Treatment can help your child with ADHD in school, social situations, and at home. The right plan can help with all three of the major components of ADHD: inattention, impulsivity, and hyperactivity control. The goal of treatment is to help your child follow rules, concentrate, and have good relationships with parents, teachers, and peers.
These treatment options have been evaluated for safety, but no two children are alike, and what works for some kids may not work as well for yours.
Together with the doctor, you’ll develop a plan that meets your child’s specific needs. It may take time to figure out what works best. The plan may include medications, behavioral therapy, or both.
Medications
The main medications used to treat ADHD are stimulants and nonstimulants. Sometimes antidepressants are also used.
Stimulants are the most common treatment in children and teens. This is usually the type of medication a doctor may try first. Stimulants have been used for a long time and are well-tested. They help the brain control impulses and control behavior and attention.
Kids with certain medical conditions shouldn’t take stimulants. Make sure the doctor knows your child’s medical history before they prescribe any medication.
Stimulants include:
- Amphetamine (Adzenys XR-ODT)
- Amphetamine/dextroamphetamine (Adderall, Adderall XR)
- Dexmethylphenidate (Focalin, Focalin XR)
- Dextroamphetamine (Dexedrine)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (Concerta, Daytrana, Metadate, Methylin, Ritalin, Quillivant XR)
Serdexmethylphenidate and dexmethylphenidate (Azstarys)
If the first medicine the doctor prescribes doesn’t seem to help, they may raise the dosage, suggest a different medication, or suggest your child take another medicine along with the stimulant.
Nonstimulants aren’t as well tested. They work in different ways than stimulants, but they can help with concentration and impulse control. For some kids, they may be a better option than stimulants, but they’re often used along with stimulants.
These non-stimulants are FDA-approved for ADHD in children and teens:
- Atomoxetine (Strattera)
- Clonidine ER (Kapvay)
- Guanfacine ER (Intuniv)
Viloxazine (Qelbree)
Antidepressants aren’t approved to treat ADHD, but they can help with inattention, impulsivity, and hyperactivity. They’re an option for children who haven’t done well on a stimulant alone. Taking an antidepressant along with a stimulant seems to work well for children who have ADHD along with a mood disorder such as depression or anxiety.
There are several types of antidepressants.
Tricyclic antidepressants. These affect chemicals in the brain.
Examples of tricyclic antidepressants include:
- Desipramine (Norpramin, Pertofrane)
- Imipramine (Tofranil)
- Nortriptyline (Aventyl, Pamelor)
Bupropion (Wellbutrin). The doctor may prescribe this if your child doesn’t benefit from stimulants.
Selective serotonin reuptake inhibitors (SSRIs). These are the most commonly prescribed antidepressants for people with depression. These have been tried for ADHD:
Venlafaxine (Effexor). This drug also affects chemicals in the brain. It helps improve mood and concentration in children and teens.
Side Effects
All these medicines can cause side effects. They usually happen when a child first starts taking them. They’re usually mild and go away fairly soon. Before your child starts any new medication, talk to their doctor about what to expect.
If you become concerned about side effects while your child is on a medication, call the doctor. Don’t make changes in the treatment without talking to them.
Meds Not for Everyone
Medications don't always work for kids with ADHD. In fact, they don’t seem to work at all in 20% to 30% of cases. In others, the improvement is only slight or the side effects are too serious. Your health care team can help you put together a combination of medication and behavioral therapy or therapy alone that works best for your child.
To know what’s working, it can help to first talk to your doctor about the goals of treatment. Another idea is to monitor and keep track of the timing and intensity of your child’s symptoms in an ADHD symptom log. Then you and your health care team can look back at the log to identify patterns that might help shape more effective treatment.
Behavioral Therapy
This type of therapy uses positive reinforcement for good behavior and negative reinforcement for unwanted behaviors. A mental health professional -- a psychologist, social worker, or family therapist -- works with you and your child's teachers to set up a program to improve your child’s behaviors.
Behavioral therapy is often used along with ADHD medications, but it can also be used alone.
Other Treatments
The FDA has two technology based therapies as nondrug treatment for children.
The first is a device is called the Monarch eTNS System and is approved for children 7 to 12. It is about the size of a cell phone and works by delivering mild stimulation to electrodes attached to the forehead. Those mild electrical pulses interact with the part of the brain believed to be responsible for ADHD.
Also approved is game-based digital therapeutic device called EndeavorRx for pediatric ADHD patients ages 8 to 12 years old. Using a video game-based approach, the device used both sensory stimuli and motor skill challenges to target areas of the brain and help improve focus and cognitive function.
In addition, some studies have shown that omega-3 supplements may help some children with ADHD.
Some kids with ADHD may benefit from changes in diet, such as going gluten-free or avoiding certain food dyes and additives. Talk to your child’s doctor about the best options for them.
