You’ve just gotten your ADHD diagnosis and you and your provider decide together that trying a stimulant together is the best next step for you– now what??
When taking stimulant medications like Adderall or Ritalin, it is important to monitor a couple of things to make sure it’s safe and effective.
BLOOD PRESSURE AND HEART RATE:
Stimulant medications can do a couple of things in your body. They increase levels of norepinephrine and dopamine, which affects your nervous system, constricts blood vessels, and can increase heart rate and blood pressure.
Sometimes your provider may ask you to get a baseline electrocardiogram (EKG) before you start a stimulant medication like Adderall. This is done for a few reasons.
- establish a baseline of your heart’s electrical activity. This can be helpful if heart stuff arises after you start the medication and give your provider something to compare a future EKG to.
- make sure that there are no underlying heart conditions that you don’t know about.
- get more information about your risk for a heart problem- especially if you have a family history of heart stuff.
This blood pressure cuff is easy to use and tracks blood pressure and pulse.
The best time to take your blood pressure and heart rate is after you wake up and BEFORE you take your medication. Your provider may ask you to take your blood pressure and pulse at other times too. You may decide to take additional readings if you are feeling weird or having symptoms like palpitations or fast heart rate.
I recommend creating a log in a planner or on your phone with the date, time, blood pressure reading, heart rate reading, and notes.
Example:
7/15/24 8am BP: 110/74 P: 75 Notes: taking first dose today
7/15/24 12pm BP: 126/82 P:98 Notes: took adderall with coffee and my heart feels like it’s beating faster. It feels uncomfortable.
If you want keep it simple, I suggest this blood pressure log from Amazon, but feel free to keep notes on your phone, in your planner, or somewhere else.
MOOD CHANGES:
It is possible that stimulant medications can have a POSITIVE or NEGATIVE effect on your mood. If you notice changes in levels of depression, anxiety, agitation, irritability, or aggression, take note and talk to your provider about it. Sometimes you might notice a change when the medication wears off. Feel free to keep any concerns with your blood pressure and pulse log
Example:
7/15/24 8am BP: 110/74 P: 75 Notes: taking first dose today.
7/15/24 12pm BP: 126/82 P:98 Notes: my heart feels like it’s beating faster. It feels uncomfortable. Mood: I feel a little anxious and unsettled, like I need to be doing something but I don’t know what to do.
If you or someone in your close family has bipolar disorder, it is important to keep an eye out for symptoms of mania and hypomania.
EFFECTIVENESS/TIMING:
One of the trickiest parts of stimulant use can just be getting the timing right for when to take the medication! Your provider may ask you to keep track of when you’re taking the medication, what time you can feel it kicking in (if you can) and when it seems like it is wearing off. This can be hard to tell sometimes but any notes about this are better than none.
Other things that can be helpful to note: changes in appetite and sleep!
Example:
7/15/24 8am BP: 110/74 P: 75 Notes: taking first dose today. Took med at 8:15am with coffee, no food.
7/15/24 12pm BP: 126/82 P:98 Notes: took adderall with coffee and my heart feels like it’s beating faster. It feels uncomfortable. Mood: I feel a little anxious and unsettled, like I need to be doing something but I don’t know what to do. Did notice that I was able to reply to several emails without getting distracted. Felt pretty distracted again by 1pm. No appetite for lunch.
LIMITATIONS OF MEDICATIONS:
Please keep in mind that treating ADHD with a stimulant medication does not automatically mean all your symptoms are going to magically disappear. Pills do NOT equal skills. Their biggest goal is to get your brain on a level playing field so that skill development, learning, planning, etc are not so dang hard!
Regular follow-up appointments with your provider are essential to monitor these factors, adjust dosages, and ensure the medication is working effectively without significant side effects.
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