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How Effective Are Your Child’s ADHD Meds? Here’s How to Tell

Medically Reviewed by Dan Brennan, MD on May 28, 2022

Medication is a mainstay of treatment for children with ADHD (attention deficit hyperactivity disorder). While not every child with this disorder will need it, most benefit from drugs that reduce the symptoms. But you want to be sure your child gets these benefits with the least amount of side effects. To do that, it’s essential to track the effectiveness of your child’s medication and make changes as needed.

Trial and Error

When your child starts ADHD meds, you and your child’s doctor will have to watch for symptoms and side effects as you determine which medicine is best for your child. You may have to do this with several different medications. Unfortunately, there’s no way to predict which will be the right one for your child. For example, about 40% of kids with ADHD respond well to both methylphenidate and amphetamine, two commonly prescribed stimulants. Another 40% respond to only one or the other.

You’ll also want to keep tabs on how well your child does with the particular dose of the medication they take. As with the drug itself, doctors can’t predict with certainty which dose will be most effective . Your doctor will start your child with a low dose and move it up as needed. The goal is the best control of ADHD symptoms with few or no side effects. It could take a few months to find the right medication and dosage. You’ll need to track symptoms and side effects regularly during that time.

Keep in mind, then, that the deciding factor may not be how well the drug reduces symptoms. You may decide the drug isn’t right for your child if it causes serious side effects. Stimulants, for example, can cause trouble with appetite and sleep, as well as stomach problems.

Even after you find that a particular drug and dosage works well, keep tracking its effectiveness. If your child’s earlier behaviors start to reappear, it may be a sign that the drug or the dosage isn’t working as well as before. You may need to try something new.

How Can I Track How Well an ADHD Drug Works?

In a large study of children with ADHD, researchers found it effective to have a monthly check-in with teachers to learn how well a medication helped with classroom behavior, schoolwork, and socializing with other kids. These monthly meetings helped them decide when it was time to make a medication change. On average, the children needed their first change within 4 to 5 months of starting a medication. But most often it was a dosage change. Very few kids needed to start from scratch.

Set up a schedule of check-ins with your child’s teacher. One way to keep track of your child’s symptoms at school would be to give the teacher an easy-to-fill-out form that lets the teacher rate your child’s behavior in different areas, such as:

  • Fidgeting and difficulty sitting still
  • Interrupting and other impulsive behaviors
  • Being easily distracted or unable to pay attention
  • Following rules
  • Getting along with other kids

Your teacher’s responses ideally will include when during the day the child’s behavior was better. Was it in the morning? The afternoon? Or did it stay the same throughout the day? This will help you know the medication's period of effectiveness. For example, let’s say your child has been prescribed a single daily dose of medication, taken before school. If they have fewer symptoms in the morning but more later in the day, that may be a sign that a single morning dose is not enough.

Keep a Medication Diary

Keeping a log of your child’s symptoms at home lets you see how they change with a particular medication at a particular dosage. A diary is also a place where you can note side effects of concern. This is important information you can provide to your doctor to help fine-tune treatment. Not only can you use it to see how well the current prescription works, but you can also use it to compare the impact that one medication or dosage has versus the effects of another.

It may help to involve your child in keeping the diary rather than simply observing and making your own notes. Ask them how they feel while on the medication and write it down in your diary. This is useful information for your doctor, but it also helps your child to become better aware of the medicine’s impact.

Essential info to include in your diary entries:

  • Date
  • Name of medication
  • Dosage and time taken
  • How long its effects lasted
  • ADHD symptoms and behaviors while on medication
  • Descriptions of your child’s reactions and physical sensations while on medication
  • Side effects your child experiences
  • Any concerns your doctor told you to watch, such as a rise in blood pressure

Looking Out for Side Effects

ADHD meds can be very helpful for easing the symptoms of the disorder. But side effects are common. In addition to keeping an eye on how well a drug works, you must keep close track of side effects. Use your medication diary for this.

Stimulants, the most commonly prescribed class of medication for ADHD, have several common side effects.

  • They can boost both heart rate and blood pressure. Usually, this effect is slight, but it can be troublesome for some children. You may need to watch this closely.
  • They can stunt growth. This usually happens in the first few years of treatment. Your child’s growth isn’t likely to catch up later on. They may grow less than expected, usually by less than an inch.

Other problems to watch for when your child takes stimulants:

  • Loss of appetite
  • Sleep difficulties
  • Headaches and stomachaches
  • Moodiness between doses

Some of these may go away after your child has been on a particular treatment for a while.

Nonstimulant medications also have side effects. One of them, atomoxetine, comes with an FDA “black box” warning about the chances of suicidal thoughts in those who take it. It also may raise blood pressure and heart rate.

Other side effects of atomoxetine to watch for include:

  • Sleep difficulties
  • Stomach problems
  • Loss of appetite
  • Temporary growth delays

The other two nonstimulants approved for ADHD, clonidine and guanfacine, may cause side effects that include:

  • Sleep difficulties
  • Dry mouth
  • Dizziness
  • Irritability
  • Low blood pressure
  • Slowed heart rate

Manage Your Expectations

ADHD medications can have a dramatic effect on your child’s symptoms. They can help your child curb impulsive and hyperactive behavior and improve their ability to pay attention. In the case of stimulants, those benefits should come within 30 to 90 minutes of taking the medication. Nonstimulants may need about 2 weeks to become fully effective.

But don’t expect all signs of the disorder to vanish while the drug is in effect. You’re more likely to see symptoms ease up rather than disappear entirely. And some symptoms may stick around even with medication. Other treatments, such as behavioral therapy, can help.

Show Sources

SOURCES:

Pediatrics: “Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents.”

CHADD: “The Importance of Treatment Monitoring,” “The Medication Diary.”

National Institute for Children’s Health Quality: “NICHQ Vanderbilt Assessment Scales.”

Cleveland Clinic: “Attention Deficit Hyperactivity Disorder (ADHD): Stimulant Therapy.”

American Academy of Child & Adolescent Psychiatry and American Psychiatric Association: “ADHD: Parents Medication Guide.”

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