Medication6 min readUpdated Jan 30, 2026

Why Your ADHD Medication Stopped Working

You've been taking your Adderall, Vyvanse, or Concerta faithfully, and it was working great—until it wasn't. Now you're wondering: Did I build up a tolerance? Is the medication broken? Or is something else going on?

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It's Not Always Tolerance

While true pharmacological tolerance does occur with stimulants, research suggests it's less common than people think. Often, what feels like tolerance is actually one of these factors:

Sleep Debt

Even one night of poor sleep can significantly reduce how well stimulants work. Chronic sleep deprivation makes it worse.

Increased Stress

High stress depletes dopamine, making your medication work harder to achieve the same effect.

Hormonal Changes

For women, estrogen levels affect stimulant metabolism. Many notice medication works differently throughout their cycle.

Diet Changes

Vitamin C and acidic foods can reduce absorption. High-protein meals can affect timing.

Dehydration

Being even mildly dehydrated affects cognitive function and can make medication seem less effective.

Life Changes

New job, relationship stress, or increased demands mean you need more from your medication.

Signs of True Tolerance

True pharmacological tolerance has specific patterns:

  • The medication worked well initially, then gradually declined over weeks/months
  • Duration of effect has shortened noticeably
  • Higher doses are needed to achieve previous effects
  • Other factors (sleep, stress, diet) have been ruled out

What To Do About It

1. Track Your Patterns

Before assuming tolerance, track sleep, stress, diet, and medication timing for 2 weeks. You might find the real culprit.

2. Talk to Your Prescriber

Don't adjust doses yourself. Your doctor might suggest dosing changes, medication holidays, switching formulations, or adding adjunct treatments.

3. Address the Basics

Prioritize sleep, manage stress, stay hydrated, and eat regularly. These fundamentals can restore medication effectiveness without dose changes.

4. Consider Medication Holidays

Some people find weekend breaks help maintain effectiveness. Only do this with your doctor's guidance—it's not right for everyone.

Frequently Asked Questions

Why did my ADHD medication stop working?

ADHD medication can feel less effective due to tolerance, sleep deprivation, stress, hormonal changes, inconsistent dosing, or changes in diet and lifestyle. It's often a combination of factors.

How do I know if I've developed tolerance?

Signs of tolerance include needing higher doses for the same effect, shorter duration of effectiveness, return of ADHD symptoms at previously effective doses, and feeling like the medication does nothing.

Can you reverse ADHD medication tolerance?

Some doctors recommend medication holidays (under supervision) to reset tolerance. Others adjust dosing strategies, switch medications, or add adjunct treatments. Always consult your prescriber.

Track what's affecting your meds

Our Med Check assessment helps identify factors that might be reducing your medication's effectiveness.

Take the Med Check