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ADHD in Children Health Center

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Drug Combinations to Treat ADHD in Children

Ask 10 different parents how they treat their children's ADHD and you're likely to get 10 different answers. That's because treatment for ADHD is personalized. Depending on the child, treatment can include:

  • A single medicine
  • Combination of medicines
  • Medicine plus behavioral therapy

Often, medicine treatment for ADHD starts with a stimulant drug, such as:

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But stimulants don't work for every child with ADHD. If that's the case with your child, the doctor might substitute another type of medicine.

Your child's doctor may also add another medicine to the stimulant drug or prescribe a combination of different medicines. This is called adjunctive therapy.

Studies show that when added to a stimulant, certain non-stimulants can improve the effectiveness of treatment.

Three non-stimulant medications are FDA-approved to treat ADHD in children:

Here's a closer look at these drugs and others that are used as part of adjunctive therapy:

Strattera

Strattera was the first non-stimulant drug approved to treat ADHD. It works by increasing amounts of chemicals called norepinephrine and dopamine in the brain. This helps lessen ADHD symptoms such as hyperactivity and impulsive behavior.

Strattera is approved for kids aged 6 and older.

Strattera can be prescribed alone. Or, it can be added to the stimulant drugs as an adjunctive treatment.

Side effects from Strattera can include:

  • Constipation
  • Decreased appetite
  • Dizziness
  • Dry mouth
  • Headache
  • Irritability
  • Nausea, vomiting
  • Stomach pain
  • Trouble sleeping
  • Weight loss

These side effects tend to be less pronounced with Strattera than with traditional stimulants.

In rare cases, Strattera has been linked to heart or liver problems. The drug also carries a warning from the FDA about the risk of suicidal thoughts in children and teenagers.

Let your doctor know if your child has suicidal thoughts before taking this drug. Also watch for unusual behavior changes while your child is on this medicine and report them to your doctor.

Alpha-2 Agonists

Two drugs called alpha-2 agonists, in extended release form, are now formally approved to treat kids with ADHD:

  • Kapvay (clonidine ER)
  • Intuniv (guanfacine ER)

These medicines can be used alone or together with a stimulant medicine. They are extended-release medicines that can last for 12 to 24 hours.

Kapvay and Intuniv were originally made to treat high blood pressure. However, they also affect certain chemical receptors in the brain that help to treat ADHD. In children with ADHD, they improve:

  • Memory
  • Attention
  • Impulse control
  • Hyperactivity
  • Agitation
  • Aggression

Research shows Kapvay and Intuniv also can help kids with ADHD who have tics.  But they have not been approved by the FDA for that purpose.

Side effects of these drugs in children and teens can include:

  • Constipation
  • Dizziness
  • Headache
  • Irritability
  • Nausea
  • Nervousness
  • Sleepiness and sedation
  • Lower heart rate
  • Lower blood pressure (if the dose exceeds range approved by FDA)
  • Stomach pain
  • Weight gain

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