Children who have attention deficit hyperactivity disorder (ADHD) are often given medication as part of their treatment plan. Health care providers usually prescribe psychostimulants, such as methylphenidate (Ritalin, Metadate, and Concerta). These drugs help balance chemicals in your child's brain that help to control their behavior and focus their attention.
Health care providers also prescribe other psychostimulants, such as dextroamphetamine (Dexedrine), a mixture of amphetamine salts (Adderall), and atomoxetine (Strattera).
Psychostimulants act quickly—doing their job over the course of 1 to 4 hours. They are then quickly flushed from the body. Newer psychostimulants on the market are designed to be longer acting. They work for up to 9 hours and need to be taken only once a day.
Occasionally, nonstimulant medications may be used to treat ADHD in children. These include the antidepressants bupropion (Wellbutrin), desipramine (Norpramin), and imipramine (Tofranil).
Your health care provider will determine your child's need for medication and select the appropriate drug, after evaluating your child's symptoms, age and health, and your preference.
Psychostimulant medications can cause side effects, but most are mild and ease with time. Side effects include insomnia, decreased appetite, stomach ache, headache, and nervousness. In addition, when the medication's effects wear off, some children's hyperactive behaviors may increase for a short while.
The FDA has ordered that medication guides for parents be included with prescriptions for psychostimulants. That's because of recent reports of sudden death in children and teens with heart abnormalities who were taking these medications for ADHD. A slightly increased risk for paranoia, mania, or hearing voices also occurs in youngsters who take these medications.
The best time for your child to take a long-acting, once-a-day medication is just after breakfast. Shorter-acting medications are best taken 30 to 45 minutes before a meal—before breakfast and before lunch.
Medication can be taken during the week, with a drug “vacation” on the weekend. Your health care provider can discuss whether this is appropriate for your child. Some children do not tolerate stopping for 2 days, and they develop behavior problems. Medication also is often stopped during the summer months, when school is out. Your health care provider can discuss the appropriate schedule for your child.
Although some experts (and parents) criticize what they see as an overuse of psychostimulants, these medications have proven to be effective and safe for the treatment of ADHD. Other treatment options may be harder to follow, less effective, and sometimes not easily available to families. Alternatives to medications such as Ritalin and other stimulants include behavioral counseling, educational support in the form of smaller classes and individualized attention, tutoring, and training in social skills.
Psychostimulants often are used in conjunction with other therapy, such as behavioral and psychological treatment. Some parents have turned to such different treatments as biofeedback, megavitamins, and blue-green algae. Discuss any alternative treatments with your health care provider before trying them, particularly if they are also taking medications at the same time.
Whatever the treatment, if your child has ADHD, he or she may have difficulty concentrating even while growing up. Most children outgrow the hyperactivity and impulsiveness of their younger years, but as adults continue to have difficulty getting organized or completing long-term projects.