In practice, ADHD medication helps many people regain focus and take back control of their daily lives. At the same time, a pattern can sometimes be observed that often goes unnoticed.

A small group of people develop symptoms after months or years of using these medications. Symptoms that suggest a nervous system that no longer fully relaxes.

This phenomenon can be described as ADHD medication overstimulation: a state in which the body’s stress and arousal system remains continuously activated.

This doesn’t mean we should be afraid of ADHD medication or reject it altogether. It simply means we should look more closely and be willing to adjust when necessary.

When the nervous system becomes overloaded

Some people develop a pattern that fits central sensitisation. This is not a diagnosis, but a description of a nervous system that has become hyper-reactive and amplifies pain, fatigue, sensory stimuli and stress signals.

This can lead to a combination of complaints such as:

• constant unrest and tension
• poor sleep
• muscle pain, headaches or jaw clenching
• brain fog and cognitive slowing
• overstimulation
• emotional instability
• rapid exhaustion

These complaints are often diffuse and variable. They don’t fit neatly into a diagnostic box, which is one reason they are frequently overlooked.

ADHD Medication Overstimulation: what stimulants do to the body

ADHD medication works by strengthening the brain’s activation system. This helps with attention, impulse control and task orientation.

At the same time, this system also increases general arousal in the nervous system. Think of slightly higher alertness, more muscle tension and a smaller margin between activity and recovery.

Important distinction:

• Non-amphetamines: methylphenidate (Ritalin, Concerta, Medikinet)
• Amphetamines: dexamphetamine, lisdexamfetamine (Tentin, Elvanse)

Both groups fall under stimulants. However, amphetamines tend to have a more direct and powerful effect on dopamine and noradrenaline. In practice, some people experience more physical activation with amphetamines, such as increased heart rate, muscle tension and reduced sleep quality.

This doesn’t mean the medication is “bad”. It simply means stimulants interact with the stress and recovery system of the body.

When the tipping point appears

Problems are seldom created by medication alone. The tipping point is often caused by an accumulation.

Think of combination like:

• Long term use of stimulants
• Chronic stress at work or at home
• Trauma or problematic relationships
• Sleep deprivation
• Hormonal changes
• Physical complaints or pain
• Drug use

Why this is often not recognised

Firstly, the symptoms look like those of ADHD, so restlessness, concentration problems, and irritability are mistaken for ADHD symptoms, whilst they could be caused by side effects or accumulation of stress.

Secondly, reassessments disappear to the background. Repeat medication prescriptions can be practical, but without periodic evaluations, the moment a person loses their balance can be missed.

Thirdly, there is an overlap with trauma, anxiety, and depression. These can also disrupt our attention span and concentration. If that context is not considered, someone might be given a label and medication, whilst the root of their problems lies somewhere else.

Differences between men and women

ADHD in women manifests itself in a less traditional way than ADHD in men. Internal restlessness, worrying, and emotional overload are at the forefront. Trauma and mood swings often play a part as well.

That increases the chance of attention- and concentration problems being treated with stimulants, whilst the nervous system is already overloaded. If this is the case, medication can be a temporary relief, but can also put pressure on the carrying capacity.

Methylphenidate or amphetamines, does that matter?

Yes and no.

• Methylphenidate acts milder and on a more short-term level, with often less physical stimulation
• Amphetamines act more powerful and longer, and cause insomnia and tension in some of its users.

What type someone is prescribed depends on their age, previous experience, duration of action and what is common for that particular area. Because of this, groups that are being researched are never completely comparable.

Practical information, how do you stay out of the danger zone?

If you’re on ADHD medication, it is useful to sometimes stop and think about your total functioning.

Signs that your nervous system is overloaded:

• You have trouble sleeping, even when you’re tired
• Stimuli hit you harder
• Your body feels tense or restless
• Your heart rate is elevated
• Your concentration span is small and rigid
• You recover very slowly from stress

What you can do with the person who prescribes your medication:

• Reassess the purpose of your medication
• Don’t just look at your ability to focus, but also to sleep and recover
• Measure a period of resting heart rate, tension, and mood
• Consider lowering your dose, or a different drug
• Take stress regulation and trauma treatment seriously
• Put sleep and biorhythm first

The happy medium

ADHD medication is not the enemy, but neither is it a ‘maintenance product’ you can thoughtlessly keep using. It requires attention, periodic reassessment, and attention to context.

If you notice you’re always ‘switched on’, don’t just think in terms of ‘less or more ADHD’. Look at the burden on your stress and arousal system. Sometimes, the key to finding space, rest, and relaxation lays there.