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What Is Adjunctive Therapy for ADHD in Children?

If your child has ADHD, you’ve got several ways to help her symptoms.

Kids with ADHD often start by taking one medicine, often a stimulant. 

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If that doesn't work well, the doctor might have your child keep taking the stimulant along with another type of medicine at the same time. This is called “adjunctive therapy.”

Treatment With Medication

The doctor will probably start your child on a small dose (or amount) of ADHD medicine. He’ll raise the dose slowly until it starts helping. The goal is to improve your child's symptoms and cause the fewest side effects.

The stimulant medications used most often for ADHD include:

  • Amphetamines: dextroamphetamine sulf-saccharate / amphetamine sulf-aspartate (Adderall), lisdexamfetamine dimesylate (Vyvanse)
  • Methylphenidates: methylphenidate (Daytrana), methylphenidate hcl (Concerta)

These drugs don’t work for every child who takes them. About 20% of kids who take stimulants don't have much symptom relief. Or they get side effects.

There isn't a one-size-fits-all treatment. Your child might need one medication or more. Combining medications with behavior therapy might help, too.

Adjunctive Therapy Medications

When a stimulant medicine is only partially effective in controlling symptoms, doctors may try to improve its effectiveness by adding one of the following non-stimulant drugs:

Atomoxetine (Strattera). This medication is related to antidepressants. It was the first non-stimulant approved as a solo treatment for ADHD.

Clonidine ER (Kapvay). This high blood pressure medication was recently approved in an extended release (long-lasting) form for ADHD.

Guanfacine ER (Intuniv). This is another high blood pressure medication that is also approved to treat ADHD.

These medicines can also be used on their own in kids with ADHD.

Non-stimulant drugs work in a different way than stimulants. This is why the two types of medicines sometimes work better when combined.

Side Effects

Any ADHD medication can cause these. They can include:

  • Headache
  • Irritability
  • Sleepiness or trouble sleeping
  • Stomach aches
  • Constipation

Changes in heart rate and other heart problems also have been reported with some of these medicines. Your doctor should check your child’s blood pressure and heart rate routinely to watch for these effects.

Researchers still need to learn more about the safety and effectiveness of combining stimulants with other types of medications to treat ADHD. They are studying these different combos in clinical trials.

If your child has side effects, tell your pediatrician or psychiatrist immediately. The doctor may suggest stopping the medication or changing the dose.

WebMD Medical Reference

Reviewed by Smitha Bhandari, MD on May 15, 2015

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