Treating your child’s ADHD takes not just a tool, but a toolbox: Behavior management, education interventions, therapy, and, often, medication. The right drugs can make a big difference in your child’s behavior and ability to focus. But the decision to medicate comes with pros and cons. That includes understanding how it may affect your child in the short term, and over time.
Stimulants. These are the most commonly prescribed ADHD drugs, and the ones your doctor likely will recommend first. They help your child pay attention, control impulses, and avoid risky behaviors.
Stimulants boost the level of a chemical called dopamine in your child’s brain to help them focus. Dopamine rises in response to pleasure. But ADHD drug doses are too low for your child to feel a “high” or to become addicted.
Stimulants come in two different classes: Amphetamines and methylphenidates. They can be long-acting pills, liquids, or patches that your child takes once a day, or quick-acting versions that require multiple doses daily.
- Mixed amphetamine salts (Adderall, Adderall XR)
- Mixed salts of a single entity amphetamine (Mydayis)
- Dextroamphetamine (Dexedrine, Dextrostat, ProCentra, Zenzedi)
- Lisdexamfetamine (Vyvanse)
- Dexmethylphenidate (Focalin)
- Methylphenidate (Ritalin, Concerta, Daytrana, Jornay PM, Metadate, Quillivant XR)
Nonstimulants. These usually don’t work as well as stimulants. They raise the amount of a brain chemical called norepinephrine to help your child focus longer, be less impulsive, and stay calmer.
How ADHD Drugs May Affect Your Child
ADHD medication can be taken for months, years, or even a lifetime. Research shows that long-term use of ADHD meds is safe.
Short-term effects. Every kid reacts differently to ADHD medication. The effects from stimulants can kick in within an hour. Nonstimulants can take a couple of weeks to start working. Your child may have side effects while the drug is active in their body -- as little as 3 hours for some immediate-release stimulants and up to 24 hours for some extended-release nonstimulants.
The American Academy of Pediatrics recommends waiting until age 6 to start ADHD medications, and the FDA hasn’t approved Ritalin for children younger than that.
For stimulants, the most common reactions include:
- Low or no appetite
- Weight loss
- Sleep problems
- Social withdrawal
Less commonly, some kids have:
- More activity or bad mood as meds wear off (a “rebound” effect)
- Tics (involuntary muscle movements)
- Minor delay in growth
For nonstimulants, side effects can include:
ADHD medications should not change your child’s personality. If you find that they seem more dazed than usual, irritable, or nervous, their dose may be too high.
Long-term effects. Some children continue taking ADHD drugs as adults. Decades of research has found no major negative health effects from taking them for a long time. Some studies have suggested that children who keep taking stimulants into adulthood may grow up slightly shorter. But other studies have found no link between medication use and adult height.
Their doctor may from time to time check to see if the dose needs to be adjusted or can be stopped. Your child may be ready to come off ADHD medication if they:
- Had no symptoms for more than a year with treatment
- Got better over time on the same dose of medication
- Stay focused and well-behaved even when they skip a dose
- Find a new way to concentrate
- Had a major change in environment, like a change in schools
Is Your Child’s ADHD Medicine Working?
Before starting a treatment, you and your child’s teacher can make a checklist of the symptoms and how strong they are. That will be your baseline.
After your child is on the medication for a while, you can each go through the list again. If a symptom isn’t as strong, the drug is probably helping with it.
Some things to check might include how often your child:
- Misses details or makes careless mistakes
- Gets off task
- Seems not to listen when spoken to
- Doesn’t follow directions or finish a task
- Can’t get organized
- Dislikes activities that take concentration
- Loses things
- Gets distracted easily
- Forgets things
- Fidgets and squirms
- Doesn’t stay in their seat
- Runs around when everyone else is seated
- Can’t play quietly
- Seems to be in constant motion
- Talks too much
- Blurts out answers
- Won’t wait for their turn
- Interrupts others
How Long Does It Take for Medicines to Work?
It depends on the medication your child takes, and if it’s extended release or short-term.
Most kids with ADHD get stimulant medication. These drugs work quickly. Behavior can change within an hour.
They also leave the system quickly. Some formulas wear off in just 3 or 4 hours. The longest acting can last 12 hours. So before doing a symptom check, you should know when your child last took their medication to make sure it’s in their system.
Nonstimulant drugs act differently. They need time to build up in your child’s system, but their effects last 24 hours. You may not see a difference for weeks, and it may take several more to fine-tune the dose.
If you think your child’s personality has changed or if they seem irritable all the time, their dose may be too high, even if their symptoms have gotten better. Talk to their doctor.
As Your Child Grows
It’s possible for ADHD drugs to work less well over time, especially once your child becomes a teen. Researchers don’t know exactly why, but changes in brain chemistry could be one possibility. If so, your pediatrician may raise your child’s dose or switch to a different drug. They can also switch to a formula that lasts longer, or add another shorter-acting pill later in the day.
For some people, the symptoms of ADHD get better with age. At some point, your child may not need medication. Don’t try to check this by stopping the medication on your own, though. Talk to their doctor about taking a monitored break from the drug to see what happens.