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Why Two Medications Can Lead to Very Different Results
When it comes to ADHD treatment, two of the most commonly prescribed stimulant medications are methylphenidate and amphetamines. Both are designed to help with focus, impulse control, and overall attention. But despite sharing similar goals, these medications can produce very different results depending on the person.
At BloomDNA, we often hear stories from patients who respond well to one medication and poorly to the other. That difference may not be about the medication itself, but how the body processes it. The reason can often be found in your DNA.
A Parent’s Story That Changed the Direction of Treatment
Melissa, a parent of an 11-year-old boy with ADHD, contacted us after struggling with three different prescriptions. The first, an amphetamine-based stimulant, caused emotional crashes and sleepless nights. The second, a methylphenidate formula, worked briefly but didn’t last through the school day. The third didn’t help at all.
Rather than continue trying medications at random, Melissa ordered a BloomDNA test. The report revealed that her son had a reduced ability to metabolize amphetamine-based drugs, while his methylphenidate response was typical. With this insight, they returned to the previous medication and adjusted the dosage. The improvement was noticeable within the first few weeks.
Why These Medications Work Differently
Even though both drug types are stimulants, they are processed through different enzyme systems in the body. That’s where genetics plays a critical role.
- Methylphenidate is mostly broken down by an enzyme called CES1
- Amphetamines rely on a different pathway, influenced by CYP2D6 and other metabolic genes
If a person has low CES1 activity, they may not retain enough methylphenidate for it to be effective. If someone metabolizes amphetamines too slowly, they may experience stronger side effects or minimal benefits.
How Pharmacogenetic Testing Helps
Our BloomDNA pharmacogenetic test looks at the genetic markers that impact medication metabolism. For ADHD medications, we focus on enzymes and transporters such as:
- CES1
- CYP2D6
- SLC6A2
By understanding these gene pathways, your provider can make more informed choices about which medication type is likely to work best. This insight often reduces the need for trial and error.
Supporting More Confident Treatment Plans
Parents and adults living with ADHD often face weeks or months of adjustment periods while testing new medications. Each failed attempt can feel discouraging and delay meaningful progress.
Knowing how your body is likely to respond gives your care team a head start. With pharmacogenetic testing, that information becomes available before another medication is prescribed.
Ready for Answers?
If ADHD treatment has felt like a cycle of uncertainty, pharmacogenetic testing may be the missing step. It brings clarity to the conversation and helps avoid unnecessary side effects or delays.