concerns about dependency. This will help them make informed decisions about your treatment.

3. Consider Alternatives: If you find that the side effects are too bothersome or that you are developing a dependency, discuss alternative treatments with your healthcare provider. Non-stimulant medications, behavioral therapies, or lifestyle modifications may be viable options.

4. Self-Care Strategies: Incorporate self-care practices such as regular exercise, a balanced diet, and mindfulness techniques to help manage symptoms of ADHD and improve overall well-being.

In conclusion, while medications like Concerta and Strattera can be effective for managing ADHD, they come with potential risks that should not be overlooked. A collaborative approach with your healthcare provider, along with a focus on holistic management strategies, can help you navigate your treatment effectively.

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