Medication can be an important part of treating attention- deficit/hyperactivity disorder. Because there are so many types of drugs that may be useful to control the symptoms of ADHD, it may take your physician some time, and a little careful, considered experimentation, to determine which drug, dosage and schedule is right for your child. Some of the drugs are short-acting, meaning the effects wear off after about three or four hours. Others, including many of the newer medications, are longer-lasting, meaning they are released slowly and can last as long as six, eight, 10 or even 12 hours.
As you work with your child’s doctor to determine which ADHD medicine works best for your child, be sure to keep track of both positive changes, such as improved focus or increased calmness. Also take note of negative changes in your child’s behavior that might be attributable to the drugs, such as a decrease in appetite or sleep issues. These side effects are not unusual, but they are generally mild, easy to manage and may even normalize themselves on their own.
Here are a few options to consider:
Among the drugs with the greatest success in treating ADHD are psychostimulants and stimulants. These medications, which work by increasing the levels of brain chemicals like epinephrine and norepinephrine in order to aid neural signal transmission, have been used for years and have been found to be effective in the majority of patients with ADHD. Stimulants can help children, teens and adults with both moderate and severe ADHD symptoms to think more clearly, focus more consistently and be less easily distracted.
While some stimulants have been approved for use in children ages 3 and up, others have only been okayed for use in children over age 6. Others have been approved for adults, but not children.
Stimulants are divided into two classes:
- Methylphenidate-based drugs: These drugs, which include Ritalin, Concerta and Metadate, have been shown in hundreds of studies to be effective in controlling symptoms for the majority of children with ADHD.
- Amphetamine-based drugs: These medications, which include Adderall, Adderall XR and Dexedrine, are useful alternatives for kids who don’t respond to methylphenidate-based medications or who prefer to seek an alternative.
Individual children and teens may respond better to one class of drugs or the other, but both are considered to be safe and effective in treating ADHD.
Stimulants used to treat ADHD include the following:
- Adderall (amphetamine/short-acting)
- Adderall XR (amphetamine/long-acting)
- Concerta (methylphenidate/long-acting)
- Decedrine (amphetamine/short-acting)
- Dexedrine spansule (amphetamine/long-acting)
- Dextrostat (amphetamine/short-acting)
- Focalin (amphetamine/short-acting)
- Metadate CD (methylphenidate/long-acting)
- Metadate ER (methylphenidate/long-acting)
- Methylin ER (methylphenidate/long-acting)
- Ritalin (amphetamine/short-acting)
- Ritalin SR (methylphenidate/long-acting)
- Ritalin LA (methylphenidate/long-acting)
Common side effects of these stimulants include:
- Decreased appetite
- Difficulty sleeping
Nonstimulant ADHS drugs
Children who do not tolerate stimulants well, or who find them ineffective, may want to use several nonstimulant drugs that have been successfully used to improve concentration and impulse control in children and teens: Strattera, which has been approved for use in children, adolescents and adults, and Intuniv, which has been approved for children and teens ages 6 to 17. Both drugs are relatively new.
Common side effects with nonstimulant ADHD drugs include:
- Upset stomach
- Decreased appetite
- Mood swings
Other medications used to treat ADHD
Children for whom stimulants and nonstimulants are not effective may have a few alternatives. These include:
- Antidepressants: These medications may also be used in children who have a mood disorder in addition to ADHD.
- Clonidine (Catapres) and guanfacine (Tenex): These high-blood pressure medications have been found to control symptoms ADHD as well.
Also note: In some rare cases, ADHD medications may cause more serious side effects, including an increased risk of cardiovascular problems or even sudden death. They may also worsen psychiatric conditions including anxiety and depression. Parents should discuss all possible side effects with their doctors before trying a medication on their children and should monitor the results closely as they work together to find the most effective treatment, with the fewest side effects, for their child.