ADHD Treatment in Children

Medically Reviewed by Zilpah Sheikh, MD on December 19, 2023
16 min read

Treatment can help your child with ADHD in school, social situations, and at home. The right plan may help lessen the symptoms of all three of the major components of ADHD: inattention, impulsivity, and hyperactivity. These treatment options have been tested for safety, but no two children are alike. What works for some kids may not work for yours.

After your child gets an ADHD diagnosis, you'll develop a plan with your child's doctor to meet their needs. Treatment may include medications, behavior therapy, counseling, educational services, and lifestyle changes. It may take time to find the right combination of these treatments that work for your child. Regardless of the treatments in your child's plan, they can relieve many symptoms of ADHD, but they won't cure it.

Medications used to treat ADHD include stimulants, nonstimulants, and antidepressants. 

Before starting ADHD medications: Things to know

It may take time to find the right medication and dosage. Medication for ADHD is more effective when combined with other nondrug treatments, such as behavior therapy and education services. If you do choose medicine as part of your child's treatment plan, know that they don't have to stay on it forever.

Everyone responds to ADHD medication differently, so it's important for you to monitor how your kid does on ADHD medication. 




Stimulants are the most common medicines used to treat ADHD in kids and teens. They have been used for decades and have the most evidence to back up their ability to help your child. Studies show that once you find the right stimulant medicine and dosage, 80% of kids who take stimulants have fewer symptoms. So, it's usually the type of medicine a doctor will try first. And, they can be used to treat kids as young as 6 years old.

These medicines are called stimulants because they increase the levels of brain chemicals (neurotransmitters) called dopamine and norepinephrine in your kid's brain. These neurotransmitters help your child pay attention, concentrate, and control their impulses. Stimulants for ADHD are either amphetamines or methylphenidates. 

Stimulants come in two forms: short-acting (immediate release) and intermediate to long-acting (extended release). Short-acting stimulants generally last up to 4 hours and so your child will likely take them 2-3 times a day. As one dose wears off, their ability to focus and their mood may drop. To avoid these sorts of cycles throughout the day, you may prefer your child take a long-acting stimulant. These typically work for 6-8 hours, and sometimes last up to 16 hours. Some kids take only short-acting stimulants, and some take only long-acting stimulants, while others take both short- and long-acting versions.

Kids with certain medical conditions shouldn't take stimulants. For instance, stimulants may be risky for kids with heart conditions or some mental health conditions. Make sure your child's pediatrician knows your child's medical and family history before they prescribe any medication. Kids with a medical or family history that suggests they have a heart condition will need an EKG to make sure they don't have one before they get a prescription for stimulant medicine.

The U.S. Drug Enforcement Administration classifies stimulants as controlled substances, which means they have a risk for abuse and may cause substance use disorder. For instance, some kids take stimulants to help them when they study for exams, and kids with prescriptions will share their medicine with or sell their medicine to classmates. If your child has a prescription for a stimulant, make sure they are taking their medicine as their doctor says and not taking more than they need to or sharing or selling their pills.

Examples of amphetamine stimulants:

Short-acting versions, such as amphetamine (Evekeo and Evekeo ODT), amphetamine and dextroamphetamine  (Adderall), dextroamphetamine (Zenzedi), and methamphetamine (Desoxyn).

Intermediate to long-acting versions, such as amphetamine (Adzenys ER, Adzenys XR-ODT, Dyanavel XR, and Mydayis), dextroamphetamine and amphetamine (Adderall XR), dextroamphetamine (Dexedrine and ProCentra), and lisdexamfetamine (Vyvanse and Vyvanse chewable).

Examples of methylphenidate stimulants"

Short-acting versions, such as dexmethylphenidate (Focalin), and methylphenidate (Methylin oral and chewable and Ritalin).

Intermediate to long-acting versions, such as dexmethylphenidate (Focalin XR), methylphenidate (Adhansia BR, Aptensio XR, Concerta, Cotempla XR-ODT, Daytrana patch, Jornay PM, Metadate CD and ER, Methylin ER, Quillichew ER, Quillivant XR, and Ritalin SR and LA), and serdexmethylphenidate and dexmethylphenidate (Azstarys).

If the first medicine the doctor prescribes doesn't seem to help, they may raise the dose, try a different medication, or try another medicine along with the stimulant. 

If your child doesn't react well to stimulants, the FDA has approved different kinds of non-stimulants, too. Non-stimulants aren't controlled substances, so they have less of a chance of abuse than stimulants. So, these may be a first choice for kids who have a history of substance use disorder. Doctors sometimes prescribe a combination treatment with a non-stimulant and a stimulant.

Non-stimulants generally take longer to start working than stimulants. You may not notice a difference in your child's behavior until they've been taking them regularly for about 3-4 weeks. However, the effects of each dose can last up to 24 hours. Also, as with all ADHD medicine, the right dose will vary from child to child, so it may take some time for your child's doctor to find the correct dose for them.  

Four non-stimulants are FDA-approved in the U.S. for kids and teens:

  • Atomoxetine (Strattera)
  • Viloxazine (Qelbree)
  • Clonidine ER (Kapvay)
  • Guanfacine ER (Intuniv)

Atomoxetine and viloxazine are in a class of antidepressants called selective norepinephrine reuptake inhibitors (SNRIs). These work by increasing the levels of the neurotransmitter norepinephrine in your child's brain. This may help them pay attention and control their impulses, although they don't seem to help as much as stimulants for symptoms of hyperactivity. Since they're antidepressants, they may be a good choice for kids who also have anxiety and depression. About 30% of kids with ADHD also have anxiety and about 14% also have depression. 

Clonidine and guanfacine are in a class of high-blood pressure medicines called alpha-2 adrenergic agonists. Since they were originally used to treat high blood pressure, they have a calming effect. They may help your child sit still and control their impulses and emotions, but they may not help them pay attention and focus on their tasks as well as other medicines.  

In the U.S., most other medicines used for ADHD are used "off label," which means your child's doctor is using an approved drug to treat something the drug wasn't specifically approved for. They may do this because you've tried drugs that are approved to treat your child's ADHD and they aren't helping. 

In the case of ADHD, though antidepressants aren't specifically approved to treat ADHD (except for the two SNRIs mentioned under non-stimulants), your child's doctor may prescribe them alone or with a stimulant if other options haven't helped. 

There are two classes of antidepressants used off label to treat ADHD: norepinephrine-dopamine reuptake inhibitors and tricyclic antidepressants. 

The antidepressant most commonly used off label to treat ADHD is the norepinephrine-dopamine reuptake inhibitor bupropion (Wellbutrin and Wellbutrin SR and XL). Bupropion increases the levels of the two neurotransmitters, norepinephrine and dopamine, in your child's brain. This may help them concentrate better. Bupropion may be a good choice for kids who have ADHD and depression or anxiety.

If none of the other medications have worked for your child, your doctor may try a tricyclic antidepressant, such as desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor). Tricyclic antidepressants are an older class of antidepressants that may have challenging side effects, which is why your doctor will likely try the other classes of medicines before they try these. 

Other types of antidepressants that increase the levels of the neurotransmitter serotonin in the brain have been tried for ADHD, but they don't seem to help these symptoms. These drugs are called selective serotonin reuptake inhibitors (SSRIs) and examples include escitalopram (Lexapro) and sertraline (Zoloft). However, if your child has ADHD and depression or anxiety, their doctor may try one of these to help with those symptoms along with a stimulant to help with their ADHD symptoms.

Stimulants are the most commonly prescribed medicine for ADHD in kids and they're probably the medicine your child's doctor will try first. Stimulants that are used for ADHD include amphetamines (such as Adderall or Dexedrine) and methylphenidate (such as Focalin or Ritalin). 

Some experts have concerns about the use of ADHD medicines, especially stimulants, including the following:

The long-term effects on people whose brains are still developing. Researchers don't yet know if stimulants affect the long-term development of the brain in children and teenagers, so some experts are wary of using these drugs in younger people.

The risk of sudden death in people with heart conditions. Before starting stimulants, the American Heart Association recommends that kids have their hearts evaluated. They recommend doctors ask about the patient's medical and family history, specifically about symptoms that could suggest a heart condition. Also, they recommend a physical exam to look for evidence of a heart condition, including an electrocardiogram (EKG) if the medical and family history or physical exam suggested a reason to suspect a heart condition. 

The increased risk for other psychiatric problems. Some people may have personality changes on stimulant medicines. For instance, stimulants may trigger or make worse symptoms of hostility, aggression, anxiety, depression, or paranoia. People who have a personal or family history of suicide, depression, or bipolar disorder may be at higher risk of this than other people and will likely be followed closely by their doctors while they're taking stimulants.

The potential for abuse. A growing problem in schools and colleges is that teens and college students may abuse stimulants when they study for exams or when they want to lose weight. Kids with prescriptions may share or sell their stimulant medicine to classmates. Make sure your child is taking their medicine and not sharing or selling it.

Giving medications safely

Stimulant medicine is considered safe when your child takes it as the doctor prescribed. To make sure your child is taking their medicine the way their doctor prescribed and to reduce the risk of misuse or abuse, follow a few guidelines:

Supervise your child when they take their medicine at home.  Don't give your child unsupervised access to their medicine. Always measure and give your child their medication dose, and follow your child's doctor's guidelines on dose and timing.

Keep your child's medicine locked away in a childproof container at home. It's best to keep all medication out of the reach of kids, but a stimulant overdose is serious and potentially fatal.

Deliver your child's medicine to their school nurse or health office. Don't send the medicine to school with your child because it could get lost, stolen, shared, or sold, which increases the risk of medication misuse or abuse.

All medicines can cause side effects. They usually happen when a child first starts taking the medicine, but they're usually mild and go away fairly soon. Before your child starts any new medication, talk to their doctor about what to expect.

Common side effects of stimulants include: 

  • Loss of appetite
  • Upset stomach
  • Feeling restless or jittery
  • Racing heartbeat
  • Trouble sleeping
  • Irritability or mood swings
  • Headaches
  • Dizziness
  • Depression
  • Tics

Long-acting medicines may have greater effects on appetite and sleep than short- and intermediate-acting stimulants. Stimulants may also raise your child's blood pressure and heart rate. 

Nonstimulant side effects:

Atomoxetine and viloxazine side effects include:

  • Stomach pain or upset stomach
  • Nausea or vomiting
  • Mood swings
  • Headaches
  • Dizziness
  • Sleepiness

These may cause insomnia and appetite suppression, but it's less common than with stimulants. Atomoxetine may also cause high blood pressure, increased heart rate, and liver problems in some people.

Rarely, SNRIs may increase the risk of suicidal thoughts and actions in some people, especially kids who have bipolar disorder or depression.

Guanfacine and clonidine side effects include:

  • Nausea, stomach pain, or vomiting
  • Loss of appetite
  • Headaches
  • Dizziness
  • Sleepiness, fatigue
  • Dry mouth

Don't let your child stop taking these suddenly because this can cause their blood pressure and heart rate to rise quickly.  

Off-label antidepressant side effects

Bupropion side effects include:

  • Nausea, stomach pain, or constipation
  • Weight loss
  • Dry mouth or a sore throat
  • Headaches
  • Dizziness
  • Insomnia
  • Increased heart rate

Some people may have more challenging side effects, such as anxiety, ringing in their ears, or changes in their vision or their heart and lung function. 

Imipramine and nortriptyline side effects include:

  • Constipation
  • Increased appetite and weight gain
  • Dry mouth
  • Dizziness
  • Blurred vision
  • Confusion
  • Seizures
  • Increased heart rate 
  • Not being able to completely empty their bladder when you pee, peeing a little bit many times over the day, or feeling like you have to pee but not being able to
  • Increased sweating

Like all tricyclic antidepressants, both imipramine and nortriptyline can change heart rhythms. Don't let your child stop taking nortriptyline suddenly because this can cause withdrawal symptoms, such as nausea, vomiting, anxiety, headaches, dizziness, and restlessness. If they want to stop taking it, their doctor will decrease their dose over time to wean them off safely.

If you become concerned about side effects while your child is on a medication, call their doctor. Don't make changes to their treatment without talking to their doctor first.

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. 

This type of therapy helps your child learn or strengthen positive or wanted behaviors and eliminate problem or unwanted behaviors. While medication may reduce symptoms of ADHD, behavior therapy is crucial in improving functional impairments, self-management, and skill building. These are key factors as the child transitions into adulthood. It may also help reduce the chance of them developing depression, anxiety, substance abuse, relationship and school failure, and suicidal ideation. 

It can be helpful to start this kind of therapy as soon as your child gets an ADHD diagnosis. Behavior therapy may include parent training in behavior management, behavior therapy with your child, and behavioral interventions in the classroom.

The American Academy of Pediatrics (AAP) has the following recommendations for behavior training, according to your child's age:

For kids younger than 6 years old, they recommend parent training in behavior management before trying medicine. Really young kids may have more side effects from ADHD medicine than older kids, and the long-term effects of medicine use hasn't been studied in really young kids. So, behavior management training gives you the skills and strategies to help your child. Studies have shown that this works as well as medicine for young kids.

For kids over the age of 6 as well as teenagers, they recommend a combination approach with medicine, behavior therapy training for the classroom, peer interventions for behavior, organizational skills training, and parent training in behavior management. 


Making helpful lifestyle choices can help you and your child manage their ADHD symptoms.

Encourage them to get good quality sleep every night. It's common for people with ADHD to have problems with sleep. It may be because of their stimulant medicine, which may cause insomnia. In that case, ask their doctor about changing their dose or when they take it or switching their medicine. In general, you can support your child's sleep by:

  • Setting and enforcing a regular bedtime
  • Making sure they switch off all electronics (TV, video games, computers, and cell phones) at least an hour before bed
  • Limiting their physical activity before bed
  • Trying a white noise machine or fan if background noise keeps them awake

Encourage them to eat a healthy diet. Here are some ways you cansupport this:

  • Schedule regular meals and snacks about every 3 hours. This helps keep their blood sugar steady, which will help them concentrate and focus on their tasks.
  • Include lean protein (such as dairy products, eggs, or beans) and complex carbohydrates (such as whole grains and fruits) at every meal or snack. Again, this helps them concentrate but may also reduce hyperactivity.
  • Have your child's levels of zinc, iron, and magnesium checked. Studies have shown that increasing iron levels with iron supplements may help reduce the symptoms of ADHD in kids with low iron levels.
  • Add omega-3 fatty acids to their diet. Studies show that omega-3s can help reduce hyperactivity and improve the ability to control their impulses and concentrate. Omega-3s are in fatty fish, like tuna and salmon, and some fortified egg and dairy products. You can also try fish oil supplements.

Some kids with celiac disease and ADHD may benefit from changes in diet, such as going gluten-free. If your child doesn't have celiac disease or gluten-sensitivity, diets that focus on getting rid of certain food dyes and additives may help more that those that eliminate gluten. Talk to your child's doctor about the best options for them.

Encourage them to exercise regularly. Physical activity boosts the levels of your neurotransmitters dopamine, norepinephrine, and serotonin. This will help your child focus and pay attention. Activities like dance, gymnastics, martial arts, skateboarding, and team sports are good choices for kids with ADHD because to succeed, they need to pay attention and/or cooperate with their teammates.

Encourage them to play outside for at least 30 minutes every day. Studies show that spending time outside, in nature, can help reduce the symptoms of ADHD.

The FDA has approved two technology based therapies as nondrug treatment for children.

The first is a device called the Monarch eTNS System and it's approved for children ages 7-12 years old who aren't taking medicine. It's about the size of a cell phone and works by delivering mild stimulation to electrodes attached to the forehead. Those mild electrical pulses seem to increase activity in the parts of your child's brain that helps them regulate their emotions and behavior and pay attention. It's meant to be used in the home while your child sleeps, and it can take up to 4 weeks to feel the full effects.

The second device is a game-based digital therapeutic device called EndeavorRx, which is approved for kids ages 8-12 with ADHD and a demonstrated problem paying attention. This uses a video game approach to give both sensory stimuli and motor skill challenges to target areas of the brain that help improve your child's ability to focus.

One of the most important skills that kids with ADHD need help with is consistency. Since kids with ADHD often struggle to apply what they learn in one setting to another, you can support them by making things more predictable. Here are some tips to help your child complete the tasks they need to get done:

Establish a routine. Set predictable rituals for meals, homework, playtime, and bedtime.

Use clocks and timers. Consider putting them throughout the house and help your child plan so that they have plenty of time to do their tasks, such as getting ready in the morning or doing their homework.

Simplify their schedule. Kids with too many things to do in a day may get anxious, so allow some down time in their schedule.

Give them their own quiet and private space. Their bedroom may work well, but make sure it's not the same space they go when they're in time out.

Set an example for good organization. Make sure everything has its place in your home and role-model neatness and organization wherever you can.

Manage distractions, especially when it's time to do homework. Turn off the TV and limit the noise. However, some kids with ADHD may do better when they have background music or are allowed to move. Work with your child to find a system that works for them.

Use goals and praise or other rewards. Use a chart to list their goals and track their positive behaviors. Look for good behavior and praise them for it. Kids with ADHD often get criticized and don't often get praised. It can really help encourage them if you focus on giving them praise for appropriate behavior and task completion. Try not to criticize inappropriate behavior and task completion. Celebrate even small victories because these can lead to bigger successes over time.

Discipline effectively. Use good communication and effective directions (be clear and brief) to help your child figure out what they're supposed to be doing. Use time-outs or remove privileges as a consequence for unwanted behavior. Scolding, yelling, and spanking don't work well for most kids, but especially not kids with ADHD.

Create positive opportunities. Find out what your child likes doing, whether that's studying, playing sports, making art or music, or playing outside, and encourage them to do those things as much as they can. This helps them find their passions and talents and improves their self-esteem. A kid with good self-esteem is more resilient because they're comfortable trying again when they don't succeed the first time they try something. This is an important life skill for everyone, but it can really help a kid with ADHD who may struggle with skills that other kids seem to master easily.