What medicines are used to treat ADHD?
Some of the medicines for ADHD are called psychostimulants. Some of these drugs include methylphenidate, dextroamphetamine, atomoxetine, and a drug that combines dextroamphetamine and amphetamine (called a d- and l-amphetamine racemic mixture). Although these medicines have a stimulating effect in most people, they have a calming effect in people who have ADHD. These medicines improve attention and concentration, and decrease impulsive and overactive behaviors. Other medicines can also be used to treat ADHD. Talk with your doctor about what treatments he or she recommends.
Other medicines sometimes used to treat ADHD include atomoxetine, clonidine, desipramine, imipramine and bupropion.
It's important to know that psychostimulant medicines used to treat ADHD are called "controlled" drugs. There are special rules about the way controlled drugs can be prescribed. The prescriptions for controlled drugs, such as methylphenidate and dextroamphetamine, must be refilled at the drug store every month.
Do the medicines for ADHD have side effects?
All medicines have side effects. Psychostimulants may decrease your appetite and cause a stomachache or a headache. The loss of appetite can cause weight loss in some people. This side effect seems to be more common in children. Some people have insomnia (trouble sleeping). Other possible side effects include fast heart beat, chest pain or vomiting. Here are some ways to avoid side effects when taking psychostimulants:
- Use the lowest possible dose that still controls the hyperactivity. Your doctor will tell you the right dose.
- Take the medicine with food if it bothers your stomach.
- Ask your doctor if you can skip the medicines on the weekends. This means that you don't take any ADHD medicines on Saturday and Sunday.
- Offer healthy snacks to children who lose weight while taking medicine for ADHD.
How should medicine for ADHD be taken?
It's important to take the medicine just the way your doctor prescribes it. Follow your doctor's advice even if you think the medicine isn't working. Be sure to talk with your doctor if you think the medicine isn't working.
It's best to take the medicine 30 to 45 minutes before a meal. Good times to take this medicine are before breakfast and before lunch (if a second dose is needed). Lunch-time doses can be given at school for some children. If your child can't take this medicine at school, tell your doctor. Your doctor might suggest a long-acting form of the medicine instead. The long-acting form of this medicine is taken once a day only, right before breakfast. If you are taking the long-acting form of this medicine, do not crush, break or chew it before swallowing it.
Will the medicines also help with other problems?
The medicines used to treat ADHD have been shown to improve a person's ability to do specific tasks, such as pay attention or have more self-control in certain situations. It is not known whether these medicines can improve broader aspects of life, such as relationships or learning and reading skills. However, when children who have ADHD are not achieving their potential in school, medical treatment can often result in better grades and behavior.
How long will this treatment last?
The length of time a person takes medicine for ADHD depends on each person. Everyone is different. Some people only need to take medicine for 1 to 2 years, while others need treatment for many more years. In some people, ADHD may continue into adolescence and adulthood.
People who have ADHD should be checked regularly by their doctors. During these checkups, the doctor will want to hear what the parents have to say about a child who has ADHD. A teacher's comments about the child are also important. If your child has ADHD, your doctor may suggest that he or she take a break from his or her medicines once in a while to see if the medicine is still necessary. Talk with your doctor about the best time to do this--school breaks or summer vacation might be best.
What else can I do to help my child?
A team effort, with parents, teachers and doctors working together, is the best way to help your child. Children who have ADHD may be difficult to parent. They may have trouble understanding directions, and their constant state of activity can be challenging for adults. Children who have ADHD also tend to need more structure and clearer expectations. You may need to change your home life a bit to help your child. Here are some things you can do to help:
- Make a schedule. Set specific times for waking up, eating, playing, doing homework, doing chores, watching TV or playing video games, and going to bed. Post the schedule where your child will always see it. Explain any changes to the routine in advance.
- Make simple house rules. It's important to explain what will happen when the rules are obeyed and when they are broken. Write down the rules and the results of not following them.
- Make sure your directions are understood. Get your child's attention and look directly into his or her eyes. Then tell your child in a clear, calm voice specifically what you want. Keep directions simple and short. Ask your child to repeat the directions back to you.
- Reward good behavior. Congratulate your child when he or she completes each step of a task.
- Make sure your child is supervised all the time. Because they are impulsive, children who have ADHD may need more adult supervision than other children their age.
- Watch your child around his or her friends. It's sometimes hard for children who have ADHD to learn social skills. Reward good play behaviors.
- Set a homework routine. Pick a regular place for doing homework, away from distractions such as other people, TV and video games. Break homework time into small parts and have breaks.
- Focus on effort, not grades. Reward your child when he or she tries to finish school work, not just for good grades. You can give extra rewards for earning better grades.
- Talk with your child's teachers. Find out how your child is doing at school--in class, at playtime, at lunchtime. Ask for daily or weekly progress notes from the teacher.
Some children benefit from counseling or from structured therapy. Families may benefit from talking with a specialist in managing ADHD-related behavior and learning problems.
Studies have shown that certain food colorings and preservatives may cause or worsen hyperactive behavior in some children. Talk to your doctor about whether you need to make any changes to your child’s diet.
What else can I do if I have ADHD?
If your doctor thinks you have ADHD, he or she may suggest counseling. Your doctor may also send you for more testing and counseling to someone who specializes in treating ADHD.
What else can I do to help myself?
You can learn ways to change your work environment and keep distractions to a minimum. Organizational tools can help you learn how to focus on activities at work and at home.
Many people who have ADHD find counseling helpful. A lifetime of ADHD behaviors and problems can cause low self-esteem and problems with relationships. Individual counseling and support groups may help you with these problems.
Adult ADHD: Evaluation and Treatment in Family Medicine by HR Searight, Ph.D., JM Burke, Pharm.D. and F Rottnek, M.D. (American Family Physician November 01, 2000, http://www.aafp.org/afp/20001101/2077.html)
Written by familydoctor.org editorial staff