Kids whose symptoms started off mild also improved, but the difference wasn't as great. Amphetamines and methylphenidates were equally associated with symptom changes in all areas See more about ADHD symptoms. Most children in our survey who were taking medication for ADHD had tried methylphenidate 84 percent or an amphetamine 51 percent in the past three years. A smaller percentage 17 percent had tried a nonstimulant medication.
There were no differences in the type of medication children were prescribed either by age or length of time since they had been diagnosed.
Most children taking these medications had been taking them for longer than two years 35 percent overall , while 22 percent had been taking them for one to two years. Our survey found there were no major differences in effectiveness between amphetamines and methylphenidates. Here's how the children fared with medication in these specific areas:. We asked parents to rate how helpful each medication was in the following areas: academic performance, behavior at school, behavior at home, self-esteem, and social relationships.
Both amphetamines and methylphenidates were equally likely to be helpful in all areas with the exception of behavior at school, where amphetamines were rated as slightly more helpful. Although we don't have enough cases of children taking "second line" medications e.
Straterra to report specific findings, the data we have indicates that they were generally less likely to be "very helpful" than amphetamines or methylphenidates in the areas we asked about.
If a child is struggling in the areas of self-esteem and relationships, and medication is not helpful, it might be useful to have him or her see a clinical psychologist or other mental-health professional. Whenever the result of taking a drug is less than desired, it might be time to consider changing medication, Goldstein suggests. Some children experience different effects from a different formulation of the same medication. A vast majority of children in our survey received medication from a pediatrician 60 percent , followed by a child psychiatrist 18 percent and a general psychiatrist 15 percent.
All of the drugs carry a warning about rare cases of sudden, unexplained death. It is recommended practice to test for life-threatening conditions, including heart-related issues, before prescribing these medications. Overall, physicians did a decent job of screening before prescribing medication. Eighty-five percent of the children we surveyed received some sort of screening, and 76 percent were given a general medical exam.
It should be checked before starting medication, and at least once while the child is taking medication. And even though 85 percent of the children were screened before starting medication, 15 percent did not receive any type of screening.
A parent should always request basic screening of their child before starting medication for ADHD. We also asked parents about other things they wished their prescribing physician had done. Parents didn't rate doctors well for managing their child's medication. He offers these additional tips:. Always call the doctor with questions.
Even if all is well, check in by phone two weeks after beginning medication and schedule a visit one month after for a follow-up. After that, return visits will depend on the success of the treatment and side effects. In general, children doing well can be seen every six months.
Reassessment should consist of a physical examination and direct questioning of the child and family member s. Teacher evaluations are also helpful. A complete re-evaluation with the family and input from others including teachers should be considered every year, although waiting two to three years is common.
Side effects are a major area of concern for many parents considering medication for their child's ADHD. Indeed, side effects might add to the overall stress of managing a child's condition. Our survey found that parents of children taking amphetamines and methylphenidates reported a high frequency of side effects.
Overall, 84 percent of the children who tried amphetamines and 81 percent who tried methylphenidates experienced side effects. And among those who reported no longer taking a specific medication, 35 percent said it was because of side effects.
Decreased appetite, sleep problems, weight loss, irritability, and upset stomach were the side effects most frequently reported by parents for both types of medication. Amphetamines and methylphenidates were equally likely to produce these side effects with the exception of irritability, which was more likely to be reported as a side effect by parents whose children tried amphetamines.
Although elevated mood or excessive energy wasn't among the more frequently reported side effects, it was more commonly reported by parents whose children were taking amphetamines compared with methylphenidates. Talk with your doctor if irritability, anger, or manic behavior become an issue.
Side effects such as a loss of appetite are very common but usually not significant, and they tend to improve over time, Michael L. Other problems children have after taking medication might not be due to the drugs at all. Sleep problems might have occurred before starting medication, for example. And taking medication at the correct time is another factor in determining side effects.
Although many parents reported side effects, they can often be managed. For example, some children have problems later in the day and a long-acting formulation is best, but sometimes the effect might persist into the evening, suppressing appetite for dinner and delaying bedtime.
Dopamine is a neurotransmitter associated with motivation, pleasure, attention, and movement. For many people with ADHD, stimulant medications boost concentration and focus while reducing hyperactive and impulsive behaviors. Stimulants for ADHD come in both short- and long-acting dosages. Short-acting stimulants peak after several hours, and must be taken times a day. Long-acting or extended-release stimulants last hours, and are usually taken just once a day. Taking just one dose a day is much easier and more convenient.
Stimulant medications may also cause personality changes. Some people become withdrawn, listless, rigid, or less spontaneous and talkative. Others develop obsessive-compulsive symptoms. Since stimulants raise blood pressure and heart rate, many experts worry about the dangers of taking these ADHD drugs for extended periods. Beyond the potential side effects, there are a number of safety concerns associated with the use of stimulant medications for ADHD. Effect on the developing brain.
The long-term impact of ADHD medication on the youthful, developing brain is not yet known. Some researchers are concerned that the use of drugs such as Ritalin in children and teens might interfere with normal brain development. Heart-related problems. ADHD stimulant medications have been found to cause sudden death in children and adults with heart conditions.
The American Heart Association recommends that all individuals, including children, have a cardiac evaluation prior to starting a stimulant. An electrocardiogram is recommended if the person has a history of heart problems. Psychiatric problems. Stimulants for ADHD can trigger or exacerbate symptoms of hostility, aggression, anxiety, depression, and paranoia. People with a personal or family history of suicide, depression, or bipolar disorder are at a particularly high risk, and should be carefully monitored when taking stimulants.
Potential for abuse. Stimulant abuse is a growing problem, particularly among teens and young adults. College students take this medication for a boost when cramming for exams or pulling all-nighters. Others abuse stimulant meds for their weight-loss properties. Call your doctor right away if you or your child experience any of the following symptoms while taking stimulant medication for ADHD:. In addition to the traditional stimulant drugs, there are several other medications used to treat ADHD, including Strattera, atypical antidepressants, and certain blood pressure medications.
Unlike stimulants, which affect dopamine, Strattera boosts the levels of norepinephrine, a different brain chemical. Strattera is longer-acting than the stimulant drugs. Its effects last over 24 hours—making it a good option for those who have trouble getting started in the morning. Straterra can also cause insomnia and appetite suppression, but these side effects are more common in stimulants.
Strattera may increase suicidal thoughts and actions in some people, especially children and younger adults who have bipolar disorder or depression in addition to ADHD. Call the doctor immediately if your child shows agitation, irritability, suicidal thinking or behaviors, and unusual changes in behavior. Options include clonidine Catapres and guanfacine Tenex. But while these medications can be effective for hyperactivity, impulsivity, and aggression, they are less helpful when it comes to attention problems.
Antidepressants for ADHD — For people suffering from both ADHD and depression, certain antidepressants , which target multiple neurotransmitters in the brain, may be prescribed.
Wellbutrin, also known by the generic name bupropion, is most widely used. Wellbutrin targets both norepinephrine and dopamine. Another option is the use of tricyclic antidepressants. Take your time to weigh the options. And if the medication is for your child, be sure to get their input in the decision-making process. Most importantly, trust your instincts and do what feels right to you.
For young children especially, medication should be viewed as a last resort, not the first course of treatment to try. Consulting with an ADHD specialist or an experienced psychiatrist can help you understand the pros and cons of medication. Here are some questions to ask:. When deciding whether or not to put your child on medication, Jerome Schultz, Ph. There are many ways to help yourself or your child tackle the challenges of ADHD and lead a calmer, more productive life. With the right tips and tools, you can manage many of the symptoms of your ADHD on your own.
Even if you choose to take medication, healthy lifestyle habits and other self-help strategies may enable you to take a lower dose. Exercise regularly. Exercising is one of the most effective ways to reduce the symptoms of ADHD. These medicines are not a permanent cure for ADHD but may help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practise new skills.
Some medicines need to be taken every day, but some can be taken just on school days. Treatment breaks are occasionally recommended to assess whether the medicine is still needed. If you were not diagnosed with ADHD until adulthood, a GP and specialist can discuss which medicines and therapies are suitable for you. If you or your child is prescribed one of these medicines, you'll probably be given small doses at first, which may then be gradually increased.
You or your child will need to see a GP for regular check-ups to ensure the treatment is working effectively and check for signs of any side effects or problems. It's important to let the GP know about any side effects and talk to them if you feel you need to stop or change treatment. Your specialist will discuss how long you should take your treatment but, in many cases, treatment is continued for as long as it is helping.
Methylphenidate is the most commonly used medicine for ADHD. It belongs to a group of medicines called stimulants, which work by increasing activity in the brain, particularly in areas that play a part in controlling attention and behaviour. The medicine can be taken as either immediate-release tablets small doses taken 2 to 3 times a day or as modified-release tablets taken once a day in the morning, with the dose released throughout the day.
Lisdexamfetamine is a medicine that stimulates certain parts of the brain. It improves concentration, helps focus attention and reduces impulsive behaviour. It may be offered to teenagers and children over the age of 5 with ADHD if at least 6 weeks of treatment with methylphenidate has not helped.
Adults may be offered lisdexamfetamine as the first-choice medicine instead of methylphenidate. Dexamfetamine is similar to lisdexamfetamine and works in the same way. It may be offered to adults, teenagers and children over the age of 5 with ADHD.
Dexamfetamine is usually taken as a tablet once or twice a day, although an oral solution is also available. It's a selective noradrenaline reuptake inhibitor SNRI , which means it increases the amount of a chemical in the brain called noradrenaline.
This chemical passes messages between brain cells, and increasing it can aid concentration and help control impulses. Atomoxetine may be offered to adults, teenagers and children over the age of 5 if it's not possible to use methylphenidate or lisdexamfetamine. It's also licensed for use in adults if symptoms of ADHD are confirmed. Atomoxetine has also been linked to some more serious side effects that are important to look out for, including suicidal thoughts and liver damage.
If either you or your child begin to feel depressed or suicidal while taking this medicine, speak to your doctor. It may be offered to teenagers and children over the age of 5 if it's not possible to use methylphenidate or lisdexamfetamine.
Guanfacine should not be offered to adults with ADHD.
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