ADHD AND LACK OF APPETITE

ADHD BLOG
ADHD AND LACK OF APPETITE
One of the most concerning aspects of treating ADHD/ADD with stimulant medication is the suppression of appetite. This problem is almost universal. Almost no one escapes this side effect. If the patient is young and growing, it can terrify the parent to see the child almost stop eating. In the growing adolescent male, lack of appetite becomes very annoying because eating is very pleasurable and it is very frustrating to never have an appetite. In the moderately obese female, or in the female adolescent who worries about her weight, lack of appetite can actually be very comforting. In all situations, lack of appetite as a side effect of ADHD medication needs to be addressed and followed by a physician.
Some of the stimulant medications suppress the appetite more than others and differently in certain individuals. The dextroamphetamines (Adderall, Vyvanse) seem to have the highest incidence of suppressing appetite. When a patient is started on ADHD medication, I always advise the parent or patient that this side effect might occur. I suggest that a big breakfast is served, including meat, vegetables, and fruit because often this is the only time of the day when the individual will be hungry. The ADHD medication can be given at the breakfast meal, although you should be aware that sometimes this may decrease some of the medication's effectiveness. If that is the case, I usually put my ADHD patients on a higher dose of medication.
Very often, a child can be encouraged to drink even if they refuse to eat. I usually suggest using protein drinks like Boost, Ensure, Carnation Instant Breakfast, etc. This provides some nourishment even if the ADHD patient will not eat a meal. You can put these drinks into the day at any time such as in the morning, noon or evening. Sometimes the ADHD patient is starving when the medication wears off and I suggest that they not eat a sugar snack when that happens. Instead they should eat a big meal that is high in nourishment. This extreme hunger may even happen right before bedtime. When that happens I still encourage the ADHD patient to eat despite the late hour.
I also point out that during the day the child (or adult) may become irritable or extremely restless. This may be due to hunger, therefore, the ADHD patient should eat is this behavior is exhibited. This is when a protein drink may be appropriate.
Frequent followup appointments are needed to keep an eye on the growth and weight of the ADHD patient. Sometimes the benefit of the medication outweighs the poor appetite and I have to follow the child's progress carefully. This also helps the parent know I am concerned but not alarmed. Other times, a change of medication is needed even if the child has done well on the medication causing poor weight gain.
The side effect of poor appetite can go away. With careful routine evaluations by the physician, this concern can be handled with a positive outcome for the child and the continued use of stimulant medication.
Http://everydayhealth.com/blog/a-doctors-personal-take-on-adhd/adhd-and-lack-of-a...