Pills Don’t Teach Skills: What to Expect When Your Child Starts Medications

One of the most common questions I get from parents is: 

“What should I expect when my kid starts ADHD meds?” 

The short answer? Change—and not always the kind you expect.

I want to caveat this with the fact that you should always work with a medical professional in regards to medication management and follow their guidance. However, please try to make sure that your doctors are knowledgeable about ADHD and how these medications work. 

The Top Medications: What They Are and What They Do

Let’s start with the basics. There are two main types of ADHD medications: stimulants and non-stimulants. Stimulants are the most commonly prescribed and tend to work quickly. Non-stimulants are usually used when stimulants don’t work well, cause significant side effects, or need to be paired with other treatments (like for emotional regulation).

Top 4 Types of Stimulants:

• Methylphenidate (Ritalin, Concerta, Focalin) – Focuses attention, reduces impulsivity. Fast-acting. Concerta and Focalin XR are extended release versions.

• Dexmethylphenidate (Focalin, Focalin XR) – A refined version of methylphenidate, often with fewer side effects.

• Amphetamine/Dextroamphetamine (Adderall, Adderall XR) – Another stimulant class that works similarly but hits slightly differently for some kids.

• Lisdexamfetamine (Vyvanse) – Longer-acting, smoother onset, lower misuse risk. Often well-tolerated.

Top 2 Non-Stimulants:

• Atomoxetine (Strattera) – Often used when stimulants are poorly tolerated. Takes 4–6 weeks to build up fully.

• Guanfacine XR (Intuniv) – Helps with impulsivity, emotional regulation, and sleep. Can make a child sleepy at first.

Supplements that may help:

• Saffron – Has been shown to help with mild ADHD symptoms, especially mood and attention. However, it should not be combined with SSRI’s.  

• L-Tyrosine — Works to improve dopamine production and reduce cognitive fatigue, really beneficial to help kids struggling with burnout, but should not be used for children with anxiety issues. 

That being said, always tell your doctor if you’re using supplements as there are sometimes interactions that can cause some pretty significant harm to your child.

Emotional Dysregulation Support

Stimulants often help with emotional regulation by improving impulse control and frustration tolerance. But for some kids—especially those with severe meltdowns, mood swings, or emotional outbursts—that’s not enough.

This is where medications like Intuniv (guanfacine XR) and one that's not listed, Kapvay (clonidine XR) come in. These aren’t ADHD medications in the traditional sense—they’re blood pressure meds that also calm the nervous system’s fight-or-flight response. When dosed correctly, they can reduce emotional flooding, improve sleep, and make it easier for kids to stay regulated during stress or overstimulation.

They can be used alone or alongside stimulants, depending on what your child needs. These medications don’t fix everything, but for kids who are constantly overwhelmed or volatile, they can make the difference between surviving the day and actually learning how to manage it.

What to Expect in the First Few Weeks

So the medications are changing how the child is experiencing the world. That means they may be feeling more emotions—or feeling them more intensely—and those emotions might be overwhelming. 

Medications do not magically create skills. They make it possible for the child to build the skills, but the skills still have to be taught and practiced.

This is exactly why Parent Training is critical. This is why Therapy matters.

Meds can make the world feel very different, and that can be disorienting and scary for a child, especially if they’re not used to having this level of awareness, inhibition, or emotional sensitivity.

Many parents expect the meds to either “fix” everything or show no effect at all. The truth is usually somewhere in the middle: some things improve, others become more obvious. That’s not failure. That’s clarity.

Common Side Effects and When They Level Out

The most common side effects in the first 1–2 weeks:

• Emotional reactivity (crying, anger, frustration)

• Appetite suppression (especially with stimulants)

• Trouble falling asleep

• Stomachaches or headaches

• Fatigue or sluggishness (especially with non-stimulants)

These side effects often level out after 7 to 14 days—if the dosage is right and the timing is good. If they get worse or don’t go away, that’s when it’s time to call your prescriber. Do not just stop cold turkey or adjust the dose yourself.

Watch for Sensory Changes

Also, the child may now be noticing or reacting more strongly to sensory input—things like fabric textures, loud or sudden sounds, light sensitivity, or even the feeling of certain foods. These sensitivities may have always been there, but the medication can make them more obvious or harder to ignore.

That alone can cause major emotional distress if no one helps them identify and manage it.

Sensory overload can look like defiance or meltdowns—but it’s not behavioral. It’s neurological.

Recognize it for what it is, and don’t punish it. Adapt and support instead.

What Improvement Looks Like (And When to Expect It)

For stimulants, you’ll often see some change within 30–60 minutes of the first dose. Full adjustment may take a week or two as your child’s brain and body adjust.

For non-stimulants like Intuniv or Strattera, it may take 2–6 weeks to see full benefit. You’re looking for small, steady improvements over time, not an overnight transformation.

Improvement doesn’t mean “perfect behavior immediately.” It means:

• Less impulsivity

• Better task initiation

• Slightly more patience

• Easier transitions

• Fewer meltdowns or shorter duration

• Calmer interactions

Do not expect medications to fix everything, and if you don’t see improvements after a few weeks and side effects are high, it may not be the right med or dose.

Why Therapy Matters

Medication may help the brain focus and slow down, but therapy teaches your child what to do with that space. Once the brain quiets down a bit, the real work begins—helping them develop emotional regulation, social communication, resilience, and coping strategies that stick.

Depending on your child’s needs, that might look like:

• Play therapy (for emotional development and expression)

• Behavior therapy (for consistent routines, rewards, and limits)

• CBT (for older kids who can talk through thoughts and feelings)

• Occupational therapy (for sensory processing, motor planning, and self-regulation)

Therapy isn’t just about “fixing behavior.” It’s about building functional tools to help your child navigate the world in a way that works for them.

Why Parent Training Isn’t Optional

Let me say this as clearly as possible: the way you respond to your child every day will make or break the effectiveness of medication and therapy.

You are the constant in their environment. No teacher, coach, or therapist spends as much time with them as you do. That means you need tools too.

Parent training gives you those tools. It helps you:

• Understand ADHD and how it shows up differently day to day

• Set expectations that match your child’s developmental reality—not just their age

• Use consistent language, consequences, and support systems

• Reduce power struggles and increase collaboration

• Take care of your own stress while staying grounded and present

Parent training isn’t about judgment. It’s about getting you the strategies, scripts, and systems you should have been handed the day your child was diagnosed. Without it, you’re flying blind—and so is your kid.

What To Do Right Now

• Track everything. When the meds are taken, what the response is, how long it lasts, what side effects happen, and how your child behaves with and without meds.

• Give it 1–2 weeks, unless things get worse. If they do, call the prescriber.

• Stay consistent. ADHD brains thrive on routine and fall apart with unpredictability—don’t skip meds unless advised.

• Build your support team. Therapy, coaching, school accommodations, and parent training are your infrastructure. Without it, the meds don’t have anything to support.

Medication Takes Time

Sometimes the first medication doesn’t work. Sometimes the second medication doesn’t work. That doesn’t mean none of them will. It takes time to figure out the right medication, dose, and timing—and every kid is different. What works for one won’t always work for another.

But while you’re figuring that out, use this time to build up the environment and teach the skills your child needs to function and grow. They need consistency, structure, patience—and grace.Especially when the meds aren’t doing all the heavy lifting.

This is a transition period. It doesn’t mean the meds are wrong. It means the support systems around the meds need to be solid.Coaching, therapy, routines, and consistent parenting responses are what make long-term change possible.

Pills don’t teach skills. They open the door. The work comes next.