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ADHD in Children Health Center

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Choosing the Right ADHD Medication for Your Child

You have many options in types of medications, doses and treatment strategies.

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"You can expect your child to have side effects," Sogn tells WebMD. "But generally those related to stimulants are easily managed. Most side effects are mild and transient."

Here is information to help you sort through your options.

Stimulant ADHD Medications

Stimulant ADHD medications work by increasing the levels of brain chemicals, like epinephrine and norepinephrine, which help transmit signals between nerves. With these medications, children are better able to focus and ignore distraction, which can help them control their own behavior. In the classroom, they may be less fidgety, less emotional, and better able to concentrate. Their relationships may also improve. They may get along better at school and at home.

There are two classes of stimulants:

  • Methylphenidate-based drugs such as Ritalin, Concerta and Metadate
    Over 200 studies have shown that methylphenidate is effective for the majority of ADHD children.
  • Amphetamine-based drugs such as Adderall and Dexedrine
    These ADHD medications provide an option for kids who don't benefit from methylphenidate, or who are looking for an alternative for other reasons. The trade names include Dexedrine, Adderall, and Adderall XR.

Both types of stimulant drugs work equally well in improving ADHD symptoms, according to the American Academy of Pediatrics (AAP). Individual children, however, may respond to one better than another.

"There's no inherent advantage of one medication over another," says Steven Parker, MD, director of behavioral and developmental pediatrics at Boston Medical Center and senior pediatric consultant for WebMD. "Most doctors start with the drug they are most comfortable with, and if it's ineffective or if there are side effects, then we try a different one." The goal is to find the drug or combination of drugs that works best for each specific child.

These stimulants are generally considered safe medications with few side effects, the AAP states in its guidelines. The side effects occur early in treatment and tend to be mild and short-lived. The most common are: decreased appetite, stomachache or headache, difficulty falling asleep, jitteriness, or social withdrawal. Most of these symptoms can be successfully reduced by adjusting the dosage or the time of day the child takes medication. From 15% to 30% of children develop tics while taking stimulants. This is a short-term side effect that goes away when the child stops taking stimulants.

Perhaps the biggest advance in ADHD stimulants is that newer versions are available in long-acting form. Here, briefly, are the pros and cons of various forms of stimulants:

Long-Acting Stimulants

 Adderall XRamphetamine10-12 hours
 Concertamethylphenidate10-12 hours
 Dexedrine spansuleamphetamine8-10 hours
 Methylin ERmethylphenidate6-8 hours
 Metadate ERmethylphenidate6-8 hours
 Metadate CDmethylphenidate8 hours
 Ritalin SRmethylphenidate6-8 hours
 Ritalin LAmethylphenidate8 hours

Because the effects of some of these drugs can last up to 10 or 12 hours, a child can take one pill in the morning, and not worry about taking another at school. Longer-acting stimulants may also help children get through after-school activities. Some children, however, may need a second dose or a shorter-acting form of a different drug if afternoons and evenings are challenging.

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