It’s a big decision to put your child on daily medication for ADHD. As a parent, you want your child to feel better and your family to have peace – but you may have some nagging doubts. For example, you might think:
- I don’t want my child depending on medicine to get through the day
- If he starts taking medication now, will he have to take it for the rest of his life?
- Will he move on to stronger medication as he gets older, and become an addict?
- Have I done the right thing?
You might have some other concerns, too. If you haven’t discussed them with your child’s doctor, please make an appointment to do so. Remember that you both have a common goal in mind – wanting the best for your child. Properly-prescribed ADHD medication can help your child to function better on a daily basis.
John and Cindy’s story
John and Cindy’s son, Jacob, is 8 years old. He’s been sent to the principal’s office several times this year by his second-grade teacher. The teacher complained that Jacob was constantly getting up from his seat, talking out of turn, not paying attention, and was distracting the class by joking around. He was already repeating the second grade because he’d had similar issues with behavior the previous year.
The principal suggested that Jacob have an appointment with the school’s psychologist for testing. After he was tested, the psychologist recommended that Jacob see a child psychiatrist – a mental health professional who is able to prescribe medication. The psychologist thought Jacob might have ADHD and that medication could help him to control his behavior.
John and Cindy brought Jacob to the psychiatrist, but they had a few concerns. They were worried if Jacob’s ADHD medication would have any side effects, and whether this treatment would get him “started on drugs” at an early age: They’d heard that medications used to treat a child’s ADHD could lead to drug addiction later on. John and Cindy didn’t want to be responsible for turning Jacob into a drug addict.
How ADHD medications work; how often they are prescribed
Medications used to treat ADHD: (brand names in parentheses)
o Methylphenidate (Daytrana®)
o Methylphenidate HCl (Concerta®, Desoxyn®, Metadate® CD, Metadate® ER, Methylin®, Methylin® ER, Ritalin®, Ritalin® LA, Ritalin® SR)
o Dexmethylphenidate HCl (Focalin®, Focalin® XR)
o Amphetamine salt combo (Adderall®, Adderall® XR)
o Dextroamphetamine sulfate (Dexedrine®, Dexedrine® Spansules, DextroStat®)
o Lisdexamfetamine dimesylate (Vyvanse®)
o Atomoxetine (Strattera®)
o Not FDA-approved for ADHD, but physicians can prescribe it for ADHD
This article focuses on stimulants, which are the most commonly-prescribed – and often the most effective – medications for treating ADHD. The goal is to find a medication and dosage to reduce your child’s symptoms with as few side effects as possible.
How stimulants work
A chemical in the brain called dopamine helps to keep a person’s behavioral-type problems under control. When there’s a low level of dopamine activity in the brain, it can cause impulsive acts, distractibility, and a lack of attention. All of these behaviors can be found in people with ADHD. Stimulants “stimulate” (increase) the activity level of dopamine in the brain, so that there are fewer behavioral problems; they don’t make already-hyperactive children more stimulated, as the name suggests.
How often they’re prescribed
About 2.4 million children from the ages of 8-15 in the U.S. were diagnosed with ADHD in 2004; this is almost twice as many children as in 1995. Prescriptions for ADHD medication were written at an even higher rate, more than doubling between 1995 and 2004. This trend shows that we can expect the number of children diagnosed with ADHD to be even higher today.
The information contained in this list is provided for informational purposes only. It is updated periodically and was last updated on April 4, 2008. It may not reflect pharmaceutical company changes, deletions, additions, or new approvals of the medications available for treating ADHD since the last update. If you have any questions about these or any other medications or treatments, you should consult your physician. For a complete statement of all disclaimers and warranties applicable to the information contained in this web site, please refer to the Terms and Conditions associated with this web site.
Prescribing ADHD medication
Only a doctor (M.D. or D.O.) can prescribe medication for your child’s ADHD, although other healthcare professionals are trained to evaluate and suggest treatment for your child.
How does the doctor know which ADHD medication to prescribe?
·Stimulants are usually the first medication choice for ADHD. Long-acting stimulants only need to be taken once each day and have results that can last 12 hours or more
·If your child has problems swallowing pills, it’s possible to prescribe ADHD medication in other forms:
o As an adhesive patch, applied to the skin like a band-aid
o As a capsule, with contents that can sometimes be sprinkled on food (check with your doctor to find out when this can be done)
·If your child has been on medication before, the physician may ask if it worked and why it was stopped
·If your child has not been on medication before, the doctor may ask:
o Does your child have problems during the day? Early evening? Late evening?
o Are his or her problems at school, at home, or both?
·If your child is young, there may be fewer side effects with methylphenidate medications than amphetamines
·Tell the doctor all prescriptions and over-the-counter drugs that your child is taking, to avoid harmful drug interactions
Drugs and foods that can change the effects of stimulants
Some drugs and foods can interact with ADHD stimulants if they’re taken together, causing changes in the stimulant’s side effects or in how the medication is absorbed. Tell the doctor about any prescription or over-the-counter medications that your child is taking now, including herbal medicines or natural treatments.
Some of the following categories of medicine may cause a drug interaction:
·Blood pressure medications
·Non-steroidal anti-inflammatory drugs (NSAID)
The following drugs/products can increase a stimulant’s effects/side effects:
·Over-the-counter cold preparations/decongestants
·Products with caffeine
Some breakfast foods raise stomach-acid levels, which keep ADHD medications from being absorbed properly; avoid them 30-45 minutes before/after taking stimulants:
·Power bars/Granola bars
This list is just an example. Make sure to discuss this issue with your doctor.
The risk of addiction and drug abuse with ADHD stimulant medication
Some parents worry that if their child takes stimulants to treat ADHD, their child will become addicted to the medication. This is a myth! As long as stimulant medication is not misused, then their child will not become addicted.
Research shows that:
·People with ADHD who take stimulant medication at the properly-prescribed dose and time don’t become addicted to stimulants
·People who take stimulant medication for ADHD are less likely to “self-medicate” – using other substances to control their symptoms and make them feel better
·By avoiding “self-medicating”, people who use stimulant medication are at less risk of developing substance abuse problems later in life
You may also be worried about your child’s stimulants being stolen, sold or abused by other children. However:
·It’s possible to prescribe ADHD medication in a form that can’t be crushed, “snorted” or injected – all are common ways to abuse medication
·Many schools require that student medications be in pharmacy-issued containers, and delivered to the school nurse by a parent
Questions the doctor may ask, and why
Before the doctor prescribes ADHD medication for your child, he or she will want to make sure that you’re comfortable with this treatment choice and that your child is healthy. You may be asked:
·Is there anything about treating your child’s ADHD with stimulants that worries you?
o The doctor can address specific fears, like whether your child will become addicted, or whether side-effects are unavoidable.
·Are there particular side effects that worry you or your child?
o A different medication may not have those troubling side effects.
·When and where does your child have behavioral problems?
o The dose and timing of ADHD medication can be fine-tuned, so that it will be effective when your child needs it most.
·Can your child swallow pills easily?
o Some ADHD medications can be given in a non-pill form.
·Does your child or your family have a history of heart problems?
o While extremely rare, some children and adolescents with structural heart problems or abnormal heart rhythms have died suddenly from the use of ADHD stimulants. If your child or your family has a history of heart problems, the doctor may order an electrocardiogram (EKG) to test your child’s heart.
Questions to ask your child’s doctor
It doesn’t matter how many doubts you’ve already raised about the use of ADHD medications – as a concerned parent, you should ask as many questions as it takes to feel comfortable with this new treatment program. Your child’s health and safety is the top priority.
·What kind of medication is this?
·Is it safe?
·What are the side effects? How should I watch for them?
·What should we do if our child has these side effects?
·How will we monitor any possible long-term side effects, like problems with our child’s appetite or growth?
·How is the medication given? (pill/capsule/liquid/patch)
·What times is it given? Should my child take it with food or on an empty stomach?
·Should we tell the school that he’s on medication?
·Does he have to take it at school? (If yes, contact the school nurse for proper procedures)
·How long does he have to be on the medication?
·Does he need to take it on weekends or holidays when he’s not in school?
·How will we know that the medication is doing what it’s supposed to?
Finally, bring a list of other medications your child is taking to the initial consultation, with the dosage, as this may affect what the doctor prescribes.
You’ve probably spent many restless hours deciding whether to use ADHD medications for your child. While it’s impossible to guarantee a good result for every person with ADHD who takes stimulants, remember the following points:
·Stimulants are the most commonly-prescribed – and often the most effective – medications for treating ADHD
·ADHD patients who take their medication as prescribed don’t become addicted
·ADHD patients who use prescription stimulants have less chance of becoming addicts than ADHD patients who don’t use any medication
·Stimulant medication is available in many different forms (pill/capsule/patch/liquid)
·It may be possible for your child to use a long-acting medication that’s taken once each day, instead of standard stimulant doses taken 2-3 times per day
In a sense, the hardest part of using stimulant medications to treat ADHD is deciding to use them. Talk with the doctor if you have any remaining questions. It’s time to make a choice, so that your child can move forward, making the best use of his or her natural, inborn talents.