ADHD Pharmacology

ADHD medication is prescribed to reduce functional impairment, not simply to make a patient quieter or more compliant. The treatment target may be sustained attention at school or work, safer driving, fewer impulsive decisions, better task completion, or improved relationships. The prescribing decision balances that benefit against appetite and growth effects, insomnia, cardiovascular changes, mood or behavioural activation, tics, and misuse or diversion. In Canadian practice, a long-acting stimulant is usually the initial pharmacological choice when medication is indicated; a non-stimulant may be more appropriate when a stimulant is ineffective, poorly tolerated, clinically contraindicated, or unsuitable because of diversion risk or comorbidity. Every medication trial therefore needs a defined functional target, a safety screen, and planned reassessment.