Rethinking ADHD Treatment: The Promise of Evening-Dosed Medication

Rethinking ADHD Treatment: The Promise of Evening-Dosed Medication

Attention-Deficit/Hyperactivity Disorder (ADHD) affects millions of children, adolescents, and adults across the country. While symptoms like distractibility, impulsivity, and hyperactivity often take center stage, what’s less often talked about is the day-to-day disruption ADHD can cause—for both individuals and their families.

From the moment the day begins, challenges can arise: difficulty getting out of bed, emotional dysregulation during the morning routine, frustration with school preparation, and struggles maintaining attention throughout the day. For many families, mornings are a battle, and medication—while helpful—doesn’t always solve the problem.

At South Chesapeake Psychiatry, we understand that no two people with ADHD are alike. That’s why we’re constantly exploring new tools and strategies to improve not just symptom control, but function and quality of life.

One of the more recent innovations in ADHD treatment is JORNAY PM, an evening-dosed stimulant that is changing how we think about medication timing and coverage.

A New Approach: What Is JORNAY PM?

JORNAY PM is a delayed-release/extended-release (DR/ER) form of methylphenidate, the same active ingredient found in medications like Ritalin and Concerta. But what makes JORNAY PM different is when it’s taken.

Unlike most stimulants, which are taken in the morning, JORNAY is taken the night before—between 6:30 p.m. and 9:30 p.m. The medication is designed to delay release for about 10–12 hours, so that it begins working just as the person wakes up.

For many families, this means:

• No more racing to give meds first thing in the morning
• No more lag time before the medication "kicks in"
• No more early-morning meltdowns while waiting for symptom relief

Instead, clients wake up with coverage already in place—ready to meet the day with more focus, regulation, and stability.

What Makes JORNAY PM Different

Beyond its unique timing, JORNAY PM offers several clinical advantages that distinguish it from other stimulants:

• Evening dosing with morning effect: Delayed-release technology allows symptom control to begin at the start of the day, not 30–60 minutes after taking a pill.
• Sustained coverage: The medication continues working throughout the school or work day, often reducing or eliminating the need for mid-day booster doses.
• Dose-dependent duration: Unlike some stimulants (e.g., Vyvanse) whose duration doesn’t significantly change with dose, JORNAY PM’s duration of effect increases with dose escalation (Childress et al., 2019). This allows for more flexible tailoring of treatment based on individual needs.
• Fewer emotional “crashes”: The slow, steady release profile reduces the likelihood of late-day mood swings or abrupt symptom rebound that can occur with some stimulant medications.

Why This Matters

Managing ADHD isn’t just about improving focus. It’s about reducing the friction in daily life. Morning routines, transitions, academic performance, workplace functioning, and emotional regulation all depend on consistent, well-timed symptom control.

With JORNAY PM, clients don’t have to wait for medication to work. They can start their day with the support already in place.

And for school-aged children and teens, eliminating the need for a lunchtime dose means:

• No visits to the school nurse
• No medication reminders mid-day
• No awkward social questions
• No disruption to learning or routines

It’s a small change in timing that can lead to a big improvement in structure, independence, and daily rhythm.

Who Might Benefit

JORNAY PM is approved for individuals aged 6 and up with ADHD. It may be a good fit for those who:

• Experience significant morning impairment
• Don’t respond well to traditional stimulant schedules
• Need extended symptom coverage into the evening
• Prefer to avoid mid-day dosing or experience “wearing off” effects too early

As always, stimulant medications require thoughtful dosing and close monitoring by a licensed provider.

What Patients and Families Say

Clients and caregivers who have transitioned to JORNAY PM often report:

• Mornings are calmer and less combative
• Symptom control starts right away and continues smoothly
• There’s no need to leave class or work to take a second dose
• Fewer emotional crashes at the end of the day
• The medication lasts longer when dosed appropriately

These lived experiences are now being reflected in published pharmacokinetic models, which show that DR/ER methylphenidate has a unique ability to personalize both intensity and duration of treatment response (Wigal et al., 2023).

The Takeaway

ADHD presents differently for everyone, and treatment should reflect that. While traditional stimulants work well for many, others may benefit from a more strategic, timing-sensitive approach. JORNAY PM represents a shift—not just in when we give medication, but in how we support people with ADHD across the full day.

If mornings are a struggle, if afternoons feel unpredictable, or if the current treatment just isn’t lasting long enough, JORNAY PM may offer a better fit.

Want to learn more?

Call 757-908-2124 or visit South Chesapeake Psychiatry to schedule a consultation. We’re here to help you find what works—not just what’s common.

References

Childress, A. C., Cutler, A. J., Po, M. D., DeSousa, N. J., Warrington, L. E., Sallee, F. R., & Incledon, B. (2019). A randomized, double-blind, placebo-controlled study of HLD200 (DR/ER-methylphenidate) in children with ADHD. Journal of Attention Disorders, 23(5), 405–417. https://pubmed.ncbi.nlm.nih.gov/31464511/

Wigal, S. B., Lopez, F. A., Childress, A. C., Cutler, A. J., DeSousa, N. J., Incledon, B., & Sallee, F. R. (2023). Modeling dose-response relationships for a delayed-release/extended-release methylphenidate formulation in children with ADHD. Journal of Child and Adolescent Psychopharmacology, 33(4), 250–258. https://pubmed.ncbi.nlm.nih.gov/36996044/

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