Stimulants

What are Stimulants?

Stimulants are the first-line medications for managing Attention-Deficit/Hyperactivity Disorder (ADHD) in both children and adults. They are often the initial choice because they are effective for many people and work relatively quickly. These medicines act on brain chemicals (dopamine and norepinephrine) that are involved in focus, attention, and self-control.


Despite the name “stimulant,” these medicines usually do not make people with ADHD more excitable. Instead, they tend to reduce restlessness, improve concentration, and help with emotional regulation.

Who is Suitable for Stimulants?

ADHD stimulants may be suitable for:

  • Children, adolescents, and adults formally diagnosed with ADHD: Especially when symptoms interfere with daily life, school, work, or relationships.
  • People who need help managing attention, impulsivity, and hyperactivity: When these symptoms are severe or persistent.
  • Patients without serious health risks: For example, stimulants may not be recommended for those with uncontrolled heart problems, certain psychiatric conditions, or substance misuse issues.
  • Individuals who can be monitored by a doctor: Since regular follow-up is essential to check effectiveness, dosage, and side effects.


Benefits of Stimulants

The benefits of ADHD stimulants are well-documented and include:

  • Improved attention and focus: Helps people stay on task at school, work, or in daily activities.
  • Reduced impulsivity: Supports better decision-making and fewer interruptions.
  • Less hyperactivity: May reduce fidgeting, restlessness, and difficulty sitting still.
  • Better organisation and task completion: Important for academic and workplace success.
  • Enhanced emotional regulation and relationships: Can lead to better communication and reduced conflict.
  • Quick action: Many stimulants work within 30–60 minutes of taking the dose.


Types of Stimulants

Common stimulant medications prescribed in Australia include:

  • Methylphenidate-based stimulants (short-acting and extended-release):
  • Examples: Ritalin, Concerta, Medikinet.
  • Widely used in children and adolescents, but also effective for adults.


  • Dexamphetamine:
  • Available in short-acting formulations.
  • May be used when methylphenidate is not effective or suitable.


  • Lisdexamfetamine (Vyvanse):
  • A long-acting stimulant that provides more consistent symptom control throughout the day.
  • Often chosen to reduce the need for multiple daily doses.


Both short-acting and long-acting formulations are available. Short-acting medicines last around 3–5 hours, while long-acting options may last up to 12 hours. This flexibility allows doctors to tailor treatment to individual needs.


Prescribing and Regulation of Stimulants

In Australia, ADHD stimulant medicines are tightly regulated. Key points include:

  • Authorised prescribers: Traditionally, only specialists such as paediatricians, psychiatrists, and neurologists could prescribe stimulants. However, reforms in some states and territories are expanding the role of GPs under strict conditions.
  • Controlled medicines: Because stimulants have a risk of misuse, they are classified as controlled substances, and prescriptions require close monitoring.
  • Guideline-based care: The Australian Evidence-Based Clinical Practice Guideline for ADHD (developed by AADPA) provides clear recommendations on when and how stimulant medications should be used.
  • Ongoing review: Prescriptions are generally limited in duration and require regular medical reviews to continue.


Alternative Options to Stimulants

Not everyone can take or benefit from stimulant medicines. Alternatives include:

  • Non-stimulant medications: Atomoxetine (Strattera), guanfacine, and clonidine are options for those who cannot tolerate stimulants.
  • Behavioural therapy: Skills-based support for managing time, organisation, and coping strategies.
  • Lifestyle approaches: A healthy diet, good sleep routines, and regular exercise may improve overall well-being.
  • Parent or family training: Helps families support children with ADHD in daily routines.
  • School or workplace support: Reasonable adjustments, such as quiet study spaces or flexible work schedules.


What to do Before Starting Stimulants?

Before starting ADHD stimulants, it is important to have a full medical assessment by a doctor, usually a GP, paediatrician, or psychiatrist. This ensures that stimulants are safe and appropriate. Steps often include:

  • Diagnosis confirmation: A detailed history, questionnaires, and sometimes school or workplace reports to confirm ADHD.
  • Physical health check: Blood pressure, heart rate, weight, and sometimes an ECG to rule out heart conditions.
  • Medication review: Checking other medicines you take to avoid interactions.
  • Discussion of benefits and risks: Your doctor will explain how stimulants work, what side effects to watch for, and expected outcomes.
  • Trial period planning: Stimulants often begin at a low dose, which is gradually increased until the optimal effect is achieved with minimal side effects.


What Happens When Taking Stimulants?

Once prescribed, stimulant treatment usually follows a structured plan:

  • Starting treatment: You take the medication as directed, often once or twice a day, depending on whether it’s a short-acting or long-acting formulation.
  • Monitoring effects: Improvement in focus, attention, and behaviour is observed at home, school, or work. Parents, teachers, or managers may be asked to provide feedback.
  • Dose adjustment: Your doctor may adjust the dose to find the optimal balance between benefits and side effects.
  • Regular check-ups: Blood pressure, heart rate, sleep, appetite, and mood are monitored.


What to Expect After Taking Stimulants?

Once the right dose is established, many patients notice improvements quickly. Common experiences include:

  • Improved concentration and focus: Ability to complete schoolwork, work tasks, and household activities more effectively.
  • Reduced impulsivity: Better self-control and less tendency to interrupt or act suddenly.
  • Decreased hyperactivity: Less restlessness, fidgeting, and difficulty sitting still.
  • Improved relationships: Easier communication with family, friends, and colleagues.
  • Ongoing monitoring: Your doctor will continue to review progress, and some people may require dose adjustments over time.


Stimulants Prognosis

For many children and adults with ADHD, stimulant medication provides significant improvement in symptoms and quality of life. The outlook (prognosis) is generally positive when stimulants are used as part of a comprehensive treatment plan, which may also include behavioural therapy, lifestyle changes, and educational or workplace support.

  • Short-term: Rapid improvement in attention and behaviour within days to weeks.
  • Medium-term: Better school or work performance, improved self-esteem, and reduced stress in families.
  • Long-term: Many people continue to benefit from stimulants into adulthood. Some may transition to non-stimulant options, lifestyle approaches, or taper off medication under supervision if symptoms reduce.


Stimulants Risks

Like all medicines, stimulants can cause side effects. Most are mild and improve over time, but some require medical review. Possible risks include:

  • Common side effects: Loss of appetite, stomach pain, headaches, difficulty sleeping, dry mouth, or irritability.
  • Less common but more serious: Increased heart rate or blood pressure, mood changes, or tics.
  • Misuse potential: Because stimulants are controlled substances, they must be taken exactly as prescribed.
  • Growth monitoring: In children, growth (height and weight) is regularly checked, as appetite suppression can occasionally affect growth.


Doctors balance these risks against the benefits, and regular monitoring ensures safety.


Why Consider Stimulants Now?

If stimulant treatment is delayed, symptoms of ADHD may continue to interfere with daily life. Possible effects include:

  • Ongoing difficulties in school or work: Poor concentration, missed deadlines, and reduced academic or professional performance.
  • Strain on relationships: Ongoing impulsivity, forgetfulness, and hyperactivity may cause family or social stress.
  • Emotional impact: Low self-esteem, frustration, anxiety, or depression may worsen if ADHD remains unmanaged.
  • Missed opportunity for early support: In children, untreated ADHD can affect learning and social development.


Delaying stimulants does not mean treatment is no longer possible, but it may mean symptoms remain disruptive for longer. In some cases, non-stimulant strategies such as therapy, lifestyle changes, or family support can be used while waiting for a medical review.


Who We Support

Our practice offers ADHD support for children (aged six and above), students, and adults of all ages, including both males and females. We also care for women during pregnancy, ensuring treatment is carefully tailored to balance effectiveness and safety.


We take a collaborative approach, working closely with a psychologist trained in supporting patients with ADHD. This ensures that medical treatment, therapy, and day-to-day coping strategies are integrated into a comprehensive care plan.


As part of our service, we also provide letters of support for schools or employers where needed, helping children, students, and adults receive appropriate adjustments and understanding in their learning or work environments.


Every treatment plan is personalised, combining medical options with psychological and lifestyle supports to improve focus, reduce symptoms, and promote long-term well-being.