Table of ContentsView AllTable of ContentsWhat Is ADHD Medication Rebound?CausesMedication Rebound vs. Side EffectsImpactTreatmentsCoping
Table of ContentsView All
View All
Table of Contents
What Is ADHD Medication Rebound?
Causes
Medication Rebound vs. Side Effects
Impact
Treatments
Coping
Close
Many people who takeADHD medicationmay find that they do well—until it starts to wear off. Then, they suddenly develop a range of severe mood and behavior symptoms. If this sounds familiar, you’re not alone. You or your child is likely experiencing what is often referred to asmedication rebound.
At a GlanceADHD medication rebound refers to the effects that sometimes appear at the tail-end of medication dosing. Fortunately, there are steps you can take to help limit these effects. Learn more about what ADHD medication rebound is and how to avoid irritability while taking Adderall (amphetamine/dextroamphetamine) and other ADHD medications as they begin to wear off.
At a Glance
ADHD medication rebound refers to the effects that sometimes appear at the tail-end of medication dosing. Fortunately, there are steps you can take to help limit these effects. Learn more about what ADHD medication rebound is and how to avoid irritability while taking Adderall (amphetamine/dextroamphetamine) and other ADHD medications as they begin to wear off.
As an immediate-release or short-actingADHD stimulant medicationstarts to wear off, people sometimes experience negative side effects. These effects are known as ADHD stimulant rebound, sometimes referred to as “the crash.” Such symptoms can appear as excessive hunger, a severe decrease in energy, and an intense mood drop.
Other signs of medication rebound may include:
Research indicates that stimulant rebound effects tend to be more common in younger children.These effects can be troubling, even impairing. Therefore, it is important to address this issue with the healthcare provider so that it may be corrected.
What Causes ADHD Medication Rebound?
Types of stimulants that may be used to help people manage their ADHD characteristics include methylphenidate-based medications such as Concerta, Focalin, andRitalinand amphetamine-based medications such asAdderall, Vyvanse, and Dyanavel XR.
ADHD medication rebound happens as a result of stimulant medication leaving the body. Medications sometimes wear off gradually and evenly, but each person metabolizes these medications differently.
People who metabolize medications more quickly may experience a sudden drop in medication levels in their bodies. As a result, they may experience rebound symptoms as their brain tries to adjust to the rapid change.
Medication rebound is not the same thing as a side effect.
Side effects are negative reactions to the medication itself. A headache, stomach ache, or loss of appetite can all beside effects of ADHD medicationsand, in most cases, become less of an issue as the body starts to get used to the medication.
If ADHD Medication Side Effects are Severe or Don’t Go AwayIf side effects are still being experienced after a few weeks of treatment or are severe, let the prescribing physician know. The dosage may need to be changed or the medication switched to ease these effects. Also, ADHD medications such as Adderall may be unsafe for people with a history of heart issues or drug abuse,so let the provider know if either of these conditions exists.
If ADHD Medication Side Effects are Severe or Don’t Go Away
If side effects are still being experienced after a few weeks of treatment or are severe, let the prescribing physician know. The dosage may need to be changed or the medication switched to ease these effects. Also, ADHD medications such as Adderall may be unsafe for people with a history of heart issues or drug abuse,so let the provider know if either of these conditions exists.
Rebound, however, is a result of the speed at which the medication is metabolized.A “four-hour pill” refers to the average duration of its effectiveness. However, your particular child may metabolize the medication more rapidly or slowly. If your child has a fairly high metabolism, they may experience a quick drop-off in medication effectiveness before it’s time for the next dose.
What Are the Effects of Medication Rebound?
If medication rebound occurs at school, it can interfere with your child’s sense of well-being as well as their educational, social, and personal success.
This is the period of time during which children tend to socialize and take part in after-school activities. Friendships and team memberships depend upon your child’s ability to respond to a coach’s instructions, collaborate with friends, or simply hang out and chat without taking over or giving offense.
Treating Medication Rebound
If your child is experiencing any of these effects, talk to their healthcare provider about your concerns. Rebound tends to occur more frequently with the shorter-acting stimulants that can move out of your child’s system quickly.
Sometimes, care providers will add a small dose of immediate-release medicine about an hour before this rebound effect occurs so the transition of the medicine is smoother.
For some people, the rebound effect is reduced when taking longer-acting stimulants, which move out of one’s system more gradually. Longer-acting stimulants have also been linked to better medication adherence.
Your treatment provider may also make other changes, such as:
Do not make any adjustments to your dose or stop taking your medication without talking to your doctor first.
Changes in ADHD medications or their doses can also help ease side effects. For example, if you’re wondering how to avoid irritability while taking Adderall, research suggests that changing to a non-amphetamine medication may help reduce this side effect.
Non-Stimulant ADHD Medication
How to Manage Medication Rebound
There are also steps you can take to help cope with the effects of ADHD medication rebound. Strategies that can help include:
As always, good communication with the healthcare provider is essential in correcting any negative effects that are occurring with an ADHD medication, as well as monitoring overall treatment progress.
Managing Side Effects of ADHD Medications
8 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.López FA, Childress A, Adeyi B, et al.ADHD symptom rebound and emotional lability with lisdexamfetamine dimesylate in children aged 6 to 12 years.J Atten Disord. 2017;21(1):52-61. doi:10.1177/1087054712474685Mahajnah M, Sharkia R, Zelnik N.The clinical characteristics of ADHD diagnosed in adolescents in comparison with younger children.J Atten Disord. 2020;24(8):1125-1131. doi:10.1177/1087054717696768Lerner A, Klein M.Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025U.S. Food and Drug Administration.Label for Adderall.Mechler K, Banaschewski T, Hohmann S, Häge A.Evidence-based pharmacological treatment options for ADHD in children and adolescents.Pharmacology & Therapeutics. 2022;230:107940. doi:10.1016/j.pharmthera.2021.107940Stuckelman ZD, Mulqueen JM, Ferracioli-Oda E, et al.Risk of irritability with psychostimulant treatment in children with ADHD: A meta-analysis.J Clin Psychiatry. 2017;78(6):e648-e655. doi:10.4088/JCP.15r10601Becker SP.ADHD and sleep: recent advances and future directions.Curr Opin Psychol. 2020;34:50-56. doi:10.1016/j.copsyc.2019.09.006Mehren A, Reichert M, Coghill D, Müller HHO, Braun N, Philipsen A.Physical exercise in attention deficit hyperactivity disorder - evidence and implications for the treatment of borderline personality disorder.Borderline Personal Disord Emot Dysregul. 2020;7:1. doi:10.1186/s40479-019-0115-2
8 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.López FA, Childress A, Adeyi B, et al.ADHD symptom rebound and emotional lability with lisdexamfetamine dimesylate in children aged 6 to 12 years.J Atten Disord. 2017;21(1):52-61. doi:10.1177/1087054712474685Mahajnah M, Sharkia R, Zelnik N.The clinical characteristics of ADHD diagnosed in adolescents in comparison with younger children.J Atten Disord. 2020;24(8):1125-1131. doi:10.1177/1087054717696768Lerner A, Klein M.Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025U.S. Food and Drug Administration.Label for Adderall.Mechler K, Banaschewski T, Hohmann S, Häge A.Evidence-based pharmacological treatment options for ADHD in children and adolescents.Pharmacology & Therapeutics. 2022;230:107940. doi:10.1016/j.pharmthera.2021.107940Stuckelman ZD, Mulqueen JM, Ferracioli-Oda E, et al.Risk of irritability with psychostimulant treatment in children with ADHD: A meta-analysis.J Clin Psychiatry. 2017;78(6):e648-e655. doi:10.4088/JCP.15r10601Becker SP.ADHD and sleep: recent advances and future directions.Curr Opin Psychol. 2020;34:50-56. doi:10.1016/j.copsyc.2019.09.006Mehren A, Reichert M, Coghill D, Müller HHO, Braun N, Philipsen A.Physical exercise in attention deficit hyperactivity disorder - evidence and implications for the treatment of borderline personality disorder.Borderline Personal Disord Emot Dysregul. 2020;7:1. doi:10.1186/s40479-019-0115-2
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
López FA, Childress A, Adeyi B, et al.ADHD symptom rebound and emotional lability with lisdexamfetamine dimesylate in children aged 6 to 12 years.J Atten Disord. 2017;21(1):52-61. doi:10.1177/1087054712474685Mahajnah M, Sharkia R, Zelnik N.The clinical characteristics of ADHD diagnosed in adolescents in comparison with younger children.J Atten Disord. 2020;24(8):1125-1131. doi:10.1177/1087054717696768Lerner A, Klein M.Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025U.S. Food and Drug Administration.Label for Adderall.Mechler K, Banaschewski T, Hohmann S, Häge A.Evidence-based pharmacological treatment options for ADHD in children and adolescents.Pharmacology & Therapeutics. 2022;230:107940. doi:10.1016/j.pharmthera.2021.107940Stuckelman ZD, Mulqueen JM, Ferracioli-Oda E, et al.Risk of irritability with psychostimulant treatment in children with ADHD: A meta-analysis.J Clin Psychiatry. 2017;78(6):e648-e655. doi:10.4088/JCP.15r10601Becker SP.ADHD and sleep: recent advances and future directions.Curr Opin Psychol. 2020;34:50-56. doi:10.1016/j.copsyc.2019.09.006Mehren A, Reichert M, Coghill D, Müller HHO, Braun N, Philipsen A.Physical exercise in attention deficit hyperactivity disorder - evidence and implications for the treatment of borderline personality disorder.Borderline Personal Disord Emot Dysregul. 2020;7:1. doi:10.1186/s40479-019-0115-2
López FA, Childress A, Adeyi B, et al.ADHD symptom rebound and emotional lability with lisdexamfetamine dimesylate in children aged 6 to 12 years.J Atten Disord. 2017;21(1):52-61. doi:10.1177/1087054712474685
Mahajnah M, Sharkia R, Zelnik N.The clinical characteristics of ADHD diagnosed in adolescents in comparison with younger children.J Atten Disord. 2020;24(8):1125-1131. doi:10.1177/1087054717696768
Lerner A, Klein M.Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025
U.S. Food and Drug Administration.Label for Adderall.
Mechler K, Banaschewski T, Hohmann S, Häge A.Evidence-based pharmacological treatment options for ADHD in children and adolescents.Pharmacology & Therapeutics. 2022;230:107940. doi:10.1016/j.pharmthera.2021.107940
Stuckelman ZD, Mulqueen JM, Ferracioli-Oda E, et al.Risk of irritability with psychostimulant treatment in children with ADHD: A meta-analysis.J Clin Psychiatry. 2017;78(6):e648-e655. doi:10.4088/JCP.15r10601
Becker SP.ADHD and sleep: recent advances and future directions.Curr Opin Psychol. 2020;34:50-56. doi:10.1016/j.copsyc.2019.09.006
Mehren A, Reichert M, Coghill D, Müller HHO, Braun N, Philipsen A.Physical exercise in attention deficit hyperactivity disorder - evidence and implications for the treatment of borderline personality disorder.Borderline Personal Disord Emot Dysregul. 2020;7:1. doi:10.1186/s40479-019-0115-2
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