Four Common ADHD Medication Mistakes and How To Avoid Them

 In ADHD Symptom Control

ADHD medicationAs an adult ADHD coach, my clients and I talk about many ways to make life with ADHD easier. When we focus on the details of their ADHD treatment, finding they are making common ADHD medication mistakes isn’t unusual.

Adults with ADHD don’t do this intentionally. Most people just don’t know what prevents ADHD meds from working correctly. A great source for accurate ADHD medication information is Dr. Charles Parker’s book ‘New ADHD Medication Rules’.

Four ADHD Medication Mistakes and How to Avoid Them

ADHD Medication Mistake #1: Drinking citrus juice. According to Dr. Parker, the acid in oranges, grapefruits, and their juices interrupts the absorption of short acting stimulant ADHD medications (you know it’s short acting if there is an SA on the bottle).

So drinking that glass of orange juice or grapefruit juice when you take your Adderall or Ritalin is a no-no. Citrus messes with the long acting medications such as Vyvance and Concerta, too, because they all start with a short acting boost to quickly kick your brain into gear.

With long acting medications you can enjoy citrus later in the day because by then the drug has moved on down to your intestines where the acid in the citrus won’t interfere.

ADHD Medication Mistake #2: Not eating breakfast. It doesn’t matter if you’re late and you don’t like to eat in the morning, you must eat something before you take your ADHD medication. Your meds will work better and you’ll get a meal in before the medication suppresses your appetite. Even a small, healthy, protein-based snack will help.

ADHD Medication Mistake #3: Not drinking enough water. Stimulant ADHD medications are dehydrating. Dehydration causes brain fog. 99% of my new coaching clients don’t drink enough water whether or not they treat their ADHD with medication. Hydrate up. If you want your brain to work it’s important. You can read about ADHD-Friendly ways to remember to drink water here.

ADHD Medication Mistake #4: Forgetting to refill your prescription. Ever experience the panic of taking your last Adderall on a Sunday morning? You need your meds to focus at work on Monday and there’s no way to get your prescription refilled in time.

The solution is simple: make a reminder in your phone to refill your prescription a week before your pills run out. Reminders will work better if you use a reminder app, like the Due App. Due doesn’t stop bugging you until you’ve done the task.

Another trick a number of my ADHD coaching clients use is to keep a couple of extra pills stashed away just for these types of emergencies. Bingo. Problem solved.

I’m curious. Which of these common ADHD medication mistakes are you making? And what steps will you take to avoid them?

Dana Rayburn is an ADHD Coach in Oregon, but don’t worry… She works by telephone helping ADHD adults all over the world live more effortlessly and successfully with ADHD.

 

 

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Showing 55 comments
  • Janelle Marie Bird
    Reply

    So i just started drinking this “lemonade” mix which has fresh squeezed lemon juice, cheyenne pepper, organic maple syrup mixed in a 50.72 oz bottle. Will this effect how fast acting adderal works? I feel more tired then usual, but the drink is to help me loose some weight. Not to mention is a detox for my body. Any advice? What exactly does citrus stuff do to adderal, and the way it works? If the combination effects me, what symptoms will i have? Thanx

    • Dana Rayburn
      Reply

      Great question! Citric acid blocks the absorption of the stimulant medications like Adderall or Ritalin. Don’t take the meds at the same time you drink your “lemonade” mix. Wait an hour and see if that helps you be less tired.

      • Benjamin
        Reply

        I wish I had known this long ago. I eat a lot of citrus fruits and drink a lot of orange/lemon/grapefruit juice. After taking Adderall (30mg) for a number of years, I switched to Vyvanse (70mg) and was amazed that I felt totally over-medicated on the equivalent dose of Vyvanse. Turns out, my morning half of a grapefruit with a glass of OJ had been decreasing the effectiveness of the Adderall. This apparently isn’t a problem with Vyvanse! So, after years of needing a larger dose of Adderall, I wound up learning that I only needed about half that amount (40mg of Vyvanse) to get the desired effect. Oddly, I don’t recall ever seeing the same “don’t eat grapefruit” warning on my Adderall bottle that I’ve seen on some other prescription medications.

  • Riley
    Reply

    I wish I could refill early. In my state, I can only refill after 30 days. Literally, I take my last pill and then the next day can get my refill. Drs can authorize an early refill in an emergency, but they rarely will do so.

    Can you explain how eating breakfast makes Adderall work better?

    • Dana Rayburn
      Reply

      Now, that’s an ADHD nightmare.

    • Kelsey
      Reply

      Hi Riley,

      I know you wrote this question long ago, but maybe someone else will read this with the same question. This is what I do in your circumstance – if there are any days during which you aren’t responsible for long focus-oriented sit-still tasks (i.e. vacation, days of physical labor work or long errands), take only part of you normal daily dose so that you can store some “safety pills”. I don’t tend to take as much on those types of days for a couple of reasons: I can make sure to keep some relative relationship with a non-medicated brain (esp since it’s not a 24-hour med that you must take consistently), my tolerance of the medication is a little more in check, and I have a small safety stash. If there are days that allow it, I enjoy letting my mind wander at will even if I’m more forgetful :/

  • Wenonah
    Reply

    What information do you have about acids/bases with ADHD meds? My son is on a Tagamet regime for treating a large wart on his toe. (weird sounding I know, but the dermatologist said there was evidence out there to support doing this) Since Tagamet lowers the pH of your stomach, will that improve absorption or do nothing at all. Would it be different for children vs. adults? My son is only 7.

    • Dana Rayburn
      Reply

      Hi Wenonah,
      That’s an interesting question. I’m sorry, I just don’t have an answer. Best check with your son’s doctor.

  • mandi
    Reply

    i take adderal for my narcolepsy and zantac for my heartburn….i take both together in the morning…..have i been cancelling my addreal out with the zantac?

    • Dana Rayburn
      Reply

      Hi Mandi, I’m not sure. You better ask your doctor.

  • Annie
    Reply

    I’ve been trying different ways to balance my digestive health naturally. Having life long issues with it and bring prescribed Nexium recently (which I won’t take because I don’t need it), I’ve found that when my acids were too low, I over absorbed Adderall XR and lost electrolytes within the hour. So I ate low to medium acidic foods to balance again and found Adderall XR working again. To try and keep balance naturally, I drink warm lemon water about 2 hours after taking my dose and the last few days my ADHD is out of control, and the Adderall stops working right after the lemon water. I’ve noted it with many foods. Being histamine intolerant, my diet is limited. For me taking Adderall XR the same time each day, drinking a nutritional shake three hours later is effective for me. I don’t puke up stomach bile as I do if I eat breakfast before the natural morning sickness goes away, with or without Adderall. I don’t have over or no absorption issues that way. Definitely for me, food intake plays a huge role in the effectiveness of my treatment. The lemon water has to go, maybe make it a night time thing. For me when digestive system is happy my treatment dose of Adderall XR 40mg in the morning, smoothly releases for 10-12 hours. Hopefully some day I’ll get this digestive system balanced with being able to continue ADHD treatments effectively.

    • Dana Rayburn
      Reply

      Hi Annie, What a challenge you have! I’m glad you’ve figured out a plan that helps your Adderall XR work. Citric acid can block the absorption of ADHD medication. That’s probably what’s happening with you and the lemon juice (orange juice would do the same). Your idea to try drinking lemon juice at night is the next thing to try. Wishing you all the best!

  • Chris Sneed
    Reply

    Ok so how long before and after to get your lemons? Seeing as lemons are one of the most alkalizing foods you can eat, I am quite confused by this. As a matter of fact many fruits that people advise not to eat on adderall, in reality alkalize the body. Also I have heard that acetic acid is not good to take either, yet once again acetic acid i.e. Apple cider vinegar alkalizes the body. All of this can be found by googling alkaline diet or the best alkaline foods. Every article I have read regarding this lists lemons at the top of the list and encourages eating lemons or drinking lemon juice. So what gives?

    • Dana Rayburn
      Reply

      Great question, Chris. It’s the citric acid that blocks the absorption of the stimulant medications. I’ve been told to wait at least an hour on either side od taking the meds to have citric. If you’re taking a long-acting like Vyvanse it’s okay to have lemons in the afternoon. By then the pill is in your intestines and the citrus won’t interfere.

  • Lauren
    Reply

    Should I be drinking more than 8-10 ounces of water per day while taking stimulants? I know for a fact I drink a minimum of 8 ounces every day.

    • Dana Rayburn
      Reply

      YES!! In case you didn’t get that, I’ll repeat…oh, YES! Medication or not, drink more water. According to Dr. Daniel Amen, a rule of thumb is to drink half your body weight in ounces. So a 180 lb person needs to drink 90 ounces of water a day. Your brain won’t work without enough water. If you exercise a lot you may need more. Water-based foods (lettuce, oranges, etc.) can help. Can be herb teas, etc. Coffee dehydrates. Hydrate up!

  • Michelle
    Reply

    Okay-I have the extended release Adderall and I’m having trouble sleeping at night. Should I ask my doc to switch my Adderall to the other type, the non-extended release?

    • Dana Rayburn
      Reply

      Michelle, are you taking your Adderall first thing in your day? The Extended Release should last 8 – 10 hours if the dose is right. If are giving it time to wear off and you still can’t sleep, yes, talk to your doctor.

  • Holt
    Reply

    I am beginning to feel as if the adderall is not lasting as long as used to, should I talk to my doctor about Adderall about the extended release as I am already taking 60mg per day or another medication?

    • Dana Rayburn
      Reply

      Hi Holt – talk to your doctor. He or she will know if you need a higher dose because you got used to it or if you need to try a different medication. Good luck!

  • Alex
    Reply

    So ive been on concerta since I was 11 and im on 54mg 1x daily. Some days when I dont drink enough it seems not to work at all. Should I try and get 8hrs sleep..no citrus juice near it and pleanty of water or should I ask to up my dosage. It was working not but. Three months ago. Im 27 now.

    • Dana Rayburn
      Reply

      Hi Alex, I always suggest doing what you can to make the medication more effective before upping the dose. Yes, drink more water and get more sleep. See if that helps before increasing the Concerta.

  • Robyn
    Reply

    Hello I drank a lot of orange juice around 7am and took concerta around 8:30 9:00 . I felt nothing at all! Could the citric acid actually effect the medication that long after?

    • Dana Rayburn
      Reply

      Hi Robyn! Do you normally feel your medication working? If the OJ is the only difference than it probably is. People don’t always ‘feel’ the longer acting meds – Concerta and Vyvanse – working. It may be more subtle. You notice you’re focused and getting stuff done.

  • Hannadhd
    Reply

    All of them. I’m doing all of this. I was supposed to pick up my medicine yesterday. I ate breakfast…it was a grapefruit. Followed by orange juice.
    And I’m fairly certain that there is no such thing as enough water. I feel like I drink constantly, but it could just be that I think about drinking every time I get thirsty but my morning grapefruit/orange juice routine means that I can’t actually remember if I really did it or not.
    Damn it all anyway. Thanks, Dana. *sigh*

  • Rory
    Reply

    Hi Dana,

    Do you do paid telephone consults? I need to speak with an experienced person, like yourself, about medication issues.

    Regards,
    Rory

    • Dana Rayburn
      Reply

      Hi Rory, No, I don’t do medicine consultations. You need to work with a licensed medical professional about your medications.

  • nancy
    Reply

    lemons are acidic themselves but alkaline when they are in the body, as such, lemon water would not interfere with Adderall right?

    • Dana Rayburn
      Reply

      Hi Nancy, my understanding it’s the citric acid that blocks the absorption of the Adderall / Ritalin.

  • denise
    Reply

    My son takes adzenys XR-ODT 6.3 mg in the am and complains of feeling “depressed” daily around 2 – 4 pm then slowly feels better, We talked to the doctor and he suggested he drink orange juice at 1 pm to increase dopamine. Do you have any suggestions to the afternoon dip?
    thanks denise

    • Dana Rayburn
      Reply

      Hi Denise, I suspect what your son is experiencing is the time when the stimulant medication wears off. Does the orange juice help? He might also try eating protein during the wear-off time. Some medications wear off less dramatically than others, so a different medication might be the solution if this side effect is unbearable. Hope this helps, Dana

  • Tony
    Reply

    I’m seriously not convinced that orange juice manipulates Adderall and it’s effects in a negative way. In fact, I feel as if orange juice in the Morning with Adderall provides and enhances the feel and helps the medication work easier.
    Unless THE Doctor can take one for himself and output this information to the public stating that he mixed adderall and orange juice and further studied its “Consequences” This information is misleading.

    • Dana Rayburn
      Reply

      Hi Tony, It’s nice to hear OJ doesn’t effect your Adderall. Many of my clients experience otherwise. Not everyone is the same. Try both and do what works for you.

  • Kate
    Reply

    I take Vyvance, it works great but I get gerd from it. Will nexium let the vyvance remain effective? Also, are you supposed to eat first just so you get a meal in you or does it really make the meds more effective? Not eating is never a problem I have and I thought taking it on an empty stomach may make it work faster. I have a large lunch.

    • Dana Rayburn
      Reply

      Hi Kate, I occasionally hear a client gets GERD from the Vyvanse. Better ask your doctor about the Nexium. Or try eating first to see if that helps. My experience with clients is eating before taking meds seems to make the meds work more smoothly and effectively. This is especially true with Vyvanse. -dr

    • Tab
      Reply

      Kate! Hi! Im On 70mg vyvance for years. A doctor told me to take it mixed in milk or a meal replaced or protien drink. Warm milk with a tea bag. Warm or cold milk with Ovaltine or what I found to be the best is yogurt I use Greek vanilla. I found it works faster better longer. I didnt notice it 1st. people around me noticed 1st. Then i realized o wow theyre right. Good luck!
      -Tab

  • Pottypants
    Reply

    Can any one help with intense salty/ sugar cravings when the Methylphenidate starts to wear off…I take 3x 10 mg a day and is my second week slowly titrating up to 20mg 3x’s day. I also take 45mg Mirtazapine.
    Incredibly thirsty and want sodas. I can’t find much on this .

    • Dana Rayburn
      Reply

      Gosh, I’m sorry, this is a new one to me. In his book, Finally Focused, Dr. James Greenblatt writes about the connection between blood-sugar / glucose and ADHD. Perhaps this is what’s going on. As the meds wear off your brain is craving glucose? I’m guessing here. What does your doctor say? Hope you find an answer! Dana

    • Dana Rayburn
      Reply

      Here’s a comment from another reader: Try looking into your Miratzapine Rx as your direct result on why you feel such intense sugar & salt cravings. POSSIBLY. I only give you my suggestion because I had been on the Exact similar prescriptions with near identical issues, and after a short while I had learned that the Miratzapine Rx was causing excessive fluid build up (primarily within my lower legs, ankles, feet). After stopping that Rx, two weeks later all was back to normal… Just an idea. Best of luck.

  • Peggy
    Reply

    Do you know if apple cider vinegar supplements will affect adderall absorption? Thank you.

    • Dana Rayburn
      Reply

      Hi Peggy, as far as I know apple cider vinegar should be okay. The citric acid in orange juice is the problem. Vinegar has acetic acid – a different molecule – according to live strong. Hope this helps, Dana

    • Thoams
      Reply

      Peggy, apple cider vinegar is unlike the other types of vinegar. Upon digestion, ACV will increase digestive pH levels, consequently lowering your urinary pH level. Taking the supplement later in the day may be more beneficial.

  • Toni - Jan
    Reply

    What about concerta 18mg and a bottle of Lucozade?…. what may that do? I just started taking concerta. … used to drink lucozade a lot… wondering if it may cause problems …

    • Dana Rayburn
      Reply

      Hummm… Does Locozade have citric acid in it? If so, wait an hour or so between taking the meds and drinking it.

  • Abe
    Reply

    Hello,
    Wanted to know if digestive aids like ginger tea specifically help or deter a derail absorption/functioning!
    Thank you

    • Dana Rayburn
      Reply

      Hi Abe, I haven’t heard any problems with ginger tea, etc., and ADHD medication. Good question! Dana

  • ashley
    Reply

    I take my medication like clockwork, morning and afternoon (20 mg twice daily) and my urine analysis came back negative for anything. scary. i have been on generic adderrall for well over a year and a half now. i have missed a few afternoons or mornings here and there but have not missed a pill in months. i do not abuse and only take as prescribed but a negative test result makes it look like i am selling or abusing. i had test result sent back for another lab to confirm results and they too came back as negative for adderrall. what happened? lab error? my metabolism? please, please help!!

    • Dana Rayburn
      Reply

      Hi Ashley. I’m so sorry you’re struggling with this. This is out of my area of expertise, but quick research shows that often the tests aren’t reliable. False negatives (and positives) happen often. Talk to your doctor. You many need to find a new doctor. I wish you all the best, Dana

  • Sophie
    Reply

    I take 54mg xenidate (concerta) daily and I’ve just been prescribed ranitidine but I’m worried it’ll effect the way my adhd meds are absorbed because it lowers the stomach acid? Can you advise me ?

    • Dana Rayburn
      Reply

      Hi Sophie, please check with your doctor or pharmacist about an interactions between your medications. Dana

  • Liam
    Reply

    Hi, I’m 17, i take concerta because of my ADHD, I don’t always take my meds on weekends,but i always drink them in the school week, will this effect me because I don’t constantly drink my concerta?

    • Dana Rayburn
      Reply

      Hi Liam, drug holidays are something to work out with your doctor and parents. One thing to notice is if you need your medication on the weekend to keep up with your homework or work. Good luck! Dana

  • Jen
    Reply

    Hey if grapefruit in a sauce could that effect the medication?

    • Dana Rayburn
      Reply

      Hi Jen, probably not enough to make a difference. If you have the sauce everyday when you take your meds maybe, but I’m suspecting that’s not what you do. Hope this helps, Dana

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