What ADHD Medication Can Actually Do(And What It Can’t)
What ADHD Medication Can Actually Do
(And What It Can’t)
A straight-talking guide to what the research shows — no jargon, no false promises, just the truth about what medication does and where it needs help.
You’ve been told medication will help. Maybe you’re hoping it will fix everything. Maybe you’re terrified it will change your child. Maybe you’ve already started and you’re wondering why your child is still struggling at school.
Here’s what twenty-five years of prescribing ADHD medication has taught me: medication is the most powerful single tool we have. But it’s a tool, not a cure. And unless you understand exactly what it does — and what it doesn’t — you’ll either expect too much or give up too soon.
The Glasses Analogy (And Why It Matters)
👓 Think of ADHD Medication Like Glasses
Glasses don’t make your child’s eyes stronger. They don’t teach your child to read. They don’t cure anything. What they do is let your child see the board clearly — so that everything else becomes possible.
ADHD medication works the same way. It doesn’t make your child smarter. It doesn’t give them knowledge they don’t have. It doesn’t teach study skills or fix a learning difficulty. What it does is turn up the power on the brain’s attention, braking, and self-control systems — so your child can finally access the intelligence that was always there.
Medication creates the conditions for learning. It does not create the learning itself. That distinction is the single most important idea in this article.
How Well Does Medication Actually Work?
The Response Rate: Who Does It Help?
on the first stimulant tried
both families are tried
If we try one type of stimulant medication, about 7 out of 10 children will show meaningful improvement. That’s a strong starting point.
But here’s what most parents don’t know. If we try both types of stimulant — and there are only two families — that number jumps to about 9 out of 10.
This means something critical: your child must try both methylphenidate (Ritalin, Concerta) AND an amphetamine (Vyvanse, Amfexa) before anyone — including you — concludes that “medication doesn’t work.” If you’ve only tried one family, you’ve only done half the job.
For non-stimulant medications like atomoxetine (Strattera), the numbers are lower — about 6 out of 10 children respond. Less powerful, but genuinely helpful for children who can’t tolerate stimulants.
The Volume Dial: How Much Does It Help?
Imagine your child’s ADHD brain is a radio playing static. The signal — their attention, self-control, ability to stop and think — is there, but it’s buried under noise. Here’s how much each intervention turns up the volume:
These effects stack. Medication plus good sleep plus exercise plus the right school support plus parenting strategies — that’s how you get the dial to 10. No single intervention gets there alone.
What Medication Is Brilliant At
Impulsivity and Hyperactivity: The Big Win
This is where stimulants shine brightest. The brain’s braking system — the ability to stop and think before acting — improves dramatically. Your child can wait their turn. They can stop themselves from blurting out. They can sit through a lesson without bouncing off the walls.
About 7–8 out of 10 children show significant improvement here. For many families, this is transformational.
Attention and Focus: Strong But Not Perfect
Medication meaningfully improves your child’s ability to sustain focus, stay on task, and filter out distractions. Think of it as cleaning a foggy windscreen. Your child can finally see the road clearly.
The improvement is real, but it’s moderate rather than dramatic. Medication helps attention, but it won’t make your child focus on things they find genuinely boring any more than glasses make you enjoy reading fine print on your insurance policy.
Classroom Behaviour: Noticeable Improvement
per session
per hour
Teachers notice. Parents notice. The child notices. This is where medication earns its keep in the school environment.
⚠️ The Academic Paradox: The Finding Every Parent Needs to Know
Medication dramatically improves your child’s ability to DO schoolwork. But it does NOT significantly improve their actual LEARNING of content.
A major study of 173 children found that medication had no detectable effect on how much curriculum content children actually learned — despite dramatically improving their productivity. They completed more work, behaved better, stayed on task longer. But when tested on what they’d actually absorbed, the medicated and unmedicated groups were virtually identical.
🏠 What This Means in Your Kitchen
Medication helps your child sit down, open the book, pick up the pencil, and do the work. It creates the window of opportunity for learning. But somebody still has to teach your child during that window.
If your child missed years of reading instruction because they couldn’t focus, medication won’t magically fill that gap. If your child has dyslexia, medication won’t cure it. If your child doesn’t understand long division, medication won’t teach it.
Medication opens the door. Education walks through it.
This is why schools, tutoring, remedial support, and appropriate accommodations remain absolutely essential — even when medication is working perfectly.
The Two Medication Families
Despite the confusing array of brand names, there are really only two families of stimulant medication.
Methylphenidate Family
Includes: Ritalin, Concerta, Ritalin LA, Contramyl
Keeps dopamine circulating longer so focus and control systems work better. Think of it as turning up the volume on your existing speakers.
Over 70 years of safety data. Well-understood side effect profile in young children.
First choice for under 12sAmphetamine Family
Includes: Vyvanse, Amfexa
Keeps dopamine circulating AND triggers additional release. Like turning up the volume AND adding bigger speakers.
More pronounced effects — both therapeutic and unwanted — particularly in younger children.
Often preferred for over 12sWhy Age Matters: Under 12 vs Over 12
Children under 12 generally experience fewer side effects with methylphenidate. International guidelines recommend methylphenidate as the first choice for younger children. We know what to expect. The side effect profile is well-understood and generally manageable.
Amphetamines in younger children can produce more pronounced unwanted effects — anxiety, emotional ups and downs, sleep disruption, and in rare cases, hallucinations or severe mood disturbance.
For teenagers and adults, amphetamines often work beautifully. The additional power is exactly what many teenagers need as academic demands increase, and the side effect profile is generally better tolerated in this older group.
The bottom line: methylphenidate first for younger children. Amphetamines available when methylphenidate isn’t enough or isn’t tolerated. For teenagers, either family may be appropriate. And regardless of age — if one family doesn’t work, try the other before giving up.
The Comorbidity Problem: Why Medication Seems to “Stop Working”
Approximately 80% of children with ADHD have at least one additional condition. Not “might have.” The vast majority. And here’s the critical point: ADHD medication only treats ADHD.
If your child has poor eyesight AND a broken arm, glasses will fix the seeing. But they won’t heal the arm. Both problems are real. Both need treatment. One solution can’t fix both.
Simple ADHD
Complex ADHD
Not because the medication stopped working. Because it’s doing exactly what it was designed to do — but other conditions are causing problems medication was never built to address.
How Each Comorbidity Affects Medication
😰 Anxiety
Can mask ADHD improvement. Your child may focus better but still can’t perform because worry consumes their mental energy. Some children’s anxiety improves on stimulants. Others feel more anxious.
😔 Depression
Makes everything harder. Children with ADHD and depression are twice as likely to resist antidepressant treatment. But treating ADHD properly often improves mood — because much of the depression comes from years of failure.
📚 Learning Disabilities
Won’t respond to medication at all. Dyslexia, dyscalculia — these need specialist teaching. Medication just makes your child available to receive that instruction.
🧩 Autism Spectrum
Only about 5 out of 10 children with both ADHD and autism respond well to stimulants. Side effects are more common. Slower dose increases and closer monitoring needed.
Undiagnosed comorbidities. Treating ADHD while ignoring anxiety, depression, or a learning disability is like changing the oil in your car while ignoring four flat tyres. You’ve done something useful, but you’re not going anywhere.
Girls, Boys, and Medication
The research doesn’t show a consistent difference in how well medication works between males and females. Once properly diagnosed and treated, girls generally respond as well as boys.
The real problem is getting to the diagnosis. Girls are diagnosed roughly four years later than boys on average. They’re more likely to have the inattentive type — the quiet daydreamer rather than the hyperactive disruptor — which means they get overlooked.
For teenage girls specifically: hormonal changes may affect how stimulants work across the menstrual cycle. Some girls report the medication feels less effective at certain times of the month. This isn’t imagined — oestrogen levels influence how stimulants are metabolised. If your daughter reports fluctuating effectiveness, mention it to your prescriber.
Age and Stage: Medication Across the Lifespan
Behavioural strategies should come first. Medication reserved for moderate-to-severe difficulties. When needed, methylphenidate is preferred. More than 40% of preschoolers on stimulants experience irritability, so careful, slow dose adjustment is essential.
The sweet spot for medication effectiveness. Response rates are highest — 7–8 out of 10. Combined medication and behavioural support recommended. Growth monitoring is important but most children catch up over time.
Academic demands increase dramatically. Medication that worked in primary school may need adjustment. Encouraging news: consistent stimulant treatment is actually protective against substance abuse — not a gateway.
Response rates somewhat lower — about 6–7 out of 10 — but medication remains effective. Many adults are only diagnosed when their child is assessed and they recognise the same patterns in themselves.
The Complete Picture: When Medication Works Best
Twenty-five years has taught me this: medication produces the most dramatic, life-changing results when all of these are in place:
✓ The medication itself is right. The right family, the right dose, the right timing. Both families tried if necessary. Expert prescriber involved.
✓ Comorbidities are identified and treated. Anxiety managed. Depression addressed. Learning disabilities receiving remedial support. Sleep sorted.
✓ The home environment supports the child. Consistent routines. Realistic expectations. Positive parenting strategies. Emotional connection prioritised over compliance.
✓ The school understands and accommodates. Appropriate classroom support. Teacher understanding. Accommodations in place. Remedial help where needed.
✓ The child understands their own brain. Age-appropriate explanation of why they think differently. No shame. No blame. Just understanding.
Strip away any of these supports, and medication alone produces modest results that leave everyone wondering what went wrong.
⚡ Quick Win Tonight
Ask yourself three questions and write down the answers:
- Has my child tried both medication families? If you’ve only tried methylphenidate OR amphetamines — not both — you haven’t completed the medication trial. This is the single most important question.
- What else might be going on? Write down any signs of anxiety, low mood, learning struggles, or social difficulties that medication hasn’t touched. These may be comorbidities that need separate attention.
- What support is medication landing on? Is there remedial help? School accommodations? Consistent home routines? Medication creates the conditions for improvement. What are you building on that foundation?
These three questions take five minutes. They might change everything about how you approach the next appointment.
🌟 Remember This
ADHD medication is the most powerful single intervention we have. The research is clear and consistent across decades of study. For most children, it produces significant, meaningful improvement in attention, self-control, and daily functioning.
But medication is the foundation, not the building. It opens the door — someone still has to walk through it. It clears the fog — someone still has to teach your child the road.
When medication is combined with proper assessment, appropriate school support, remedial help, consistent parenting strategies, and a child who understands their own brain — that’s when real transformation happens.
Your child’s brain isn’t broken. It’s wired differently. And with the right support — medication as the foundation, with everything else built on top — your child can thrive. Not perfectly. Not without hard days. But genuinely, meaningfully, life-changingly better.
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