Over the years there has been conflicting information on how, why and even if, certain foods or drinks impact the effectiveness of ADHD medications. For example, does a breakfast high in fat make medications less effective? In this post, I will try to clear up some of the confusion surrounding whether what you eat changes how your medication works.

Methylphenidate-Based Medications (Ritalin, Concerta, Focalin, Metadate, Methylin)

It is recommended that short acting medications, such as Ritalin be taken between 30 and 45 minutes before eating in order for someone to receive the full effect of the medication.  The prescribing information for Concerta, however, indicates it can be taken with or without food.

A study released in 2002 compared the effects of Concerta with Adderall after children had eaten a breakfast high in fat. The study, which was completed by McNeil Labs (the manufacturer of Concerta) showed that high-fat breakfasts had no impact on the effectiveness of Concerta but did slow down the absorption of Adderall.

Amphetamine-Based Medications (Adderall, Adderall XR, Desoxyn, Dexedrine, DextroStat, Vyvanse)

Although Adderall XR prescribing information indicates that this medication can be taken with or without food, certain foods do often impact the absorption, and therefore the effectiveness of amphetamine based medications.

For example, acidic foods decrease the absorption of the medication, reducing the medication's effect.  Acidic foods tend to make urine more acidic, which increases the rate the medication is released from the body, decreasing the effectiveness.  Some foods that acidify the urine include:

• Cranberries

• Dairy Products, such as cheese, milk and butter

• Oils, such as canola, corn, olive, safflower, sunflower, sesame

• Grains, such as rice, wheat, corn, oats

• Nuts such as cashews, peanuts, pecans, walnuts

• Vitamin C

On the other hand, when the urine is more alkaline, the medication is not eliminated from the body as quickly and therefore increasing the effectiveness of the medication.  Some foods that make the urine more alkaline are:

• Vegetables, such as asparagus, broccoli, cauliflower, cucumbers, peas, squash

• Fruits, such as apples, bananas, cherries, grapes, grapefruit, oranges, lemons, pineapples, berries, tropical fruits, watermelon

• Protein foods, such as, eggs, chicken, yogurt, almonds

The National Alliance on Mental Illness (NAMI) states, "The absorption of amphetamine medications can be reduced if strong organic acids are present in the stomach at the time of taking amphetamine medications.  The following foods should be avoided for 1 hour before and after taking an amphetamine medication:  citrus fruit, citrus juices, sodas/carbonated beverages, lemonade, Gatorade, vitamins/food and food supplements containing vitamin C." [1]

Guanfacine (Intuniv)

The prescribing information for Intuniv indicates it should not be taken with high-fat meals as this can increase the level of medication in the blood.