Attention-deficit hyperactivity disorder
(ADHD) in children
Treatments and drugs
Thanks By MayoClinic.com staff
Standard treatments for ADHD in children include medications and counseling.
treatments to ease ADHD symptoms include special accommodations in the
classroom, and family and community support.
Currently, stimulant drugs (psychostimulants) and the nonstimulant medication
atomoxetine (Strattera) are the most commonly prescribed medications for
Stimulant medications for ADHD include:
* Methylphenidate (Ritalin, Concerta, Daytrana)
* Dextroamphetamine-amphetamine (Adderall)
* Dextroamphetamine (Dexedrine)
Although scientists don't understand exactly why these drugs work, stimulants
appear to boost and balance levels of the brain chemicals called
neurotransmitters. These ADHD medications help improve the core signs and
symptoms of inattention,
impulsivity and hyperactivity — sometimes dramatically. However, effects of the
drugs wear off quickly. Additionally, the right dose varies from child to child,
it may take some time in the beginning to find the correct dose.
Stimulant drugs are available in short-acting and long-acting forms.
* The short-acting forms last about four hours, while the long-acting
preparations last between six and 12 hours.
* Methylphenidate is available in a long-acting patch that can be worn on the
hip (Daytrana). It delivers medication for about nine hours and is approved for
in children between the ages of 6 and 12. While the long-lasting effects mean
child won't need to take medication as often, it can take up to three hours to
working. For it to work in the morning, the patch needs to be put in place early
while your child is still asleep.
Stimulant medication side effects...
The most common side effects of stimulant medications in children include:
* Decreased appetite
* Weight loss
* Problems sleeping
* Irritability as the effect of the medication tapers off
A few children may develop jerky muscle movements, such as grimaces or twitches
(tics), but these usually disappear when the dose of medication is lowered.
Stimulant medications may also be associated with a slightly reduced growth rate
children, although in most cases growth isn't permanently affected. There's been
some concern about using stimulants to treat preschoolers who have ADHD.
ADHD medications and heart problems
Although a rare occurrence, several heart-related deaths have occurred in
and adolescents taking stimulant medications. Your child's doctor will want to
sure your child doesn't have any signs of a heart condition before prescribing a
stimulant. Experts disagree about whether children need an extensive evaluation
before taking these medications. The American Heart Association has said that
child should have a heart test called an electrocardiogram (ECG) before getting
stimulant medications for ADHD, while other organizations such as the American
Academy of Pediatrics say that a thorough history and physical exam is enough to
screen for heart problems.
Atomoxetine (Strattera) is generally given to children with ADHD when stimulant
medications aren't effective or cause side effects. In addition to reducing ADHD
symptoms, atomoxetine may also reduce anxiety. Given one or two times a day,
atomoxetine side effects can include nausea and sedation. It can also cause
appetite and weight loss.
Atomoxetine has been linked to rare side effects that include liver problems. If
your child is taking atomoxetine and develops yellow skin (jaundice),
urine or unexplained flu symptoms, contact the doctor right away.
There's been some concern that children and adolescents taking atomoxetine have
increased risk of suicidal thinking. Although atomoxetine has never been linked
an actual suicide, contact your child's doctor if you notice any signs of
thinking or other signs of depression.
Other medications used to treat ADHD include:
* Antidepressants. These medications are generally used in children who don't
respond to stimulants or atomoxetine or have a mood disorder as well as ADHD.
* Clonidine (Catapres) and guanfacine (Tenex). These are high blood pressure
drugs shown to help with ADHD symptoms. They may be prescribed to reduce tics or
insomnia caused by other ADHD medications, or to treat aggression caused by
Giving medications safely
Making sure your child takes the right amount of the prescribed medication is
important. Parents are understandably concerned about stimulants — which are
similar to amphetamines — and the risk of abuse and addiction. But dependence
hasn't been reported in children who take medications at the proper dose. That's
because drug levels in the brain rise too slowly to produce a "high." On the
other hand, there's concern that siblings and classmates of children and
teenagers with ADHD might abuse ADHD medications. To keep your child's
medications safe and to make sure your child is getting the right dose of
medication at the right time:
* Administer medications carefully. Children and teens shouldn't be in charge of
their own ADHD medication.
* At home, keep medication locked in a childproof container. An overdose of
stimulant drugs is serious and potentially fatal. Young children are especially
sensitive to drug overdoses.
* Don't send supplies of medication to school with your child. Deliver any
medicine yourself to the school nurse or health office.
ADHD counseling and therapy
Children with ADHD often benefit from counseling or behavior therapy, which
provided by a psychiatrist, psychologist, social worker or other mental health
professional. Some children with ADHD may also have other conditions such as
anxiety disorder or depression. In these cases, counseling can help both ADHD
and the coexisting problem.
Counseling types include:
* Psychotherapy. This allows older children with ADHD to talk about
bother them, explore negative behavioral patterns and learn ways to deal with
* Behavior therapy. Teachers and parents can learn behavior-changing
for dealing with difficult situations. These strategies may include token reward
systems and timeouts.
* Family therapy. Family therapy can help parents and siblings deal with
stress of living with someone who has ADHD.
* Social skills training. This can help children learn appropriate social
* Support groups. Support groups can offer children with ADHD and their
a network of social support, information and education.
* Parenting skills training. This can help parents develop ways to
and guide their child's behavior.
The best results usually occur when a team approach is used, with teachers,
and therapists or physicians working together. You can help by making every
to work with your child's teachers and by referring them to reliable sources of
information to support their efforts in the classroom.
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