Medication to Treat ADHD in Children

Ask 10 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. Kids have different symptoms, and treatment depends on what a child needs.

The options include:

  • A single medicine
  • A combination of different types of medicine (adjunctive therapy)
  • Medicine plus behavioral therapy

Your doctor might try different treatments to find what works best for your child.

Three different types of medications are used to treat ADHD:

Stimulants

Your child’s doctor will probably try a low-dose one of these first. Stimulants have been used for a long time and are well-tested. They’re often helpful for children and teens who have a hard time at school, work, or home. While these drugs are stimulants, they don’t make children more excitable. Instead, they can help kids focus their thoughts and ignore distractions.

Some are approved for use in children over age 3. Others are approved for children over age 6.

Often, treatment starts with a drug such as:

These medications come in different forms:

  • Short-acting (immediate-release). These take effect quickly and can wear off quickly, too. Your child may need to take these several times a day. They usually work for about 4 hours.
  • Intermediate-acting. These last a few hours longer than short-acting versions.
  • Long-acting forms. Your child might need to take this kind only once a day. They work for 8-12 hours.

The form and dosage your child takes will depend on his symptoms and needs.

If your child has certain medical conditions, he shouldn’t take stimulants. Make sure the doctor knows his complete medical and family history before he prescribes him anything.

Nonstimulants

These medications can improve concentration and impulse control. In cases where stimulants aren’t an option for your child, don’t work for him, or cause strong side effects, he may be prescribed nonstimulants alone. But they’re often used with stimulant medication -- studies show that they can help the treatment work better.

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These nonstimulants are FDA-approved to treat ADHD in children. (All three can be used as adjunctive therapy, along with a stimulant.):

Atomoxetine (Strattera) was the first nonstimulant medication approved by the FDA. It’s for kids ages 6 and older. It works by increasing the amount of the chemical norepinephrine in the brain. This helps lessen ADHD symptoms such as hyperactivity and impulsive behavior.

Clonidine and guanfacine were originally made to treat high blood pressure. But they affect certain chemical receptors in the brain and can help improve:

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

They’re long-acting extended-release drugs and can last for 12 to 24 hours.

All three of these nonstimulant medications are often used in adjunctive therapy with a stimulant. Studies show that when taken with a stimulant, they can help the treatment work better.

Antidepressants

For children and teens who also have mood issues, doctors may prescribe antidepressant drugs along with a stimulant.

These drugs aren't specifically approved for ADHD, but studies show they help control symptoms such as hyperactivity and aggression.

Bupropion ( Wellbutrin ) can help improve mood in children and teens with ADHD and depression. It’s known to improve concentration, energy and motivation.

Imipramine ( Tofranil ) and nortriptyline ( Pamelor ) are two others . These are called tricyclic antidepressants, and they affect the neurotransmitters in your brain. They’ve been around for a while but are used less often due to their side effects.

Venlafaxine ( Effexor ) . In its extended-release form, this drug can be used for children with ADHD and mood or anxiety issues.

Children who already take a MAO inhibitor antidepressant shouldn’t take these medications.

Side Effects

Many medications that treat ADHD have side effects. Make sure you know what to expect and what to look for before your child starts a medicine.

Watch for unusual behavior changes while your child is on any medicine, and report them to your doctor. Also let him know if a medicine isn't working or if it's causing side effects. Don't stop the medicine without talking to your child’s doctor.

Sources

SOURCES:

National Institute of Mental Health: "Attention Deficit Hyperactivity Disorder."

Medscape: "Combination Pharmacologic Treatment for ADHD: The Emerging Evidence Base."

FDA: "Strattera."

American Academy of Child & Adolescent Psychiatry: "New Advances in the Pharmacological Treatment of Attention-Deficit/Hyperactivity Disorder."

UpToDate: "Attention deficit hyperactivity disorder in children and adolescents: Treatment with medications" and "Pharmacology of drugs used to treat attention deficit hyperactivity disorder in children and adolescents."

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