First, some corrections to this statement:
“If you’re not sensitive to amphetimes (Adderol, Ritalin) then those are the most effective. However, Straterra and Concerta are non-amphetimes.”
1. There is no “most effective” medication for ADHD. Individual neurochemistry is the biggest factor, and no one can predict which medication will work best for an individual.
2. Ritalin is not an amphetamine. It is methylphenidate, which is milder than an amphetamine class medication.
The methlphenidate class medications for ADHD are Ritalin, Concerta, Focalin, and the Daytrana patch. These are all, essentially, the same medication but in very different delivery systems. The choice of delivery system can make a huge difference.
Adderall is a mixed-amphetamine salt and is in the amphetamine class that includes Dexedrine and Vyvanse.
The general rule is that for about 40 percent of the population, one class works better than the other.
In general, the newer formulations are designed to produce a smoother delivery, eliminating the problematic “roller coaster” effect of the quick-release medications that can start abruptly and end abruptly (Ritalin, Adderall, Dexedrine, etc.)
3. Strattera is a norepinephrine-reuptake inhibitor. Anecdotally, many people with ADHD and their physicians find it less effective for ADHD symptoms than the methylphenidate or amphetamine class medications (considered the first-line treatment), though it does help some people with mood.
As to the original question, you need to define the term “works.” If you are going solely by how “buzzy” you feel, that’s not a good indicator. You need to be using objective measures and rating scales. If your physician is not using rating scales to measure progress, ask him/her to start doing so. Your treatment should have been initiated on the basis of targeted behavior, such as challenges with reading, driving, temper, listening, etc. In other words, proper medication treatment does not consist of the doc asking, “How are you doing?”
If you are doing all that and still find Vyvanse works for only 3 hours, you might be a fast metabolizer. This is typically related to a genetic mutation. But there can be other factors.
Gina Pera, author
Is It You, Me, or Adult A.D.D.?