When the doctor tells you that your child has ADHD ( Attention Deficit Hyperactivity Disorder) and tells you to start medication for it, it's normal for you as a parent to feel a great burden on your heart. "What will happen if I give my little one medication?", "Will this hurt him?", etc. Many questions probably come to mind. But don't worry. In this article, we will talk about this in simple terms to answer your questions. We will explain these things one by one, just like you would talk to your own friend.
Does the same treatment work for every child?
No. This is the first thing we need to understand. The way ADHD is treated varies from child to child. Imagine, even if ten children in the same class have ADHD, the treatment plan given to all ten of them may be different. The reason for this is that each child's symptoms, their impact, and their needs are different.
Doctors usually plan treatment like this:
- For children under 6 years of age: Experts often recommend starting with behavioral therapy before giving medication.
- For children over 6 years old: For children of this age, a combination of medication and behavioral therapy is considered the most effective method.
The doctor treating your child will choose the one that best suits your child from these options.
- Maybe only one type of medicine is given.
- Or, a combination of several medications (we call this adjunctive therapy) can be given.
- Behavioral therapy is often recommended along with medication.
The important thing is that the doctor may change the type of medication or dosage until he finds the treatment that works best for your child. So don't worry.
What are the main medications used for ADHD?
There are three main types of medications used to treat ADHD. Let's take a look at what they are.
1. Stimulants
3. Antidepressants
Now let's talk about each of these types separately, in detail.
Let's talk about stimulants first.
Often, your doctor will start your child on a low dose of this type of medication. These medications are long-term, well-tested medications for ADHD. They can be very helpful for children who have difficulty with schoolwork, homework, or socializing.
Although these are called "stimulants," taking them does not make the child more naughty. In fact, the opposite happens. These medications help keep the child's attention focused and stop them from being distracted by unnecessary things .
Stimulant-type drugs
Here are some examples of this type of medication. Your doctor may prescribe one of these. (Not all of these brands may be available in Sri Lanka, but these are the main drugs used internationally.)
| Generic Name of the Drug | Brand Names |
|---|---|
| Amphetamine | Adderall, Adderall XR, Adzenys XR-ODT |
| Dexmethylphenidate | Focalin, Focalin XR |
| Lisdexamfetamine | Vyvanse |
| Methylphenidate | Concerta, Daytrana, Jornay, Ritalin |
| serdexmethylphenidate/ dexmethylphenidate | Azstarys |
The duration of action of this medicine also varies.
These stimulant medications are also divided into several categories based on the duration of action.
- Short-acting: These work quickly and are quickly eliminated from the body. So you have to take them several times a day. They usually last about 4 hours.
- Intermediate-acting: These are active for a few hours longer than short-acting ones.
- Long-acting: This type of medication is usually taken once a day. It can last for about 8-12 hours. These are very convenient for school-age children because they can be given one in the morning to cover the entire day.
Very important: If your child has other medical conditions (e.g. heart disease), or if anyone in your family has a history of such conditions, you should tell your doctor all the details before giving this medicine.
Now let's see what non-stimulants are.
These are non-stimulant medications. They can also help with your child's concentration and impulse control. If stimulant medications don't work for your child, or if they cause severe side effects, your doctor may recommend a non-stimulant medication.
Sometimes this type of medication is given in addition to a stimulant medication. Studies have shown that when given in this way, the success of the treatment is even greater.
| Non-stimulant medications approved for ADHD | |
|---|---|
| Atomoxetine | (Strattera) |
| Clonidine hydrochloride ER | (Kapvay) |
| Guanfacine ER | (Intuniv) |
| Viloxazine | (Qelbree) |
- Atomoxetine (Strattera): This medication works by increasing the amount of a chemical called norepinephrine in the brain. This can help reduce a child's hyperactivity and impulsive behavior.
- Clonidine and Guanfacine: These medications were originally developed to treat high blood pressure, but they also affect certain chemical receptors in the brain, helping to control a child's memory, attention, impulsivity, and hyperactivity.
In what situations are antidepressants given?
Some children with ADHD may also have other mental health conditions, such as depression. In these cases, the doctor may prescribe an antidepressant along with a stimulant medication.
These medications are not specifically approved for ADHD, but studies have shown that they can help control symptoms such as hyperactivity and aggression.
- Bupropion (Wellbutrin): This helps improve the mood of children with ADHD and depression.
- Imipramine (Tofranil) and Nortriptyline (Pamelor): These are older antidepressants. They affect neurotransmitters in the brain. However, they are less commonly used now due to side effects.
- Venlafaxine (Effexor): This can be used for children who have anxiety or psychological problems along with ADHD.
Be aware of the side effects of medications.
Many medications for ADHD can have side effects, so before starting your child on any medication, ask your doctor about the possible side effects and what you should be aware of.
If you notice any unusual changes in your child's behavior while taking medication, tell your doctor immediately. Also, tell your doctor if the medication doesn't seem to be working properly or if the side effects seem excessive.
Never stop your child's medication without talking to your doctor. This is very important.
Other conditions that may coexist with ADHD
Many children with ADHD also have one or more other conditions, such as depression or anxiety. The best part is that doctors can treat both conditions at the same time. Sometimes, the same medication can control both conditions. So be open and honest with your doctor about any changes you notice in your child's behavior.
Take-Home Message
- ADHD treatment is unique and individualized for each child. What works for one child may not work for another.
- Medication is only one part of the treatment plan. It is often best used in conjunction with behavioral therapy.
- There are three main types of medications used (Stimulants, Non-stimulants, Antidepressants). Your doctor will choose the most appropriate one for your child.
- Always talk to your child's doctor about how their medicine is working and whether there are any side effects. What you see is very important in developing a treatment plan.
- Never change or stop your child's medication dosage without medical advice.
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