How to Find the Right ADHD Medication Dosage for You

It may take a few adjustments to find the right dose for you

Woman talking to doctor in hospital waiting room

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What's the most important information I should know about titrating ADHD medication?

  • Stimulants are often the first choice to help people manage their ADHD traits. These medications can have side effects and carry a risk for dependence and withdrawal.
  • Keep track of any side effects as your doctor titrates your dose and alert them if you experience any concerning reactions.

Medication is one treatment option that can help you manage characteristics of ADHD, such as impulsivity, hyperactivity, and inattention. How do doctors know how much ADHD medication someone needs? It's usually a process of trial and error. Titrating a dose is a process doctors use to find the most effective amount of medication for a person.

Keep reading to learn more about the titration process, potential side effects of ADHD medication, how adjustments are made to your dosage, and how to know you've found the right dosage for you.

What to Know About Medication Titration

To figure out your proper dosage, a doctor will factor in your height, weight, and ADHD characteristics when titrating ADHD medication.

However, a doctor's first estimate may not be ideal for you because biology is an inexact science, and every individual is unique. They must titrate the amount for the greatest effect with the fewest side effects.

Titration

Titration is the process of determining the medication dose that helps you manage your ADHD traits to the greatest possible degree while minimizing side effects.

Titration helps your body adapt to the medication and also helps you and the doctor find the optimal dose to improve your daily functioning.

This gradual increase usually occurs every one to three weeks.

Doctors will often start you on a lower dose of medication and increase it over time if your ADHD characteristics don't improve. This process may be rather quick, or it could take some time.

What Is the Purpose of Titration?

The purpose of titration is to find the perfect balance of a particular medicine for your body.

The goal is for the medication to do its job and produce the desired effects of helping to manage your ADHD traits. At the same time, the doctor wants to reduce or eliminate any adverse effects.

If medication adjustments don't create that balance of managing ADHD characteristics with the fewest side effects, then the doctor may choose to try another medication. With patience, time, and by working closely with a doctor, it's likely that you'll eventually find a suitable medication and dose.

Assessing How You Respond to the First Dose

Once a doctor provides you with an initial prescription for ADHD medication, there should be a process of determining whether or not your dose should be increased or decreased.

The doctor will also determine whether the medication they've prescribed is overall the best medication for you based on any side effects you experience.

Potential Effects of Your ADHD Medication

You and the doctor will be working together to determine whether you're experiencing any of these effects from your ADHD medication:

  • Too little response: The medication isn't sufficiently controlling your ADHD traits such as inattention, impulsivity, and hyperactivity.
  • Intolerable side effects: The medication may be working, but the side effects are severe and/or intolerable.
  • Too much response: Instead of gaining greater control over your traits, you become passive, depressed, or unlike yourself.

What happens when the dose of a medication such as Vyvanse (lisdexamfetamine) is too low? In such instances, you might experience inadequate relief of behaviors that interfere with your ability to function. If your dose is too high, however, you might develop intolerable side effects or unwanted changes in mood and behavior.

Pay Attention to How the Medication Is Affecting You

If you're beginning a trial of stimulant medication, the doctor will likely start with an initial low dose of stimulant.

At this point, it will largely be up to you to watch carefully to determine whether or not the medication is helping to alleviate your ADHD characteristics, whether and to what degree you're experiencing side effects, and whether any of these side effects increase or decrease over time.

Keep a Journal to Log the Effects of the Medication

Consider keeping a diary to record any improvement you notice from the medication and any side effects you experience. You might ask trusted friends or colleagues that you see on a regular basis whether they notice a difference in your behavior or mood. They may be able to provide helpful details or observations.

If your child has ADHD, you might ask their teachers or people that interact with them on a regular basis whether they've noticed any changes in your child's behavior as a result of their ADHD medication.

Side Effects of ADHD Medication

With stimulant medications prescribed for ADHD like Ritalin (methylphenidate), Concerta (methylphenidate), Quillivant (methylphenidate), Vyvanse (lisdexamfetamine), Focalin (dexmethylphenidate), and Adderall (dextroamphetamine-amphetamine), there are some potential side effects you should watch for.

Stimulant ADHD medications have a risk for dependence. Always take your medication as prescribed and talk to your doctor if you experience any concerning side effects.

The doctor prescribing your medication may add more side effects to this list, so write them down if needed. It's also a good idea to read through the information you receive from the pharmacy and ask any questions you may have.

Common Side Effects of Stimulant Medication

If stimulants are not a good fit for you, non-stimulants and antidepressants are also options. Some examples of other medications that may be prescribed for ADHD include:

Non-stimulant side effects can include fatigue, reduced appetite, nausea, increased blood pressure, and difficulty sleeping. 

Antidepressant side effects can include dry mouth, sexual side effects, abnormal bleeding, vomiting, and cardiovascular issues.

Antidepressants carry a black box warning for an increased risk of suicidal thoughts and behaviors in children, teens, and young adults. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911

When to Speak to Your Doctor

You can wait to share any mild side effects with the doctor at your next visit, but you should report any significant issues or strange symptoms immediately. Some side effects may decrease or even go away with time as your body adjusts to the medication.

Any problems you experience may be due to the dose or an unusual reaction indicating that the medication is not right for you.

Don't stop taking (or have your child stop taking) the medication without talking to the doctor first since doing so can be dangerous.

ADHD Medication Dosage Adjustments

Assuming that the medication you're trying is reducing your ADHD traits with few or no side effects, the doctor will carefully and gradually adjust (titrate) the dose upwards to adequate levels.

Medication dosage adjustments might look like the following:

  • The highest dose: The doctor will eventually increase your dose to the highest dose that you can tolerate.
  • When to lower the dose: If your ADHD traits do not improve as the dose increases, the doctor will lower the dose to the previous one. If you find that a higher dose produces too many side effects, the dose will also be lowered.

How to Tell You've Found the Right Dosage of ADHD Medication

The optimal dose of ADHD medication is one with which your daily function is significantly improved and side effects are minimized.

While finding the best dose can be frustrating and it may seem like nothing is working, it's important to remember that medication management is a very individualized endeavor that's based on your personal needs and responses. This is why close communication with a doctor is vital.

Think of your relationship with your doctor as a partnership. Be open and communicative about your needs and experiences, and together you will arrive at the most beneficial outcome.

As you work with a doctor to find the best dose for you, remember you can talk to a mental health professional to help you manage the changes in your behavior, emotions, and mood.

Summary

ADHD medication affects everyone differently. That's why it can take some adjustments to figure out the dose of ADHD medication that is right for you.

The goal is to find a dose that helps you manage your ADHD effectively while keeping side effects to the minimum. To do this, your doctor will prescribe a low dose and slowly increase it over a period of several weeks.

Keep track of your ADHD traits, the impact of medication, and any side effects you experience—and alert your doctor if you experience any unusual or severe reactions.

8 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Huss M, Duhan P, Gandhi P, Chen CW, Spannhuth C, Kumar V. Methylphenidate dose optimization for ADHD treatment: Review of safety, efficacy, and clinical necessity. Neuropsychiatr Dis Treat. 2017;13:1741-1751. doi:10.2147/NDT.S130444

  2. Brown KA, Samuel S, Patel DR. Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: A review for practitionersTransl Pediatr. 2018;7(1):36-47. doi:10.21037/tp.2017.08.02

  3. Taylor E. ADHD medication in the longer term. Z Kinder Jugendpsychiatr Psychother. 2019;47(6):542-546. doi:10.1024/1422-4917/a000664

  4. American Psychiatric Association. Attention-deficit/hyperactivity disorder (ADHD): Parents' medication guide.

  5. King SA, Casavant MJ, Spiller HA, Hodges NL, Chounthirath T, Smith GA. Pediatric ADHD medication exposures reported to US poison control centers. Pediatrics. 2018;141(6). doi:10.1542/peds.2017-3872

  6. Gregoire-Bottex M, Soe K. Adverse effects of non-stimulant adhd drugs: atomoxetine, alpha-agonistsCPSP. 2018;7(1):11-14.

  7. Wang SM, Han C, Bahk WM, et al. Addressing the side effects of contemporary antidepressant drugs: a comprehensive reviewChonnam Med J. 2018;54(2):101.

  8. Food and Drug Administration. Suicidality in children and adolescents being treated with antidepressant medications.

By Keath Low
 Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD.