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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
{{chapters}}
[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
{{chapters}}
[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
{{chapters}}
[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
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
Ryan & Mike take on ADHD kids' medication based on research and doctors, not social media. They cover untreated ADHD risks, debunk the psychiatrist myth, and put decisions with parents and prescribers.
Find Mike @ www.grownowadhd.com
Find Ryan @ www.adhddude.com
{{chapters}}
[00:00:00] Start
[00:01:05] Why Parents Get Confused About Medication
[00:03:40] The Risks of Untreated ADHD
[00:06:46] Where Medication Misinformation Comes From
[00:10:15] Do You Really Need a Child Psychiatrist?
[00:13:34] Who Makes the Medication Decision
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 Academy of Child and Adolescent Psychiatry. (n.d.). Pharmacogenetic testing. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Pharmacogenetic_Testing-128.aspx
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
Ryan and Mike take on four of the loudest myths in Facebook ADHD parenting groups: pharmacogenetic ("cheek swab") testing for medication selection, the idea that every ADHD child needs one-to-one talk therapy, the "everything is sensory" framing, and rejection sensitive dysphoria as a discrete diagnosis. For each one, they walk through what the actual research and clinical practice guidelines support — and what they don't.
Find Mike @ www.grownowadhd.com & on IG
Find Ryan @ www.adhddude.com & on Youtube
{{chapters}}
[00:00:00] Start
[00:02:13] Myth 1: Genetic Panel Testing for ADHD Meds
[00:04:25] Myth 2: Every ADHD Kid Needs Therapy
[00:10:36] Myth 3: Everything Is Sensory
[00:13:00] Myth 4: Rejection Sensitive Dysphoria
[00:16:25] Closing: Research Over Popularity
CITATIONS:
American Academy of Pediatrics. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528.
Antshel, K. M., & Barkley, R. A. (2020). Psychosocial interventions in attention deficit hyperactivity disorder. Child and Adolescent Psychiatric Clinics of North America, 29(3), 499–519.
Barkley, R. A. (2013). Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults. Journal of Abnormal Psychology, 122(4), 978–990.
Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.
Barkley, R. A. (2020). Taking charge of ADHD (4th ed.). Guilford Press.
Doffer, M., et al. (2023). Behavioral parent training for children with ADHD: Long-term outcomes and effectiveness. Journal of Attention Disorders, 27(5), 1–14. (Note: verify exact pages for final)
Evans, S. W., Owens, J. S., & Bunford, N. (2014). Evidence-based psychosocial treatments for children and adolescents with ADHD. Journal of Clinical Child & Adolescent Psychology, 43(4), 527–551.
Luman, M., Tripp, G., & Scheres, A. (2010). Identifying the neurobiology of altered reinforcement sensitivity in ADHD. Neuroscience & Biobehavioral Reviews, 34(5), 744–754.
Pinquart, M. (2017). Associations of parenting dimensions and styles with externalizing problems of children and adolescents: An updated meta-analysis. Developmental Psychology, 53(5), 873–932.
Sibley, M. H. (2021). Annual research review: Defining and treating ADHD in adolescents. Journal of Child Psychology and Psychiatry, 62(6), 706–724.
Tripp, G., & Wickens, J. R. (2020). Neurobiology of ADHD. Neuropharmacology, 173, 108–127.
In this episode of the ADHD Parenting Podcast, hosts Mike and Ryan tackle a provocative but critical topic: why high expectations are the most loving thing you can do for a child with ADHD. They respond to a listener’s experience in which an effective classroom point system—backed by decades of research—was canceled after other parents of children with ADHD complained. Mike and Ryan break down the difference between evidence-based structure and popular social media narratives, explaining why removing consequences and lowering the bar can lead to learned helplessness, prompt dependence, and failure to launch. They cite leading ADHD researchers like Dr. Russell Barkley, clarify what the science actually says about connection vs. consequence, and offer practical advice for IEP meetings, home life, and navigating parent group chats. Above all, Mike and Ryan argue that high expectations combined with high empathy aren’t the opposite of love—they are love.
Find Mike @ www.grownowadhd.com & on IG
Find Ryan @ www.adhddude.com & on Youtube
{{chapters}}
[00:00:00] Start
[00:05:29] Debunking the "connection, not consequence" myth
[00:08:14] Dr. Russell Barkley: ADHD as a self-regulation problem
[00:10:39] The cost of removing structure: Learned helplessness
[00:14:05] "It's not fair": Neurology explains but does not exempt
[00:15:30] Setting kids up for failure to launch
[00:16:53] Research-backed classroom policies that work
[00:21:26] What parents can do at home and in IEP meetings
[00:25:05] Confidence is earned by meeting standards
[00:25:44] Closing: High expectations + high empathy = love
Citations:
Gaastra, G. F., Groen, Y., Tucha, L., & Tucha, O. (2016). The effects of classroom interventions on off-task and disruptive classroom behavior in children with symptoms of ADHD. Consequence-based approaches showed the largest positive effect.
Barkley, R. A. (2015 / 2022). ADHD: A Handbook for Diagnosis and Treatment. Self-regulation model and "point of performance" principle.
Power, T. J., Mautone, J. A., & Soffer, S. L. Family-School Success for Children with ADHD: A Guide for Intervention. Guilford Press. From the Center for Management of ADHD at Children's Hospital of Philadelphia — research-based home-school partnership intervention.
Pelham, W. E., Fabiano, G. A., and colleagues. Daily Behavior Report Card evidence base.
Rosenthal & Jacobson lineage. Pygmalion Effect / adult-expectation research in education.
Milich and colleagues; 2024 review on learned helplessness in ADHD populations.
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