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ADHD Medication Guide - Adderall, Concerta, Methylphenidate

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"Will I get addicted if I take medication?" "Can't I just get Adderall?" There are many misconceptions about ADHD medication. Especially, Adderall is illegal in Korea, and self-medication is very dangerous. ADHD medication absolutely requires professional diagnosis and prescription.

Related articles: What is ADHD? | How to Improve Focus Without Medication

How ADHD Medications Work​

Dopamine System Regulation​

Characteristics of ADHD Brain

  • Prefrontal cortex dopamine deficiency
  • Dopamine transporter (DAT) hyperactivity
  • Weak brain "reward circuit"
  • Lack of attention-maintaining hormones

Role of Medication

1. Block dopamine reuptake
   → Dopamine stays longer in synapses
   → Improved concentration

2. Promote dopamine/norepinephrine release
   → Activate prefrontal cortex
   → Improved impulse control

"Normalization" Effect

  • Non-ADHD individuals: Arousal, excitement (misuse risk)
  • ADHD individuals: Calm, focused (therapeutic effect)
  • Brings brain to "normal" level

Adderall - Illegal in Korea​

What is Adderall?​

Components

  • Mixed amphetamine salts
  • Combination of 4 amphetamine salts
  • Strong stimulant effect
  • High addiction potential

Use in the United States

  • FDA-approved ADHD medication
  • Requires prescription
  • Serious abuse problem
  • Illegal distribution as "study drug"

Adderall is Illegal in Korea​

Legal Status

  • Psychotropic substance under Narcotics Control Act
  • Not approved by Korea FDA
  • Domestic import/sale/possession completely prohibited
  • Even with prescription not allowed

Penalties

Import/sale: 1+ years imprisonment or 10+ million won fine
Possession/use: Up to 5 years imprisonment or up to 50 million won fine
Overseas purchase: Confiscation + prosecution upon detection

Why is it illegal?

  • Very high addiction potential
  • High misuse possibility
  • Alternative medications exist in Korea
  • Insufficient safety verification

Risks of Illegal Adderall Purchase​

Health Risks

  • Heart attack, stroke
  • Psychotic symptoms (hallucinations, delusions)
  • Dependence, withdrawal symptoms
  • Interactions with other drugs
  • Multiple death cases

Legal Risks

  • Criminal record for drug offense
  • Unable to get employment/immigrate
  • Fines/imprisonment
  • SNS transactions also prosecuted

Fake Drug Risks

  • Most online purchases are fake
  • Substances of unknown composition
  • May contain toxic substances
  • Fatal accidents have occurred

Absolutely Do Not

  • No overseas purchases
  • No SNS black market
  • No getting from acquaintances
  • No taking "to study better"

ADHD Medications Available in Korea​

1. Methylphenidate Family​

Most Commonly Prescribed Medication

Concerta​

Characteristics

  • Extended-release (12-hour duration)
  • Once daily dosing
  • Korea FDA approved
  • Most widely used

Advantages

  • Only need to take once
  • Stable effect
  • Easy to hide at school/work
  • Consistent blood levels

Disadvantages

  • Expensive (100,000-150,000 won/month)
  • Takes time to take effect (1-2 hours)
  • Some don't get full 12 hours

Dosage

  • Adults: 18-72mg
  • Children: 18-54mg
  • Gradual dose increase

Metadate CD​

Characteristics

  • Extended-release (8-hour duration)
  • 1-2 times daily
  • Shorter than Concerta

Advantages

  • Cheaper than Concerta
  • Can control evening effect

Disadvantages

  • May need twice daily
  • Less stable than Concerta

Medikinet​

Characteristics

  • Short-acting immediate release (4 hours)
  • Immediate effect
  • Can take as needed

Advantages

  • Fast effect (30 minutes)
  • Easy dose adjustment
  • Affordable

Disadvantages

  • Take 2-3 times daily
  • Short effect
  • Large blood level fluctuation
  • Rebound effect (fatigue when wearing off)

Pemoline​

Characteristics

  • Old medication
  • Liver toxicity concerns
  • Rarely used now

Problems

  • Liver damage risk
  • Regular blood tests required
  • Not first choice

2. Atomoxetine - Non-Stimulant​

Brand Name: Strattera

Characteristics

  • Non-stimulant (not a stimulant)
  • Norepinephrine reuptake inhibitor
  • No addiction potential
  • 24-hour duration

Advantages

  • No addiction risk
  • Not a psychotropic medication (less prescription restrictions)
  • All-day effect
  • Good with comorbid anxiety
  • Can use with tic disorders

Disadvantages

  • Takes 4-6 weeks to show effect
  • No immediate effect
  • Weaker effect for some
  • Appetite loss, nausea
  • Expensive

Suitable For

  • Cannot tolerate stimulant side effects
  • History of substance abuse
  • Comorbid anxiety disorder
  • Comorbid tic disorder
  • Want long-term medication

3. Other Medications​

Intuniv - Guanfacine​

Characteristics

  • Originally hypertension medication
  • ADHD adjunct therapy
  • Non-stimulant
  • Effective for impulsivity/aggression

Advantages

  • No addiction potential
  • Reduces aggression
  • Improves tics

Disadvantages

  • Weak effect alone
  • Drowsiness
  • Hypotension
  • Mainly combination therapy

Wellbutrin - Bupropion​

Characteristics

  • Originally antidepressant
  • Acts on dopamine/norepinephrine
  • Unofficial ADHD treatment

Use

  • With comorbid depression
  • Stimulant adjunct
  • Not first choice

Medication Selection Guide​

First Choice: Extended-Release Methylphenidate​

Why Use Concerta/Metadate First?

  • Proven efficacy (70-80%)
  • High safety
  • Easy dose adjustment
  • Immediate effect (within days)
  • Insurance coverage

Starting Method

Week 1: 18mg (minimum dose)
Week 2: Evaluate effect
Week 3: Increase to 27-36mg if needed
Weeks 4-6: Find optimal dose (36-54mg)

Effect Evaluation

  • Feel concentration improvement?
  • Reduced impulsivity?
  • Daily life improved?
  • Are side effects tolerable?

Second Choice: Non-Stimulant​

When to Use Strattera?

  • Severe stimulant side effects
  • Worsening insomnia
  • Severe appetite loss
  • Tic disorders
  • History of substance abuse
  • Comorbid anxiety disorder

Starting Method

Weeks 1-2: 10-18mg
Weeks 3-4: 40mg
Weeks 5-6: 60-80mg
After 6 weeks: Evaluate effect

Patience Required

  • No immediate effect
  • Effect after 4-6 weeks
  • Don't give up midway, wait

Combination Therapy​

Stimulant + Non-Stimulant

  • Day: Concerta (concentration)
  • Evening: Strattera (24-hour coverage)
  • Distributed side effects

Stimulant + Antidepressant

  • ADHD + depression
  • Combine with Wellbutrin
  • Requires specialist judgment

Starting Medication Treatment​

Step 1: Psychiatric Diagnosis​

Essential Process

  • Official ADHD diagnosis
  • Check comorbid conditions
  • Check medication contraindications
  • Heart examination (ECG)

Verify

  • Any heart disease?
  • Any hypertension?
  • History of psychosis?
  • History of substance abuse?
  • Pregnant/nursing?

Step 2: Medication Selection and Start​

Consult with Doctor

  • Explain lifestyle patterns
  • Discuss main symptoms
  • Set priorities
  • Degree of side effect tolerance

Get Prescription

  • Start with small dose
  • Schedule follow-up in 2-4 weeks
  • Keep symptom journal
  • Monitor side effects

Step 3: Dose Adjustment​

Finding Right Dose

  • Too low: No effect
  • Just right: Symptom improvement, mild side effects
  • Too high: Severe side effects, over-arousal

Adjustment Period

  • Takes 4-8 weeks
  • Patience needed
  • Don't rush increases

Step 4: Maintenance and Management​

Regular Visits

  • Monthly (initially)
  • Every 3 months when stable
  • Check blood pressure, pulse
  • Growth monitoring (children)

Long-term Use

  • Take as long as needed
  • Consult doctor if want to stop
  • Don't stop suddenly
  • "Drug holidays" can be considered

Side Effects and Management​

Common Side Effects (10-30%)​

1. Appetite Loss​

Symptoms

  • Not hungry
  • Reduced food intake
  • Weight loss

Management

  • Eat sufficient breakfast (before medication)
  • Eat when medication wears off in evening
  • High-calorie snacks
  • Nutritional supplements
  • Adjust dose if severe

2. Insomnia​

Symptoms

  • Difficulty falling asleep
  • Continued arousal state
  • Insufficient sleep time

Management

  • Avoid late afternoon dosing
  • Switch to short-acting
  • Strict sleep hygiene
  • Consider melatonin (consult doctor)
  • Regular exercise

3. Headache​

Symptoms

  • Headache during day
  • Especially afternoon
  • When medication wears off

Management

  • Adequate water intake
  • Regular meals
  • Adjust medication dose
  • Possible rebound effect

4. Indigestion​

Symptoms

  • Heartburn
  • Nausea
  • Abdominal pain

Management

  • Take with food
  • Avoid irritating foods
  • Change medication if persists

5. Increased Heart Rate, Elevated Blood Pressure​

Symptoms

  • Palpitations
  • Elevated blood pressure
  • Chest tightness

Management

  • Regular monitoring
  • Reduce caffeine
  • Stop medication if severe
  • Consult cardiology

Serious Side Effects (Rare but Dangerous)​

See Doctor Immediately If:

  • Chest pain, breathing difficulty
  • Hallucinations, delusions
  • Severe anxiety, panic
  • Suicidal ideation
  • Seizures
  • Allergic reactions (hives, breathing difficulty)

Risks of Medication Misuse​

Smart Drug Misuse​

Reality

  • Distributed among students as "study drug"
  • Taking without ADHD
  • For alertness before exams
  • Purchase without prescription

Risks

  • High addiction risk
  • Dependence formation
  • Tolerance (need increasing amounts)
  • Withdrawal symptoms (depression, fatigue)
  • Cardiovascular risks

Legal Issues

  • Purchase/possession without prescription illegal
  • Transfer to others illegal
  • Prosecution upon detection

Dependence and Addiction​

Normal Use vs. Abuse

Normal Use (Low Dependence)

  • As prescribed by doctor
  • Therapeutic purpose
  • Follow dosage
  • ADHD patients

Abuse (Addiction Risk)

  • Exceed prescribed dose
  • For arousal/excitement
  • Continuously increase dose
  • Non-ADHD individuals

Warning Signs

  • Original dose not effective
  • Want to take more
  • Anxious without medication
  • Increase dose without doctor
  • Get prescriptions from multiple hospitals

Prevention

  • Strictly follow doctor's instructions
  • Don't adjust dose on your own
  • Regular medical checkups
  • Report abnormal symptoms immediately

Maximizing Medication Treatment Effectiveness​

1. Regular Dosing​

Consistency Important

  • Same time every day
  • Don't skip doses
  • Set alarms
  • Use pill organizer

If Missed

  • Within 4 hours: Take immediately
  • Over 4 hours: Skip (next day)
  • Never double dose

2. Combine with Lifestyle Habits​

Synergistic Effect

  • Adequate sleep (7-9 hours)
  • Regular exercise (3+ times/week)
  • Balanced diet
  • Control caffeine (too much causes anxiety)
  • Stress management

Related: ADHD-Friendly Lifestyle Habits

3. Combine with Cognitive Behavioral Therapy​

Medication + Therapy Best

  • Medication: Symptom control
  • Therapy: Skill acquisition
  • Lower relapse rate when combined
  • Better long-term effects

What Can Be Learned

  • Time management skills
  • Emotion regulation methods
  • Interpersonal skills
  • Problem-solving strategies

4. Monitor Effectiveness​

Keep Symptom Journal

Date: 2024-XX-XX
Medication: Concerta 36mg, 8 AM
Concentration: 7/10 (10 is best)
Impulsivity: Improved
Side effects: Slight appetite decrease
Note: Effect drops after 3 PM

Regular Assessment

  • Report to doctor monthly
  • Objective indicators (grades, work performance)
  • Feedback from others
  • Quality of life changes

Stopping Medication Treatment​

When Can You Stop?​

Considerations

  • Symptoms sufficiently improved
  • Acquired life skills
  • Environmental change (graduation, job change)
  • Difficulty tolerating side effects

Caution

  • Must consult doctor
  • Don't stop suddenly
  • Gradually reduce dose
  • Relapse possible

Drug Holidays​

Concept

  • Not taking medication on weekends/vacations
  • Time to recover from side effects
  • Minimize growth impact (children)

Advantages

  • Appetite recovery
  • Tolerance prevention
  • Cost savings

Disadvantages

  • Difficult if have symptoms on weekends
  • Less consistency
  • Not suitable for all patients

Consult Doctor

  • Varies by individual
  • Decide based on situation
  • Distinguish during semester/vacation

Frequently Asked Questions​

Q: Do I have to take medication for life? A: No. Take only as long as needed. Many people reduce or stop medication as adults when symptoms ease or coping skills improve. But some need long-term medication. Individual variation is large.

Q: Will medication stunt growth? A: Long-term studies show no effect on final adult height. Short-term growth rate may slow slightly, but growth period lengthens, so final height is similar. Safe with regular growth monitoring.

Q: If medication doesn't work, is it not ADHD? A: No. 20-30% don't respond to first medication. Need to try different medication or adjust dose. If no effect after trying multiple medications, diagnosis may need reassessment.

Q: Will medication change personality? A: No personality change at normal doses. Rather, return to true self. At excessive doses, may appear emotionless or "zombie-like." Should reduce dose then.

Q: Can I take medication during pregnancy? A: Better to avoid if possible. If planning pregnancy, consult doctor to adjust or discontinue medication. If essential, decide by comparing risks-benefits. Caution needed while nursing too.

Q: Is Adderall more effective than Concerta? A: Research shows similar effectiveness. Adderall is widely used in US for historical reasons, but Concerta/Metadate is sufficient in Korea. Adderall is more addictive and illegal in Korea.

Conclusion​

ADHD medication treatment requires specialist diagnosis and prescription. Adderall is illegal in Korea, and self-medication is very dangerous. Medications approved in Korea are sufficiently effective for treatment.

Key Points

  1. Adderall illegal in Korea - Import/sale/possession all illegal, subject to prosecution
  2. Many alternatives - Concerta, Metadate, Strattera etc. are effective
  3. Specialist prescription required - Absolutely no self-diagnosis/medication
  4. 70-80% effective - Symptom improvement with right medication and dose
  5. Side effects manageable - Most are mild and improve over time

Absolutely Don't

  • Overseas purchase/black market Adderall
  • Purchase medication without prescription
  • Take "for studying" without ADHD
  • Get prescription drugs from others
  • Adjust dose without doctor

Proper Treatment

  • Psychiatric diagnosis
  • Select medication with specialist
  • Start with low dose
  • Regular monitoring
  • Combine lifestyle improvements
  • Take only as long as needed

Meaning of Medication Treatment

  • Tool to control symptoms
  • "Management" not "cure"
  • Nothing to be ashamed of
  • Goal of improving quality of life
  • Help realize your potential

"ADHD medication is not magic, but a tool. Like glasses, it normalizes brain function like correcting vision. Carefully weigh side effects and benefits, and work with your doctor to find the right treatment for you."

Medication treatment is not the only answer. But for many people, it's an effective choice that changes lives. Don't be afraid, consult a professional.