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.
ADHD drugs fall into two camps: Stimulants and nonstimulants. It may take a while for your child’s pediatrician to figure out the best medication and dose with the fewest side effects.
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, )
- 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
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 up your child’s dose or switch to a different drug.