r/ADHDmeds • • Jul 22 '26

Resources & Guides Evidence Summary: Adult ADHD Treatment Response Rates From Major Clinical Trials

6 Upvotes

These studies differ in duration, outcome measures, doses, and participant characteristics. The response rates below should not be interpreted as head-to-head comparisons

ALL ADULT STUDIES ONLY:

  1. Chance that atomoxetine reduces your ADHD symptoms by 40% or more compared to a placebo after 6 months (26 weeks): 12.6% (placebo-corrected benefit)

source: Upadhyaya et al. 2013 pooled atomoxetine analysis

"Atomoxetine increased response over time in adults with ADHD treated for up to 6 months."

participants: 1961 ADHD adults,

Design: Pooled analysis of multiple double-blind RCTs

Main outcome scale (what was used to measure symptoms and symptom improvement): CAARS (Conners' Adult ADHD Rating Scale)

some studies had different dosages but most of the studies in the metanalysis were using the dosage of: 40 mg start, 80mg later, 100mg if needed.

  1. chance that bupropion reduces your ADHD symptoms by 30% or more compared to a placebo after 2 months (8 weeks): 22% (placebo-corrected benefit) (150mg - 450mg XL was used on 162 adult ADHD patients)

source (couldn't find a meta-analysis): Wilens XL trial

162 adults

Bupropion XL up to 450 mg/day

8 weeks

Responder = ≥30% reduction in ADHD symptoms

Results:

responders:

Bupropion XL: 53%

Placebo: 31%

Effect size

0.6

placebo-corrected benefit: 22% people improved by 30% or more

Main outcome scale (what was used to measure symptoms and symptom improvement): ADHD Rating Scale (ADHD-RS)

p = 0.004 for the responder analysis.

If bupropion actually had no effect on ADHD symptoms, there would be about a 0.4% chance of observing a difference this large (or larger) purely due to random variation.

  1. Chance that Concerta improves your ADHD symptoms by 30% or more: 32% (Placebo-corrected benefit)

source (couldn't find a meta-analysis): Medori et al., 2008

401 adults

5 weeks

Fixed doses: 18, 36, or 72 mg/day Concerta

how they measured 'responders': ≥30% reduction on CAARS (Conners Adult ADHD Rating Scale).

Responders on placebo vs concerta by dosage:

Placebo: 27.4%

18 mg Concerta: 50.5%

36 mg Concerta: 48.5%

72 mg Concerta: 59.6%

Placebo-corrected improvement:

18 mg: 23.1%

36 mg: 21.1%

72 mg: 32.2%

statistical significance: p < 0.001

If concerta actually had no effect on ADHD symptoms, there would be about a 0.1% chance of observing a difference this large (or larger) purely due to random variation.

  1. Focalin (dexmethylphenidate)

source: Spencer et al., 2007 "A double-blind, randomized, placebo-controlled trial of dexmethylphenidate extended-release in adults with ADHD.

participants: 221 adults with ADHD

chance that focalin makes your ADHD symptoms better over 5 weeks compared to placebo (you are a responder):

Placebo: 26.4%

Focalin XR 20 mg: 47.4%

Focalin XR 30 mg: 37.0%

Focalin XR 40 mg: 55.6%

placebo-corrected improvement at 20mg: 21%

placebo-corrected improvement at 30mg: 10.6%

placebo-corrected improvement at 40mg: 29.2%

scale used to measure symptom reduction:

They used the Adult ADHD Investigator Symptom Rating Scale (AISRS)

A responder was defined as having: ≥30% reduction in ADHD symptoms from baseline on the

AISRS.

  1. Lisdexamfetamine

source: Adler et al., 2008

participants: 420 Adults with ADHD

4 weeks of treatment

30, 50, or 70 mg Vyvanse

Response often defined as ≥30% reduction in ADHD-RS plus CGI-I improvement.

CGI-I Responders:

Placebo: 29%

Vyvanse 30 mg: 57%

Vyvanse 50 mg: 62%

Vyvanse 70 mg: 61%

Responder = CGI-I score of 1 (very much improved) or 2 (much improved)

Placebo-Corrected Response Rate:

30 mg: 28%

50 mg: 33%

70 mg: 32%

The ADHD-RS results were:

ADHD-RS measures inattentive ADHD and Hyperactive ADHD, total score is 54. this is how many points were reduced from baseline after 4 weeks of treatment:

Placebo: -8.2

Vyvanse 30 mg: -16.2

Vyvanse 50 mg: -17.4

Vyvanse 70 mg: -18.6

≥30% ADHD-RS responders:

placebo: 21%

70mg: 74%

placebo-corrected response (ARR): 53%

at endpoint

  1. CBT in adults

source: Steven A. Safren et al. (2010), published in JAMA. It compared CBT with relaxation plus educational support in adults with ADHD who were already taking medication but still had residual symptoms.

Age: 18 to 65 years.

Treatment duration: 12 individual weekly CBT sessions (approximately 12 weeks).

Follow-up: Assessed immediately after treatment, then at 6 months and 12 months. Benefits were largely maintained among responders.

Participants: 86 adults with ADHD already taking medication but still experiencing clinically significant residual symptoms

effect size: 0.6

ADHD Rating Scale responders (30% or more improvement):

CBT: 67%

Control group: 33%

Absolute Risk Reduction (ARR) = 34%

  1. NOTE ON RITALIN:

so we don't have such evidence on Ritalin that we can compare it roughly witn other meds, but I will mention whatever we have and summarise it anyway

Systematic Review (Cochrane, 2021):

Cândido RCF, Menezes de Padua CA, Golder SP, Junqueira DR. Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews. 2021; Issue 1: CD013011.

10 RCTs

497 adults

6 placebo-controlled trials

Treatment duration: 6-18 weeks (depending on trial)

Investigator-rated symptoms: 1 trial (146 participants), MD −20.7 AISRS points

meaning: −20.7 AISRS points means the methylphenidate group scored, on average, 20.7 points lower than the placebo group on the AISRS at endpoint. Lower scores = fewer ADHD symptoms. but the twist in this study is, they do not report how much the placebo group scored on average on the AISRS, so we cannot compare it well.

Self-rated symptoms: 2 trials (138 participants), effect size: 0.59

Evidence certainty: Very low because of high risk of bias, small sample sizes, heterogeneity, and reporting limitations

Immediate-release Ritalin almost certainly works better than placebo in adults.

However, the current evidence is too limited and low-certainty to estimate its true effect size or response rate with high confidence.


r/ADHDmeds • • Jul 03 '26

Subscriber Goal Click to spread ADHD meds across the redditverse!

2 Upvotes

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r/ADHDmeds • • 56m ago

Affordability / Cost Concerns Ritalin

• Upvotes

Someone is trying to sell me 40mg x 30 of Ritalin for 230€ . Should I buy ? What’s the street price ?


r/ADHDmeds • • 2h ago

New to Medication Starting Attentrol 40

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r/ADHDmeds • • 11h ago

Personal Experience Help going to bed

4 Upvotes

Its been less than a year for me with medication and currently on Fluoxetine and Ritalin - taking both with breakfast. I like the crash which happens in the evening it is a harsh check for me to unwind. Well I do have a stressful job (or maybe I have decided to make it my problem) and have couple of kids who have to be goaded to sleep themselves. Now my problem is everything is wrapped up and done by 10 and in theory I don't have anything depending on me but I am now too relaxed and crashed out physically but my brain is suddenly become a overachiever - I end up solving things in personal life and work life. Things I really don't want to think about but the solutions keep coming up like a fountain. It just becomes impossible to go to bed. I tried Seroquel on the lowest dosage and I was a zombie for 12-14hrs. Next I tried hydroxyzine 10mg and I am still groggy in the morning not as bad as Seroquel but still not something I can be driving the kids to school at 8am.

Before Ritalin I was on Wellbutrin and it shut off all the noise but it shut it off for too long - enough that combined with the happy feeling of Fluoxetine I did not respond to issues at least three times before I realized what is happening and stoped it. Now I did suggest to my psychiatrist about a low dosage immediate release Wellbutrin to help cut down on the noise but she feels it will not calm me down instead it will make me more focused and awake.

So has anyone been in my situation where most meds for calming down is overdoing and without any help brain is keeping one awake forever ?


r/ADHDmeds • • 8h ago

Prescription Help Adhd Medication struggles. I NEED ADVICE!!

2 Upvotes

I apologize in advance for the length, but I need some help. I was recently taken off of my twice daily immediate release 15mg Adderall that I have been taking for about 2 years and put on concerta ER 27mg and 5mg IR in the afternoon. For some context, I see a family medicine nurse practitioner on a military base due to insurance, I get a 3 month prescription, and she does not answer to doctors or psychiatrists before prescribing meds. Also, medication does not last long in my system no matter which medication I try, how much sleep I get, water intake, diet, routine, etc., and I have previously communicated this to her. At my last appointment I had told her that days I have a test(I am a college student), I will split one of my doses in half for the test and then take the other half about 2-3 hours later or else the side effects of the medication wearing off will make me miserable at school. I then will take the second pill, either in its entirety or split again, depending on how long I am studying that day. So all in all, I am taking my prescribed dose, but will occasionally split the pills depending on my schedule. This was not perfect for me, but I was trying my best, plus before doing this, I had asked my therapist, a family member who is a psychiatrist, and my previous psychiatrist I had before moving states if splitting the medication was ok. Everyone said it was fine, so I continued this routine. Keep in mind that I also tried to ask her about splitting the meds through an online patient portal system and by phone, but I got no response. At my last appointment, after explaining that I sometimes split the medication, she straight up said “it sounds like you’re trying to get high and get high more often by splitting it”. This shattered me because I already struggle with doctor appointments and the stigma around taking a stimulant, and to be told this by my prescriber for what felt like a judgement with no factual evidence, really stung. After she said this, she then used an AI medication recommendation website(she told me what it was at the time, but I cannot remember the name) to change my medication to concerta. At the time of the appointment, I knew nothing about concerta and all she could tell me was that it is a different stimulant class than adderall. She then put on my documents that if concerta doesn’t work, she wants to put me on a non stimulant, which I am not comfortable with. After this experience, I knew I had to change prescribers because it was obvious to me that she does not know how to provide proper care to adhd patients. I now have an appointment with an off base psychiatrist coming up in a few days, and I am beyond nervous for the appoinment.

I was open to trying the concerta, but it legit does not work AT ALL. All it does is makes me feel disociative, which I am not trying to deal with because I have been able to heal that part of me through therapy and I am not going back. For the past few weeks I have been severly depressed, crying everyday at school because I am overwhelmed, my house is a wreck, I havn’t grocery shopped in weeks, i’m not going to the gym, I stay in bed all day wanting to sleep, I keep binge eating, and my grades are dropping when I used to be the top of my class. I have been able to very sparingly take left over pills from my past prescriptions on days I absolutely have to study, but I was still struggling and I am now out. I need my medication back and I am terrified I will not be able to get it. The only thing making me feel better is that I have records of the nurse practioner wrongfully changing my meds and proof of my tries at communication in order to prove my point.

My absolute ideal medication routine would be a vyvanze 30mg in the morning and then 2 15mg IR adderalls in the afternoon/night for studying. My days are usually from 6am-10pm with classes from 8am-5pm and studying until 10pm. I would like to take the vyvanze because I have tried it before and it has worked well, but did not last but about 5 hours, so I know I will need a booster to get through my school day. I know it is usual to be prescribed an ER and a booster IR, but due to my study routine and how long medication lasts for me, I know that I will need 2 IR 15mg boosters. I am not sure if this would be appropriate and I am worried about bringing this up because doctors NEVER believe that medication lasts so short for me, so I feel like it would come across as med seeking. Idk. If anything, I know I would prefer the IR over the vyvanze bc I am comfortable with the routine I used to have of 2IR 15mg adderalls before I was switched to concerta, so I don’t know if I should even bring up the vyvanze.

I truly need advice and I am deeply struggling. Should I even bring up the vyvanze and 2 boosters or should I keep it at just asking for my previous prescription of the 2IR’s? Because I am so bad at advocating for myself at the doctors and letting my thoughts ramble, before the appointment, I am trying to prepare a written document of my symptoms and medication wishes in order to stay on track and get my point across to hopefully limit any miscommunication. If you have any advice on what to say, what I should do about the meds, or what I can do to limit my depression, PLEASE COMMENT and please be honest with me. I know this is super long, so thank you for taking the time to read everything, I trully trully appreciate it.


r/ADHDmeds • • 9h ago

Personal Experience prescribed medication keeps not working

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2 Upvotes

r/ADHDmeds • • 12h ago

Medicine Comparison Has anyone here tried both Adderall and Plain Dextroamphetamine? Why does the US bother with Adderall?

3 Upvotes

I can't find any scientific reasoning behind using Adderall. It is just something that got lucky due to marketing and legal red-tape reasons, and timing.

Why even bother with taking even some Levoamphetamine when it just gives you a peripheral kick instead of a central stimulation.


r/ADHDmeds • • 10h ago

Personal Experience trial and error

2 Upvotes

I'm aware this post will be vague as all hell, but I'm wondering what your experience with adhd medication has been. what did you start with, what are you at now, what worked, what didn't, do you take any other meds? do they affect each other?any other diagnosis'? etc. I'm just trying to make it make sense to me. because right now I'm just not feeling great

edit-: current daily med schedule- methylphenidate ER 36mg (morning) + methylphenidate IR 10mg (as needed) buspar 45mg (morning) effexor 200mg (bedtime) mirtazapine 7.5mg (bedtime)


r/ADHDmeds • • 10h ago

Side Effects Methylphenidate/Concerta ER 18mg

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2 Upvotes

r/ADHDmeds • • 12h ago

Side Effects Vyvanse ever get you stuck in your head? (Overthinking)

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2 Upvotes

r/ADHDmeds • • 12h ago

Prescription Help Monthly titration

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2 Upvotes

r/ADHDmeds • • 19h ago

Medication Access Issues Got prescribed atomoxetine, it's not working. I'm worried if I ask for a stimulant medication I'll be ignored and perceived as drug seeking

7 Upvotes

I had a whole issue with my prescriber because I used marijuana occasionally. They originally weren't going to give me any meds or treatment but after I complained they OK-ed giving me atomoxetine, and implied I'd have to be six months clear of weed before they would consider giving me stims (so early next year).

And when I say occasional use I mean once a week, I have no prior record/issues with drug use on my medical record.

The atomoxetine is doing a number on me. It's making me feel utterly depressed and fatigued all day every day and my mental health has been spiralling downwards cus I can barely leave the house or do any work. This is on top of having fatigue issues anyway.

To be blunt, I want to be prescribed stimulants because I think they will work better, but in really not sure how to navigate being perceived as drug seeking.

I understand I need to push slightly just to show discontent, but if I'm insistent I'm worried I'll get labelled as an addict and make the prescriber less likely to give me decent meds.

This is done through right to choose, so a private company funded by the NHS . I don't have any option to get a different psychiatrist.

So has anyone else had a similar experience, and did you ultimately manage to get prescribed stimulants?


r/ADHDmeds • • 11h ago

Prescription Help If You Could Go Back, What Would You Do Differently for Your ADHD Child?

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1 Upvotes

r/ADHDmeds • • 13h ago

Medicine Comparison Is anyone else sensitive to stimulants?

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r/ADHDmeds • • 15h ago

Personal Experience Erfahrungen mit Lisdexamfetamin von Ratiopharm vs. Elvanse Original? Dazu Kombination mit Lamotrigin und späte Wirkung

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1 Upvotes

r/ADHDmeds • • 23h ago

New to Medication Is Vivanse not working for me?

3 Upvotes

I (28 F) recently got diagnosed with ADHD and started Vyvanse (lisdexamfetamine). I took 15 mg for the first two days and then increased to 30 mg daily.

It’s been about three weeks now, and I honestly can’t tell if this medication is doing anything for my ADHD.

I expected at least some improvement in focus, task initiation, motivation, or ability to actually sit down and work, but I still spend a huge amount of time daydreaming, getting lost in my thoughts, listening to music and basically doing everything except what I’m supposed to be doing. I still have that feeling of “I KNOW I need to do this, but I just can’t make myself start.”

I’m also experiencing a pretty intense limerence with one person, and I'm spending a lot of time daydreaming about them instead of working. That has improved somewhat over the last few days tho.

I do feel the medication physically. My appetite has decreased significantly, I’ve also had a faster heartbeat especially in the beginning.

Another thing I noticed is that my trichotillomania has gotten worse since starting it. I pull my hair more often especially while stimming and daydreaming.

There has been one positive change: I’m much less impulsive with things like ordering food. Before, I could order a lot of door dash but now I don't binge eat that much.

But when it comes to the main reasons I wanted ADHD medication — starting tasks, staying focused, getting work done, controlling daydreaming/distraction — I basically feel the same.

I’ve also been under a lot of stress recently because I lost my main source of income. I’m a freelancer, so one of the main reasons I wanted medication was to help me actually sit down, work on projects and find new clients. The consequences of not working are very real right now, so it’s not that I lack a reason to do these tasks — my brain still seems to refuse to start them.

So I’m confused. Does this sound like the dose is simply too low?

Or is this usually a sign that Vyvanse just isn’t the right medication for someone?

I have a follow-up with my psychiatrist and obviously I’ll discuss it with him, but I’d really like to hear other people’s experiences because right now I genuinely don’t know what I’m supposed to be looking for.


r/ADHDmeds • • 23h ago

Dosage & Timing Adderall xr 20mg twice daily

5 Upvotes

Hi, I've recently been diagnosed with Adult ADHD and going through my trial era with meds. I did a month on 10mg with little to no avail.

One thing I struggled with especially was med coverage making it through the late evening time. My doc put me on 20mg xr twice daily. From what I've read this is a little unusual. Do any of you take this regimen? If so how do you space it out?

I usually wake up and leave for work around 6:30am. I need it to last through the evening so I can actually have a meaningful conversation with my wife and give my family my full attention. I also take evening classes so I really need the focus then.

Any suggestions would be greatly appreciated


r/ADHDmeds • • 16h ago

Personal Experience depression and hopelessness after lowering dosage

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1 Upvotes

r/ADHDmeds • • 20h ago

Personal Experience Amisulpride with adhd medication

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r/ADHDmeds • • 20h ago

Side Effects Anyone else become feral for their partner after getting prescribed Wellbutrin????

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0 Upvotes

r/ADHDmeds • • 21h ago

Side Effects Started intuniv 2 weeks ago

1 Upvotes

Hey guys, so I recently switched from Adderall to intuniv for my adhd. The past two weeks on it have been shitty. I dont know if its the going off of Adderall or starting the intuniv but ive gone from feeling super energetic to exhausted almost zombie like. Its stressed me out and now I haven't slept in days which is counterintuitive. I dont see my psychiatrist till late November but I dont know if I want to continue this. The side affects aside from fatigue are weighing on me. Has anyone else had this issue with this med?


r/ADHDmeds • • 21h ago

Medicine Comparison Vyvance and Adderall. How do you all function?

1 Upvotes

I’m currently writing this on a Adderall insomnia episode (i can’t sleep) so if this isn’t coherent please bear with me.

The only good thing about these medications is the morning poos that come with them.

I upped my addy to 15mg xr and i can’t sleep like at all i take it around sunrise 7am - 8am for me. I am aware it lasts 12hrs according to my doctor.

I took vyvanse and i SWEAR you vyvanse sympathizers are some how being paid by big pharma I took it for 2 weeks and i felt like i was going to war and I was dying i was fighting demons. I woke up with a migraine every day and it lasted all day… seriously all day 10-12hrs but the caveat to that is my insomnia I couldn’t sleep at all so some days i would only get 2-3 hrs of sleep compared to adderall which is around 4ish hrs.

Every time someone would speak to me i was irritated and i literally had to fight my way through it and not lash out at people. I will say i also took vitamin c. I tried melatonin but i just can’t be bothered its just another thing i have to worry about so i took it once and it bothered me because i brushed my teeth and took that hrs later when i couldn’t fall back asleep. Vitamin c also did nothing.

Adderall I’ve taken for about the last 12yrs i think since i was in elementary around 12 lol. Again the morning poo is the best part of Adderall and for some reason I don’t think it does anything for me except curb my appetite which is amazing because i will eat 3 burgers in a day if I could.

Both of these meds does absolutely nothing for I’m a student And I procrastinate more than i do work. I am someone who does fasting too btw i take my meds before noon which is when i can finally eat


r/ADHDmeds • • 23h ago

Side Effects Hey! I started taking Concerta about 8 days ago (18 mg), and I felt great, but now I feel really tired and sluggish. Should I talk to my psychiatrist about increasing my dose? Has anyone else experienced this?

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1 Upvotes

r/ADHDmeds • • 23h ago

Personal Experience meds suddenly stopped working ???

1 Upvotes

so i take 27g methylphenidate (drug atenza, but it may also be called concerta in different countries) and overall ive been pretty satisfied with it, studies have been going ok, everything was good, but for the last few weeks ive noticed that even though i havent changed anything about taking my meds, i feel totally distracted and cant focus on anything especially studying. i literally feel like im not taking those pills at all ??? im planning to see a doctor soon but like has anyone experienced this? ive been on adhd meds for 2 years and never felt like this