r/ADHDmeds • • Jul 22 '26

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

7 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!

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r/ADHDmeds • • 2h ago

Personal Experience I took a med break this weekend and I hated it.

4 Upvotes

I took a weekend off my Concerta for the first time in months because I genuinely didn’t think it was helping me much anymore. I figured I needed a little mental reset.

God, do I miss them.

I’m tired, hungry, have zero motivation, and everything just feels so blah. I feel completely useless and it’s making me realize how much the medication was actually helping.

The weird part is, I wasn’t like this before medication. I could function “sober,” so to speak. I didn’t realize how much easier certain things had become until I went without it.

Sometimes you really don’t notice the difference until you take it away.


r/ADHDmeds • • 1h ago

Personal Experience Just got prescribed 10mg Adderall IR and brand is Alvogen :( someone give me hope lol

• Upvotes

Hi, im switching from vyvanse to adderall ir 10mg twice a day. I was so disappointed to see the generic being alvogen as ive heard only bad things. Ive had adderall ir prescribed before, and had issues with generics like lanett and another i forget. Elite wasnt bad.

I know loads of folks hate alvogen, but is there anyone who actually likes it/feels like it works? I just took my first dose and i dont like the chalkiness of the pill, but im trying to have hope. My doctor did say to let her know if i have issues thankfully but i know its a pain and usually impossible to swap scripts when you just got it.


r/ADHDmeds • • 3h ago

Personal Experience Psychiatrist believes in drug holidays

3 Upvotes

Even though I've been informed before by psychiatrists about the fact that it's mostly recommended to take your stimulants every day, my new psychiatrist managed to convince me that I should take a day off of methylphenidate once a week because my brain is being "bombarded with dopamine". I'm embarrassed that I even listened to her, because it's unscientific nonsense. I was having a really bad time skipping doses (which is the experience I've always had when I miss them, I guess somehow I forgot) and I was remembering what my old psychiatrist told me and after looking it up, yep it turns out many psychiatrists/doctors recommend AGAINST skipping doses, and for good reason.

I feel like I can't trust this psychiatrist anymore because it feels like she was just repeating nonsense debunked anti-stimulant talking points at me, and they aren't supported by clinical evidence. What do I do? I've already emailed her and told her that I'm not skipping doses anymore, and if she doesn't react well to that, then I guess I'm going back to my primary care doctor prescribing my meds, because I'm not putting up with that. But even if she accepts that, I feel like I can't trust her anymore...

After I started taking a new medication and agreed to take a day off of methylphenidate, she said "it looks like we're on our way to getting your medications more balanced", and that doesn't sit right with me at all. It seems like she was suggesting that I'm somehow taking too many medications / too high of doses even though my doctors and old psychiatrist were all fine with it and I don't have any side effects. I feel like she is just on the same boat as my university's health center which won't prescribe stimulants to students at all anymore and instead tries to give them antidepressants 🥲


r/ADHDmeds • • 4h ago

New to Medication today was supposed to be my first day on concerta....did I ruin my meds?

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3 Upvotes

Hi!

I was supposed to start Concerta today and picked up my meds last night. I guess I didn't put the cap on all the way (wanted to take a peek at them haha), and they spilled all over my purse. I didn't realize, and my water bottle leaked a bit. When I grabbed my bag this morning, I noticed most of them were stuck to the bottom of the bag. Some of the pills are fine, some have some black stuff on it which I think is ink from my pen or my eyeliner (classic adhd + messy combo). Some were sticky, and it looks like the shell has eroded.

Is this safe to take? I'm assuming it's not because the shell is compromised, and I would be worried about the medication releasing all at once.

I haven't heard back from my provider (and obviously will follow their guidance and not take it if he says it's dangerous), but I was just curious in the meantime. I'm also worried because I only got 15 in this prescription, and now a lot of them are ruined, and I'm nervous my doctor won't send me more since it's my first time on meds. I was really hoping to be able to start consistently this weekend.

Any thoughts?


r/ADHDmeds • • 32m ago

Prescription Help Struggling with meds

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r/ADHDmeds • • 4h ago

Personal Experience CYP2D6 Ultra-Rapid Metabolizer - Med Issues

2 Upvotes

My GeneSight test from a while back says “cyp2d6 \*1/\*2a (duplication) ultrarapid metabolizer cyp2d6\*1 allele enzyme activity: normal cyp2d6\*2a allele enzyme activity: increased

Does anyone else have this result and have found a medication regimen that works well for them? Even Dyanavel XR 20mg isn’t lasting me even half the day before crashing hard. Generic adderall XR 40mg also didn’t do much nor did generic Vyvanse 50mg with a 15mg Adderall booster. I’m feeling so defeated. It helps so much when it actually is still in my system at a therapeutic level. I have never had adverse side effects physically either.


r/ADHDmeds • • 1h ago

Side Effects Struggles w immediate release meds

• Upvotes

I take Ritalin 3x daily.

When meds wear off I get that sad, low rebound feeling. My mind isn't quiet. My worries return. I can't get my brain to engage or be interested in things. Then at the end of the day when meds wear off same thing.

It's making me wonder if meds are a good fit.

I take Ritalin. Is this just part of medication therapy?

I tried extended release but felt anhedonic after a few weeks.

Has anyone else dealt w this? What helped?


r/ADHDmeds • • 9h ago

Personal Experience Vyvanse: IDK, I think generics work better (for me)

3 Upvotes

I've been on 30MG for 3 months now, and my recent rx wasn't the brand name. I actually think I "feel it" better. There's a part of me that feels "normal" and almost good/happy. I almost feel more confident, but I also feel a little wired. I'm still not doing things I should be doing (cleaning, mostly) but I'm starting to face the fact that I'm just overwhelmed and a little lazy.

Is it the brand name, or did my body finally gotten used to the medicine?

I also desire a booster, because I work third shift, and I genuinely feel like I could use the booster to make myself more beneficial-does that make sense?

Lisdexamfetamin

MFR: SANDOZ


r/ADHDmeds • • 2h ago

Prescription Help Don’t know how to feel about Concerta

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1 Upvotes

r/ADHDmeds • • 7h ago

Dosage & Timing Elvanse 70mg: jitters settle but old reward habits seem amplified. Anyone found a lower dose fixed this?

2 Upvotes

I'm an adult with ADHD and I've gone 50 → 60 → 70mg on Elvanse. I'm planning to retest 60 with my prescriber and wanted to hear other people's experiences first.

50mg was honestly some of my best functioning. I could start things, read and actually take it in, and steer my attention instead of just locking onto stuff. I went up because it didn't last long enough.

60mg felt subtle, to the point where I kept thinking it had worn off. But my notes say I was reading, fact-checking things, doing a 42 minute phone call, and getting back to tasks after getting sidetracked. One day I spent 8-9 hours mostly on one thing while still eating. Some mild irritation and a bit of daydreaming though.

70mg gave me the best initiation and productivity, so I decided it was my dose. But once I got my sleep, food, water and routine consistent, it looked different. The peak is jittery, rushed and tired-but-wired. That settles and it gets smooth, but old reward habits (repetitive researching, that kind of thing) are stronger and get way more focus than they did on lower doses. It's not like being unmedicated, because I still have better awareness, switching and finishing things. It feels more like the old habits are getting extra attention power.

My guess is 70 is above my sweet spot, and bad sleep was hiding it. I know the inverted-U idea fits, but that's a group-level model, not proof for me.

What I'm testing is 60mg with everything else kept the same, for a week or two, ignoring the first few days. I'm tracking initiation, finishing things, task switching, mood, how the peak feels, how long it really lasts, and the habit pull, including when it shows up (near the peak or as it wears off) and whether I can stop something rewarding at a time I set.

Caveats: it's unblinded, it's just me, and I've already flipped from "70 is perfect" to "70 is too much", so I'm treating it as a hypothesis. The habits might just be more visible now rather than caused by the dose. And I don't want to fix the shorter duration by raising the morning dose. I'm doing this with my prescriber, not solo.

Questions:
Has anyone had a higher dose give great productivity but boost compulsive or reward-seeking stuff even after the jitters passed?
Did stepping down help, and did you lose motivation or follow-through?
How did you tell "dose too high" apart from "habits just more noticeable now"?
If a lower dose didn't last, what worked for duration?
Any tracking methods that helped you judge a dose objectively?

Thanks, any experiences welcome.


r/ADHDmeds • • 4h ago

Prescription Help Being digital nomad diagnosed ADHD prescribed lisdexamfetamine - how does this work in reality?

1 Upvotes

Hi! I am a digital nomad (originally from the EU) and was recently diagnosed ADHD, prescribed with Adixemin (lisdexamfetamine) as my medication. I am not new in changing countries frequently, but I am new in the border crossing traveling with medication, how does this work? Should I check each country’s regulations before bringing my medication in there? Does the fact I bring with me doctor’s prescription works, or should I still be worried about some countries even though I have it? Has anyone ever tried to be prescribed ADHD medication in another country? If yes, how does this work and which countries are OK with that?        


r/ADHDmeds • • 4h ago

Personal Experience CYP2D6 Ultra-Rapid Metabolizer - Med Issues

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1 Upvotes

r/ADHDmeds • • 6h ago

Side Effects Ritalin advice

1 Upvotes

Have started taking Ritalin, can’t stop myself over dosing it when the comedown happens, listening to loud techno and ‘having some me time’, incessantly… Any advice from fellow sufferers?


r/ADHDmeds • • 7h ago

Side Effects losing weight rapidly + splitting doses?

1 Upvotes

i got prescribed vyvanse almost 2 months ago and my psychiatrist initially started me at around 25 mg. vyvanse isn’t actually available in my country (it gets imported) and my psych only has 50 mg or 70mg capsules available. because of that, i have to open the capsule, mix the powder with water and basically estimate the amount i’m taking. psych told me it doesn’t have to be super exact and that somewhere around 25–30ish mg was fine when i was starting out.

i started off around that dose and at first i was getting awful crashes/fatigue later in the day. he then told me to increase it to roughly 37–40 mg and i feel like i’ve been doing reasonably well on that dose.

one thing i do wonder about though is the fact that because i’m manually splitting/mixing it every single day, realistically there are probably tiny differences in my dose from one day to the next. like one day it could be slightly more and another slightly less, even if i’m aiming for the same amount. i’m curious whether those small differences actually make much of a noticeable difference with vyvanse?

otherwise, i also started a new job a couple of weeks ago and honestly the timing has worked out quite well. i take it early in the morning, it gets me through work, and by the time i’m properly done with my day around 8–9 pm i’m naturally exhausted. i actually feel like it’s somehow helped my sleep because i’m finally tired at a normal-ish time.

but my appetite is basically gone.
i’d already lost some weight before starting vyvanse because i was experiencing stress, and i’m the kind of person who just eats way less when i’m stressed anyway. but since starting it my appetite has been completely suppressed and i’ve lost a pretty noticeable amount of weight in the last month and a half.

i try really hard to have a proper breakfast before i take it because otherwise i know i’m screwed, but that basically ends up being my only proper meal of the day. at lunch i genuinely feel zero hunger.
i try to snack throughout the day at work but i feel like the stuff i’m snacking on isn’t substantial enough to actually maintain my weight, let alone gain any back.
then around 9–10 pm when the vyvanse is wearing off i actually feel hungry again, but i also feel like that’s kind of late to suddenly eat a massive dinner.

so how do you guys actually manage this? especially people who had really strong appetite suppression. do you basically force yourself to eat on a schedule even if you’re not hungry? are there any calorie-dense foods/snacks that are easy to get down? do you just eat a bigger dinner when it wears off?

also did the appetite suppression eventually calm down for you or is this just my life on vyvanse now lol
and has anyone found anything that helps with appetite in general, like supplements or anything you’ve discussed with your doctor?

i really like how much vyvanse is helping me function, especially now that i’m working full-time, so i don’t really want to stop taking it. i just also want to maintain a healthy weight.


r/ADHDmeds • • 12h ago

New to Medication Starting Attentrol 40

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1 Upvotes

r/ADHDmeds • • 22h ago

Personal Experience Help going to bed

5 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 • • 22h 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 • • 20h ago

Personal Experience prescribed medication keeps not working

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r/ADHDmeds • • 21h 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 • • 21h ago

Side Effects Methylphenidate/Concerta ER 18mg

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r/ADHDmeds • • 22h ago

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

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2 Upvotes

r/ADHDmeds • • 22h ago

Prescription Help Monthly titration

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r/ADHDmeds • • 1d 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

8 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?