ADHD Parenting Podcast – Episode 66: Understanding ADHD Medications: What Parents Need to Know – Part Two

Hosts Ryan and Mike continue their two-part deep dive into ADHD medications by walking through the actual medication categories and how they differ. They cover the two stimulant families — methylphenidate-derived (Ritalin, Concerta, Focalin, Jornay PM) and amphetamine-derived (Adderall, Vyvanse, Dexedrine) — and explain why a poor response to one class doesn't mean all stimulants will fail. From there they break down alpha agonists like clonidine and guanfacine, non-stimulants including Strattera and Qelbree, and the role SSRIs play when anxiety or depression co-occurs with ADHD. They also address the growing reality that pediatricians and nurse practitioners — not psychiatrists — are now the primary prescribers of ADHD medication due to a severe nationwide shortage that isn't getting better. The episode closes with a reminder that parents don't need to become medication experts; they need enough knowledge to ask better questions and partner effectively with their child's prescriber.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

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[00:00:00] Start

[00:01:35] The Two Stimulant Families Explained

[00:03:42] Why Finding the Right Medication Takes Time

[00:05:11] Alpha Agonists: A Different Category

[00:06:44] Non-Stimulants: Strattera and Qelbree

[00:09:40] SSRIs and ADHD: Separate but Related

[00:11:12] Why Pediatricians Now Prescribe Most ADHD Meds

[00:13:11] Conclusion and Key Takeaways

Hosts Ryan and Mike tackle one of the most frequently asked questions from parents: Is ADHD medication safe? In this first installment of a two-part series, they break down what the long-term research actually shows about stimulant medications, address common fears around side effects — including appetite suppression, sleep difficulties, growth concerns, personality changes, tics, and cardiovascular risks — and explain how each is typically monitored and managed by prescribers. They also discuss the medication holiday debate, make the case that medication decisions should be adult-guided with input from the child rather than child-decided, and explain why pharmacogenetic testing doesn't deliver on its marketing promises. Throughout the episode, Ryan and Mike emphasize that the right question isn't just whether medication has risks, but what the risks of untreated ADHD look like — and that informed decisions should be made with a licensed clinician, not strangers in Facebook groups.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠{{chapters}}[00:00:00] Start[00:02:21] Long-Term Safety of ADHD Medication[00:06:15] Common Side Effects and How to Manage Them[00:10:51] Height Velocity and Growth Concerns[00:12:15] Personality Flattening and the Zombie Myth[00:16:11] Should Kids Take Meds Only on School Days?[00:19:05] Who Should Make Medication Decisions?[00:22:18] Why Genetic Testing Doesn't Pick the Right Med[00:24:05] Conclusion and Part Two Preview

Hosts Ryan and Mike deliver the high school companion to their elementary and middle school back-to-school episode, focusing on the shift parents need to make from managing their teen to consulting.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

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[00:00:00] Start

[00:04:26] Tip 1: Stop Rescuing Executive Functions

[00:06:43] Tip 2: Set Technology Expectations Now

[00:10:00] The Phone You Bought Is Your Problem

[00:14:01] Tip 3: Build Independence, Not Dependence

[00:16:38] Bonus: Collaborative Relationships With Teachers

Hosts Ryan and Mike share the three things that will have the biggest impact on an ADHD child's school year — and none of them involve buying supplies. First, they explain why setting clear, specific expectations before school starts (morning routines, homework, electronics, bedtime, after-school activities) prevents the negotiation battles that derail families every fall. Second, they walk through building routines now rather than scrambling once school begins, with particular emphasis on keeping school-issued laptops out from behind closed doors and advocating with the school when technology becomes a distraction rather than a tool. Third, they lay out how to start strong with teachers through concise, collaborative communication — and why badmouthing a teacher in front of your child or demanding a classroom switch does more harm than good. Throughout the episode, Ryan and Mike stress that consistency lowers emotional intensity and that small changes now prevent big problems in September and October.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

{{chapters}}

[00:00:00] Start

[00:05:19] Tip 1: Set Clear Expectations Before School

[00:09:23] Tip 2: Build Routines Before You Need Them

[00:13:45] Managing School-Issued Laptops and Screens

[00:16:37] Tip 3: Start Strong With Teachers

[00:21:18] Don't Badmouth Teachers in Front of Your Child

[00:22:47] Summary: Small Changes Now Prevent Big Problems

Hosts Ryan and Mike make the case that children with ADHD don't need fewer responsibilities — they need better-scaffolded, consistent ones. They introduce the idea of a "competent role": an ongoing, child-owned job that genuinely matters to the family, distinct from a random chore. Along the way they name the "high giving, low expectations" trap that well-meaning parents fall into, explain why learned helplessness gets weaponized to escape non-preferred tasks, and walk through the executive-function skills these roles quietly build. The episode closes with a practical playbook for creating one competent role this week, grounded in research on autonomy, competence, and relatedness.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

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[00:00:00] Start

[00:02:14] What a Competent Role Actually Is

[00:04:09] High Giving, Low Expectations

[00:11:09] The Four Parts of a Competent Role

[00:14:19] How Roles Build Executive Function

[00:16:50] Create One Competent Role This Week

Hosts Ryan and Mike work through five real listener questions covering some of the most common — and most misunderstood — challenges of raising kids with ADHD: a six-year-old with borderline intellectual functioning caught between a cautious school and a hands-off psychiatrist, a ten-year-old with total time blindness for non-preferred activities, sibling conflict where the hosts openly diverge on whether to hold the older child more accountable or redirect the younger one, a physically aggressive first-grader stuck in a cycle of ineffective next-day suspensions, and a fifteen-year-old with ADHD, anxiety, OCD, and autism who avoids school at the first sign of feeling unwell. The thread running through all five: executive functioning is environment-dependent, and parental accommodation — however loving — tends to make avoidance and anxiety worse rather than better.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

{{chapters}}

[00:00:00] Start

[00:00:52] Borderline Functioning: School vs. Psychiatrist

[00:05:16] Time Blindness and Non-Preferred Activities

[00:09:03] Sibling Conflict and the Dopamine Cycle

[00:15:15] Aggression, Suspensions, and Brain Breaks

[00:22:28] Autism, Illness Avoidance, and School Refusal

In part two of this two-part series, Mike and Ryan discuss why families often abandon medication too quickly after a single difficult trial, the importance of trial-and-error in finding the right medication regimen, and why genetic testing isn't the shortcut many parents hope it will be.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

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Timestamps

[00:00:00] Start

[00:00:46] Why Families Give Up on Medication Too Easily

[00:01:30] Two Main Stimulant Categories Explained

[00:03:42] Non-Stimulant Medication Options

[00:04:22] Why Medication Alone Is Not Enough

[00:07:15] Genetic Testing Is Not Recommended

[00:09:43] Key Takeaways on ADHD Medication

[00:12:13] Final Thoughts on Kids and Medical Decisions

Citations

American Academy of Child and Adolescent Psychiatry. (2020). Clinical use of pharmacogenetic tests in prescribing psychotropic medications for children and adolescents. ⁠https://www.aacap.org/aacap/Policy_Statements/2020/Clinical-Use-Pharmacogenetic-Tests-Prescribing-Psychotropic-Medications-for-Children-Adolescents.aspx⁠

American Academy of Child and Adolescent Psychiatry. (2022). Attention-deficit/hyperactivity disorder: Parents’ medication guide. ⁠https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/med_guides/ADHD_Medication_Guide-web.pdf⁠

American Psychiatric Association. (n.d.). What is ADHD? ⁠https://www.psychiatry.org/patients-families/adhd/what-is-adhd⁠

Centers for Disease Control and Prevention. (2024). Clinical care of ADHD. ⁠https://www.cdc.gov/adhd/hcp/treatment-recommendations/index.html⁠

Dalsgaard, S., Leckman, J. F., Mortensen, P. B., Nielsen, H. S., & Simonsen, M. (2015). Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: A prospective cohort study. The Lancet Psychiatry, 2(8), 702–709. https://doi.org/10.1016/S2215-0366(15)00271-0

Dalsgaard, S., Østergaard, S. D., Leckman, J. F., Mortensen, P. B., & Pedersen, M. G. (2015). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: A nationwide cohort study. The Lancet, 385(9983), 2190–2196. https://doi.org/10.1016/S0140-6736(14)61684-6

de Vries, W., Boer, M., Stevens, G. W. J. M., & van Dorsselaer, S. (2025). Exploring concept creep: Youth’s portrayal of ADHD on TikTok. SSM Mental Health, 7, 100374.

Harpin, V., Mazzone, L., Raynaud, J. P., Kahle, J., & Hodgkins, P. (2016). Long-term outcomes of ADHD: A systematic review of self-esteem and social function. Journal of Attention Disorders, 20(4), 295–305. https://doi.org/10.1177/1087054713486516

Myer, N. M., Boland, J. R., & Faraone, S. V. (2018). Pharmacogenetics predictors of methylphenidate efficacy in childhood ADHD. Molecular Psychiatry, 23, 1929–1936.

Shaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A. G., & Arnold, L. E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: Effects of treatment and non-treatment. BMC Medicine, 10, 99. ⁠https://doi.org/10.1186/1741-7015-10-99⁠

Wetterer, L. (2020). Attention-deficit/hyperactivity disorder: AAP updates guideline for diagnosis and management. American Family Physician, 102(1), 58–60.

Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. ⁠https://doi.org/10.1542/peds.2019-2528⁠

Yeung, A., Ng, E., & Abi-Jaoude, E. (2022). TikTok and attention-deficit/hyperactivity disorder: A cross-sectional study of social media content quality. The Canadian Journal of Psychiatry, 67(12), 899–906. ⁠https://doi.org/10.1177/07067437221082854⁠