Standard treatments for ADHD in children include medications, education, training and counseling. These treatments can relieve many of the symptoms of ADHD, but they don't cure it. It may take some time to determine what works best for your child.
Currently, stimulant drugs (psychostimulants) are the most commonly prescribed medications for ADHD. Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters. These medications help improve the signs and symptoms of inattention and hyperactivity — sometimes dramatically.
Examples include methylphenidate (Concerta, Metadate, Ritalin, others), dextroamphetamine (Dexedrine), dextroamphetamine-amphetamine (Adderall XR) and lisdexamfetamine (Vyvanse).
Stimulant drugs are available in short-acting and long-acting forms. A long-acting patch is available that can be worn on the hip.
The right dose varies from child to child, so it may take some time to find the correct dose. And the dose may need to be adjusted if significant side effects occur or as your child matures. Ask your doctor about possible side effects of stimulants.
Stimulant medications and heart problems
Although rare, several heart-related deaths occurred in children and teenagers taking stimulant medications. The possibility of increased risk of sudden death is still unproved, but if it exists, it's believed to be in people who already have underlying heart disease or a heart defect. Your child's doctor should make sure your child doesn't have any signs of a heart condition and should ask about family risk factors for heart disease before prescribing a stimulant medication.
Other medications used to treat ADHD include atomoxetine (Strattera) and antidepressants such as bupropion (Wellbutrin, others) and desipramine (Norpramin). Clonidine (Catapres) and guanfacine (Intuniv, Tenex) have also been shown to be effective. Atomoxetine and antidepressants work slower than stimulants and may take several weeks before they take full effect. These may be good options if your child can't take stimulants because of health problems or if stimulants cause severe side effects.
Ask your doctor about possible side effects of any medications.
Although it remains unproved, concerns have been raised that there may be a slightly increased risk of suicidal thinking in children and teenagers taking nonstimulant ADHD medication or antidepressants. Contact your child's doctor if you notice any signs of suicidal thinking or other signs of depression.
Giving medications safely
Making sure your child takes the right amount of the prescribed medication is very important. Parents may be concerned about stimulants and the risk of abuse and addiction. Dependence hasn't been shown in children who take these drugs for appropriate reasons and at the proper dose.
On the other hand, there's concern that siblings and classmates of children and teenagers with ADHD might abuse stimulant medications. To keep your child's medications safe and to make sure your child is getting the right dose at the right time:
- Administer medications carefully. Children and teens shouldn't be in charge of their own ADHD medication without proper supervision.
- At home, keep medication locked in a childproof container. An overdose of stimulant drugs is serious and potentially fatal.
- Don't send supplies of medication to school with your child. Deliver any medicine yourself to the school nurse or health office.
ADHD behavior therapy and counseling
Children with ADHD often benefit from behavior therapy and counseling, which may be provided by a psychiatrist, psychologist, social worker or other mental health care professional. Some children with ADHD may also have other conditions such as anxiety disorder or depression. In these cases, counseling may help both ADHD and the coexisting problem.
Examples of therapy include:
- Behavior therapy. Teachers and parents can learn behavior-changing strategies for dealing with difficult situations. These strategies may include token reward systems and timeouts.
- Psychotherapy. This allows older children with ADHD to talk about issues that bother them, explore negative behavioral patterns and learn ways to deal with their symptoms.
- Parenting skills training. This can help parents develop ways to understand and guide their child's behavior.
- Family therapy. Family therapy can help parents and siblings deal with the stress of living with someone who has ADHD.
- Social skills training. This can help children learn appropriate social behaviors.
The best results usually occur when a team approach is used, with teachers, parents, and therapists or physicians working together. Educate yourself about ADHD, and then work with your child's teachers and refer them to reliable sources of information to support their efforts in the classroom.
March 05, 2013
- Attention-deficit/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Jan. 7, 2013.
- Attention deficit/hyperactivity disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/index.shtml. Accessed Jan. 7, 2013.
- ADHD factsheet. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/adhd/. Accessed Jan. 7, 2013.
- Bader A, et al. Complementary and alternative therapies for children and adolescents with ADHD. Current Opinion in Pediatrics. 2012;24:760.
- Rucklidge JJ. Gender differences in attention-deficit/hyperactivity disorder. Psychiatric Clinics of North America. 2010;33:357.
- Vaughan B, et al. Pharmacotherapy of pediatric attention-deficit/hyperactivity disorder. Child & Adolescent Psychiatric Clinics of North America. 2012;21:941.
- Emond SK, et al. Management strategies for attention-deficit/hyperactivity disorder: A regional deliberation on the evidence. Postgraduate Medicine. 2012;124:58.
- Kim DH, et al. Relationship between attention deficit hyperactivity disorder symptoms and perceived parenting practices of school-age children. Journal of Clinical Nursing. In press. Accessed Jan. 8, 2013.
- Parenting a child with ADHD. National Resource Center on AD/HD. http://www.chadd.org. Accessed Jan. 8, 2013.
- Attention-deficit/hyperactivity disorder (ADHD). Facts about ADHD. Centers for Disease Control and Prevention. http://www.cdc.gov/NCBDDD/adhd/facts.html. Accessed Jan. 25, 2013.
- Jensen PS (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2013.
- Swintak CC (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 21, 2013.
- Goodlad JK, et al. Lead and attention-deficit/hyperactivity disorder (ADHD) symptoms: A meta-analysis. Clinical Psychology Review. 2013;33:417.
- Lindstrom K, et al. Preterm birth and attention-deficit/hyperactivity disorder in school children. Pediatrics. 2011;127:858.