As parents and therapists, we hope for a non-medical treatment that is 100% effective. However, that treatment has yet to be developed. Medication treatment is among the most effective medications in the treatment of ADHD in children. It is highly effective in 75%-90% percent of children with ADHD. Stimulants are shown to help a child maintain attention and exhibit greater self control. They also have been shown to provide the greatest improvement in the core symptoms of ADHD (inattention, impulsivity and hyperactivity) of any treatment method.
What Medications are Available?
Stimulant Medicaton
Stimulant medication treat ADHD by “stimulating” the frontal lobe of the brain. Many stimulant medications have received FDA approval for the treatment of ADHD in children. Stimulants are fast-acting and work the same day that they are administered. Many types of stimulant medications exist including:
Extended release stimulants: These medcations are usually administered once a day in the morning, and maintain effectiveness for 8-12 hours. Extended-release stimulants are currently the most commonly used forms of stimulants. Examples include:
Concerta (Methylphenidate)
Adderall XR (Mixed amphetamine salts)
Focalin XR (Dexmethylphenidate)
Metadate CD (Methylphenidate)
Ritalin LA (Methylphenidate)
Vyvanse (Lisdexamfetamine Dimesylate)
Daytrana (Methylphenidate trans-dermal patch)
Moderate release stimulants: These medicines are often effective over the school day, but usually do not provide treatment in the afterschool hours as they work for 6-8 hours. Examples include:
Ritalin SR (Methylphenidate)
Dexedrine Spansule (Dextroamphetamine)
Metadate ER (Methylphenidate)
Short acting stimulants: These medications are typically strongest 1-2 hours after administration, and are no longer effective after 3-4 hours. They often need to be administered multiple times per day. Examples include:
Adderall (Mixed amphetamine salts)
Methylin (Methylphenidate)
Focalin (Dexmethylphenidate)
Ritalin (Methylphenidate)
Non-Stimulant Medication
Although stimulant mediction are the most effective treatment for children with ADHD, non-stimulant medication options do exist. Initial evidence suggests that Intuniv and Strattera show some effectiveness at reducing ADHD symptoms, but may not be as effective as stimulant medication Many times it may be used in cases where the child has not responded to stimulant medications or where supplemental medication treatment is required. Current non-stimulant medications include:
Guanfacine (Intuniv)
Atomoxentine (Strattera)
ADHD Medication Myths
Myth: ADHD medications have dangerous side effects. Fact: ADHD medications are among the most heavily researched of all psychiatric medications. Research has shown that most children only experience a few minor side effects, such as decreased appetite or difficulty falling asleep. While all medications carry some risk, very few children experience serious side effects from medications used to treat ADHD.
Myth: The medication will make my child act like a “zombie.” Fact: Most children with ADHD are still energetic and full of life while taking medication. They are just better able to control and channel their energy. If your child does exhibit a loss of energy or appears withdrawn this may mean that the dose of medication is too high, or there is a co-occurring condition such as depression. In these instances, talk to your child’s pediatrician about an adjustment of the medication dose to help lessen the side effects, or a possible screening for another illness like depression.
Myth: If I put my child on medication there is no reason to try psychosocial treatment (counseling) Fact: Studies report that medications are most effective when combined with psychosocial treatment/counseling. Medications reduce the core symptoms of ADHD – inattention, hyperactivity, and impulsivity – but will not necessarily eliminate all problems with behavior, organization, mood, peer relationships, etc. An analogy that may be helpful is to consider treatment of reading difficulties in a child with poor eyesight. In this analogy medication may be thought of as similar to putting glasses on a child – it will allow them to better see the words but will not teach them to read. Psychosocial treatment/counseling can help you and your child learn to use their improved attention and impulse control to build better social skills, coping skills, and academic strategies to improve their mood, behavior, and academic performance.
Myth: Using medication will make my child more likely to abuse drugs or alcohol in adolescence. Fact: Studies have shown that children with ADHD who are on effective medication treatments are actually less likely to abuse drugs or alcohol in adolescence and adulthood. Instead, people with untreated ADHD are more likely to engage in risky behaviors such as drug or alcohol use. Children cannot get “high” off their ADHD medication if it is taken properly, and they do not get “addicted” to the medication either.
Myth: Medication is an excuse for laziness and will make my child less motivated to work hard Fact: An ADHD medication can allow your child to see the rewards of his/her hard work. A medication can help your child do well in school, exhibit good behavior, and have successful relationships with peers. Studies show, too, that children who benefit from ADHD medications see their success as a result from their effort and hard work rather than from the medication. Your own motivational words and actions as a parent can erase any negative impact that taking medication may have on your child
What About Side Effects?
The most common difficulties include:
Lack of effectiveness:
About 20-25% of children will not show a significant improvement as a result of stimulant treatment. In some cases, adjusting the dose or trying a different stimulant medication will produce an effective response. In other cases, a child may respond to a non-stimulant medication, such as Atomoxotine (Strattera).
Most commonly demonstrated side effects of stimulant medication treatment are:
