Children with ADHD must be treated with a combination of behavioral, educational, medical, and psychological strategies. Frequently referred to as “multimodal,” this all-encompassing treatment strategy includes medication, behavior management techniques, parental and child education regarding diagnosis and therapy, child and/or family counseling, and school programming and support. It is imperative that each infant and family be provided with personalized care that is tailored to their specific needs.
The role of medication
In the majority of cases, medication is a vital component of the treatment plan for children with ADHD. It is not employed for behavioral control. The goal of ADHD medication is to alleviate symptoms so that individuals with the disorder can function more effectively. It is exclusively administered by medical professionals.
Each household that is providing treatment for a child with ADHD must carefully consider the benefits and drawbacks of medication. People who take medication to treat the symptoms of ADHD in children and adults typically attribute their success to their own abilities rather than the medication, according to research.
Psychostimulant medications
Psychostimulant medications are the most commonly prescribed treatments for symptoms associated with ADHD. In 1937, the first children with academic and behavioral issues were administered psychostimulants. Contrary to their moniker, these medications do not increase one’s level of stimulation. They facilitate more efficient communication between the main neuronal networks of the brain. Eighty to seventy percent of children with ADHD exhibit improvement after taking these medications. Occasionally, the initial medication administered may not be optimal, or a higher dosage may be necessary.
Reports regarding drug use vary. Certain individuals experience notable benefits from medication, while others merely find it to be of moderate assistance. Still others observe less remarkable enhancements. There is often an increase in attention span, impulsivity, and on-task behavior, especially in structured environments. Furthermore, certain children exhibit improvements in their handwriting, collaboration, and even their capacity to manage frustration. Additionally, improved relationships with instructors, guardians, and peers were evident.
Medication for ADHD, when taken as prescribed, aids in symptom management but does not resolve the disorder. As a result, its mechanism of action is more akin to that of eyeglasses, which enhance vision exclusively when they are worn, rather than an antibiotic, which could potentially treat a bacterial infection.
Methylphenidate (Ritalin, Concerta, Metadate, Focalin); mixed salts of a single-entity amphetamine product (Adderall, Adderall XR); and dextroamphetamine (Dexedrine, Dextrostat) are common psychostimulant drugs used in the treatment of ADHD. Presently available are formulations of methylphenidate, amphetamine, and combined compounds of amphetamine that exhibit both short-acting and long-acting effects. Some long-acting medications have a half-life of 6–8 hours, while more recent formulations have a half-life of 10–12 hours. Typically, short-acting medications have a duration of four hours. Unpredictable and potentially substantial individual variation may exist, which may not be detected until the drug undergoes testing.
Nonstimulant medications
Although stimulants are the most extensively studied and widely prescribed medications for ADHD, non-stimulant alternatives may occasionally be just as effective or even more effective in treating the disorder in specific children, adolescents, and adults. Nonstimulant medications may be used when psychostimulant drugs have failed to produce the desired results, caused undesirable side effects, or are not preferred by the child’s parents or the patient for other reasons.
Although they are less common, medications that were once created as antidepressants have been proven to be beneficial for ADHD. ADHD symptoms may be positively impacted by antidepressants, such as tricyclics and new drugs like bupropion, which actively affect the neurotransmitters dopamine and norepinephrine. Serotonin selective reuptake inhibitors (SSRIs), an antidepressant class that only affects the serotonin system and includes citalopram (Celexa), sertraline (Zoloft), and fluoxetine (Prozac), have not been proven to be effective in treating the primary symptoms of ADHD, but they may be helpful in treating co-existing conditions. According to recent studies, children with ADHD who are taken long-acting clonidine (Catapres) or guanfacine (Tenex) to treat severe sleeplessness or excessive hyperactivity may also benefit from an increase in attention span.
Possible adverse consequences of ADHD medications
The early adverse effects of these drugs are predominantly mild and typically temporary in nature. Among the most commonly observed adverse effects are reduced appetite and difficulty initiating sleep. When the effects of the drug wear off, some kids suffer stimulant rebound, which is a transient period of low mood, exhaustion, or increased activity. For short-acting drugs, these side effects are typically controlled by adjusting the dosage and timing or switching to a prolonged-release formulation. There is also a chance of headaches and stomachaches, which usually go away with time or, if needed, a dosage reduction. Although studies indicate that ultimate height and weight are rarely influenced, certain children may have an early, minor effect on height and weight gain. Some children with ADHD may enter puberty later than their classmates, according to a few studies, but this does not seem to be related to pharmaceutical treatment.
Uncontrollable facial twitches, eye blinking, shrugging, and throat clearing are examples of tics. Children who use stimulant medicine occasionally seem to acquire tics. But rather than causing the tics, the medicine may make them more noticeable or cause them to become noticeable earlier than they otherwise would. Frequently, they disappear with time, even if the patient is still receiving medicine.
Starting medication
Before beginning pharmaceutical therapy for ADHD, any individual thinking about it should have a thorough evaluation to confirm the diagnosis, find any additional medical, psychological, or learning issues that may be present, and gain knowledge about ADHD. Following diagnosis, a treatment plan should be created in collaboration with the doctor or other health care provider. The patient, family, and medical professional can collaborate to discuss the many treatment options during this planning session. In the event that medicine is necessary, the physician will recommend a certain drug.
It is imperative to closely monitor the pharmaceutical trial, particularly during the initial weeks of treatment, in order to make any necessary modifications to the dosage and schedule. The prescribing expert will probably make changes if the initial medicine tried is ineffective or has adverse side effects. If the modifications are insufficient to elicit a favourable reaction, an alternative medicine may be attempted. Any of the commonly prescribed ADHD drugs work well for the majority of people with ADHD. Some react to one considerably better than the other. It’s always a good idea to try a different kind of ADHD medication if the first one does not provide an acceptable result.
Continued monitoring
The patient and a dedicated team of carers must work together for treatment to be successful in the end. Medication can increase the efficacy of the entire multimodal therapy programme. It is frequently insufficient to manage ADHD with medication alone, proper education on the condition, and other suitable treatment approaches. Non-compliance, or failing to take medication as directed, can result in medication failure.
Sometimes parents say that as their child approaches puberty, medicine that had worked for them as a youngster no longer does. Changing to a different medicine or modifying the dosage will often alleviate this issue. If receiving medical attention for ADHD during adolescence has proven beneficial in the past, it is generally not the time to stop. Talk to your doctor about your findings and concerns if your adolescent is experiencing such issues.
