How to Treat AD/HD

Attention-Deficit/Hyperactivity Disorder (AD/HD) is a disorder that can be well managed through medical, educational, psychological, and behavioral treatments. Finding the right combination of treatments can be a difficult process. It’s important to work with your child’s physician, team of educators, and others as you figure what works for your child and what does not. And remember, be patient! This can be a trying time for your child, your family, and you.

Medications

While there are no known medical treatments for learning disabilities, there are a number of medical approaches that have proven to be highly effective for treating AD/HD. Finding the most effective medication can be tedious but well worth the time and effort. The medicines most often used to treat AD/HD fall into two categories: stimulants and non-stimulants. Stimulant medications are the best-studied class of drugs for reducing hyperactivity and impulsivity. AD/HD medications are also used to help children, adolescents, and adults focus their attention and ignore distractions.

Stimulants

Stimulant medications are the most commonly used drugs to treat AD/HD. Common stimulant medications include:

• Methylphenidate (e.g., Ritalin, Concerta, Metadate)
• Dexmethylphenidate (e.g. Focalin)
• Amphetamine / Dextroamphetamine (e.g., Adderall, Dexedrine, Dextrostat)
• Lisdexamfetamine (e.g., Vyvanse)

Many parents worry about the side effects from taking daily stimulant medications. Like any type of medicine, the effects of drugs used to treat AD/HD can differ for each child. In most cases, there are few if any negative side effects to the medications and those that do occur often disappear by themselves or in response to adjustments in dosage or timing of administration. Some commonly reported side effects are:

• Decreased appetite
• Weight loss
• Difficulty falling asleep
• Feelings of restlessness, jitters and a racing heart
• Mood changes

If your child experiences any of these side effects, consult the prescribing physician so they can re-evaluate the situation and consider changing the dosage level, adjusting the medication regimen, or switching to a different type of drug.

Non-stimulants

Non-stimulant drugs such as Strattera have been approved for use in treating AD/HD in children and adults. These medications can be effective in improving concentration and impulsivity, though they often take longer than stimulant drugs to take effect. Special care should be taken with these types of drugs to monitor for changes in mood or behavior which, if noticed, should be brought to the attention of the prescribing physician.

In certain instances, other types of medicines have been used successfully to treat AD/HD. These include:

• Antidepressants – bupropion (e.g., Wellbutrin)
• Tricyclics – imipramine (e.g., Tofranil), nortriptyline (e.g., Pamelor, Aventyl), desipramine (e.g., Norpramin)
• Alpha-2 agonists – clondine (e.g., Catapres), guanfacine (e.g., Tenex)

There is no one-size-fits-all approach to choosing a medication and different drugs are given in different doses and on different schedules. Some medications are short-acting and only work for a few hours, while others are long-acting and can have extended benefits over the course of an entire day. Some medicines are metabolized quickly and exit the body quickly; others have a cumulative effect and build up in the body over time. There are many different types of stimulant drugs and each can vary in dosage strength.  It is important to consult your child’s physician in deciding which type of drug is right for your child and to keep to an approved schedule of administration, never stopping a medication suddenly without first consulting the physician And remember, medications of any kind do not cure AD/HD. But when taken under the right conditions, they can reduce symptoms and greatly improve your child’s ability to learn, work, and play.

Behavioral Treatments

In addition to the appropriate medications, counseling and behavioral therapies are very important parts of managing AD/HD. For example, behavior modification can be very helpful to parents and teachers in managing a child’s hyperactivity and impulsivity. When carried out appropriately, children can learn positive behavior management principles and self-control techniques. Behavioral treatments can also be very effective in shaping (and repairing) social and familial relationships. 

Related Resources

A Guide to AD/HD Medications
Straight Talk About Medications for AD/HD
National Resource Center on AD/HD
American Academy of Pediatrics 
Pediatric Labeling Information Database