Ask 10 parents how they treat their children's ADHD, and you're likely to get 10 different answers. That's because treatment for ADHD is personalized. Kids have different symptoms, and treatment depends on what a child needs.
- A single medicine
- A combination of different types of medicine (adjunctive therapy)
- Medicine plus behavioral therapy
Your doctor might try different treatments to find what works best for your child. It’s important to remember that ADHD medications may not work for all symptoms. Medication plus therapy is the recommended treatment for children older than 6.
Your child’s doctor will probably try a low-dose one of these first. Stimulants have been used for a long time and are well-tested. They’re often helpful for children and teens who have a hard time at school, work, or home. While these drugs are stimulants, they don’t make children more excitable. Instead, they can help kids focus their thoughts and ignore distractions.
Some are approved for use in children over age 3. Others are approved for children over age 6.
Often, treatment starts with a drug such as:
- Amphetamine (Adderall, Adderall XR, Adzenys XR-ODT)
- Dexmethylphenidate (Focalin, Focalin XR)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (Concerta, Daytrana, Jornay, or Ritalin)
- serdexmethylphenidate/dexmethylphenidate (Azstarys)
These medications come in different forms:
- Short-acting (immediate-release). These take effect quickly and can wear off quickly, too. Your child may need to take these several times a day. They usually work for about 4 hours.
- Intermediate-acting. These last a few hours longer than short-acting versions.
- Long-acting forms. Your child might need to take this kind only once a day. They work for 8-12 hours.
The form and dosage your child takes will depend on his symptoms and needs.
If your child has certain medical conditions, they shouldn’t take stimulants. Make sure the doctor knows their complete medical and family history before they prescribe them anything.
These medications can improve concentration and impulse control. In cases where stimulants aren’t an option for your child, don’t work for them, or cause strong side effects, they may be prescribed nonstimulants alone. But they’re often used with stimulant medication -- studies show that they can help the treatment work better.
These nonstimulants are FDA-approved to treat ADHD in children. (All three can be used as adjunctive therapy, along with a stimulant.):
- Atomoxetine (Strattera)
- Clonidine hydrochloride ER (Kapvay)
- Guanfacine (Intuniv) ER
Atomoxetine (Strattera) was the first nonstimulant medication approved by the FDA. It’s for kids ages 6 and older. It works by increasing the amount of the chemical norepinephrine in the brain. This helps lessen ADHD symptoms such as hyperactivity and impulsive behavior.
- Impulse control
They’re long-acting extended-release drugs and can last for 12 to 24 hours.
All three of these nonstimulant medications are often used in adjunctive therapy with a stimulant. Studies show that when taken with a stimulant, they can help the treatment work better.
For children and teens who also have mood issues, doctors may prescribe antidepressant drugs along with a stimulant.
These drugs aren't specifically approved for ADHD, but studies show they help control symptoms such as hyperactivity and aggression.
Imipramine (Tofranil) and nortriptyline (Pamelor) are two others. These are called tricyclic antidepressants, and they affect the neurotransmitters in your brain. They’ve been around for a while but are used less often due to their side effects.
Children who already take a MAO inhibitor antidepressant shouldn’t take these medications.
Many medications that treat ADHD have side effects. Make sure you know what to expect and what to look for before your child starts a medicine.
Watch for unusual behavior changes while your child is on any medicine, and report them to your doctor. Also let them know if a medicine isn't working or if it's causing side effects. Don't stop the medicine without talking to your child’s doctor.
ADHD and Other Conditions
Many children who have ADHD also have at least one other condition, such as depression or anxiety. Doctors can often treat these disorders at the same time, sometimes with the same medications.