Medicines to Treat ADHD in Children
Children who have attention deficit hyperactivity disorder (ADHD) often take prescription
medicine as part of their treatment plan. Healthcare providers usually start out prescribing
a psycho-stimulant medicine. These medicines have a long record of safety. Stimulates
help kids with ADHD with impulse control, attention, and other behavioral issues.
Treating ADHD also reduces the increased risk for substance use disorder. This disorder
is more common in kids with ADHD.
The most common stimulants prescribed are variations of the stimulant called methylphenidate.
Amphetamine-based stimulants are also used. But these are used less often because
of more severe side effects.
Psycho-stimulants act quickly, over 1 to 4 hours. This fast action helps children
in school because ADHD can interfere with attention in class. Some psycho-stimulants
are longer acting. They work for up to 9 hours and need to be taken only once a day.
Sometimes nonstimulant medicines may be used to treat ADHD in children. These include:
Your healthcare provider will determine your child's need for medicine. They will
choose the best medicine for your child. This is done after evaluating your child's
symptoms, age and health, and your preference.
Before ADHD medicine is started, your child will be checked to be sure they meet certain
standards for treatment. These can include:
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A health history that focuses on the heart, plus a family history and physical exam
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Height, weight, blood pressure, and heart rate
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Exam and tests to rule out bipolar disorder. This can be made worse with stimulant
medicines.
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Information for common side effects linked to ADHD medicines. These include belly
pain, sleep patterns, and appetite.
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Substance use evaluation. Children with symptoms of substance use will be referred
for evaluation and treatment for addiction before certain ADHD medicines are prescribed.
The provider will set up education about medicine use if these standards are met.
This can include talking about:
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The medicine choice and why this medicine is being recommended
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The medicine dose, how often it should be given, and frequency of follow-up visits.
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The risks and benefits of treatment
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Possible physical and emotional side effects
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How long treatment is expected to take
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The behaviors and physical symptoms the family should watch for and report
Possible side effects
Psycho-stimulant medicines can cause side effects. But most are mild and ease with
time. Side effects include trouble sleeping, decreased appetite, stomachache, headache,
and nervousness. Some children's hyperactive behaviors may increase for a short while
when the medicine's effects wear off.
The FDA has ordered that medicine guides for parents be included with prescriptions
for psycho-stimulants. That's because of recent reports of sudden death in children
and teens with heart problems who were taking these medicines for ADHD. A slightly
increased risk for paranoia, mania, or hearing voices also happens in children who
take these medicines.
When to take
The best time for your child to take a long-acting, once-a-day medicine is just after
breakfast. Shorter-acting medicines are best taken 30 to 45 minutes before a meal,
such as before breakfast and before lunch.
Medicine can be taken during the week and stopped on the weekend. Your healthcare
provider can discuss if this is advised for your child. Some children don't do well
stopping medicine for 2 days. They develop behavior problems. Medicine also is often
stopped during the summer months when school is out. Your provider can talk with you
about the right schedule for your child.
Other therapies
Some experts (and parents) criticize what they see as an overuse of psycho-stimulants.
But these medicines have been proved to work well and be safe for treating ADHD. Other
treatment choices may be harder to follow and work less well. And sometimes they are
not easily available to families. Other choices to psycho-stimulants medicines include:
Psycho-stimulants often are used along with other therapy and educational plans in
the school. This includes behavioral and psychological treatment. For your child's
benefit, it's important to work with school staff. Coordinated approaches and appropriate
support can be provided to both you and your child.
Some parents have turned to alternative treatments such as biofeedback, megavitamins,
and blue-green algae. Talk about any alternative treatments with your healthcare provider
before trying them. This is even more important if your child is also taking medicines
at the same time.
Whatever the treatment, if your child has ADHD, they may have trouble focusing even
when they are adults. Most children outgrow the hyperactivity and impulsiveness of
their younger years. They may still have trouble getting organized or finishing long-term
projects as adults.