Are medications necessary?
The vast majority of people who have attention deficit hyperactivity disorder (ADHD) use some form of stimulant medication for their disorder. Research has shown that medication combined with behavior modification and therapy is the most effective treatment for ADHD.
Why didn't they prescribe all of these medications when I was a kid?
Medication for ADHD has been in use since the 1930s. Ritalin has been in use for over 40 years. Medication is more visible now, in part because there has been an increase in the rates of diagnosis of ADHD and in part because of increased media attention.
Some researchers feel that ADHD is actually under-diagnosed and that more children could benefit from medication treatment. A study in the Journal of the American Medical Association reported that although ADHD affects between 3 and 6 percent of school-aged children in the United States, only 2.8 percent of children aged 5 to 18 years were taking Ritalin.
What medications are used to treat ADHD?
Methylphenidate is the name of the most common medication used to treat ADHD. This is the generic drug contained in prescriptions for Ritalin, Ritalin-SR, Concerta and Metadate. Methylphenidate is also available as a generic medication. Methyphenidate is a Central Nervous System stimulant, or a CNS stimulant.
Adderall is another popular medication for ADHD. Adderall is a mixture of four different amphetamine salts. Dexedrine, which is also an amphetamine, is also used to treat ADHD. Cylert (pemoline) is another CNS stimulant used to treat ADHD. Cylert has been associated with liver damage and includes a warning that it should not ordinarily be considered as first line drug therapy for ADHD.
While stimulants are the medication of choice for treating ADHD, there are other options. Welbutrin, an atypical antidepressant, is also used to treat ADHD, especially in adults. Tricyclic antidepressants, such as imipramine, are also used. In some cases, antidepressants may be used along with stimulant medications.
Depakote, an anticonvulsant medication originally developed to treat epilepsy, is sometimes prescribed, particularly if there is a need for a mood stabilizer.
Medications used to treat hypertension, or high blood pressure, are sometimes used to treat ADHD. Among these medications are Clonidine and Tenex (guanfacine).
Should the dose of my child's medication increase as he or she grows?
Not necessarily. Research published in the Journal of Experimental and Clinical Psychopharmacology on Dose-Response Effects of Methylphenidate shows that increases in the amounts of methylphenidate, the most common medication for ADHD, may not be helpful.
Other medications may require adjusting, either due to increased body weight or other factors. The body will develop a tolerance for some medications, which may require an increased dose. Talk with your child's physician about what is the appropriate dose for your child.
Are medications used to treat ADHD abusable drugs?
Yes. Ritalin is a Schedule II medication, indicating a high potential for abuse. Dexedrine also has a high potential for abuse. People have died from abuse of these medications. Typically, Ritalin abuse happens when a person with a prescription gives pills to someone who does not have ADHD.
Are these medications addictive?
Typically not, although addiction is a possibility. Patients with a history of drug abuse need to be cautious with stimulant medications. Tell your doctor about any history of substance abuse that you may have.
Should I continue to give medication to my child during summer vacation?
At one time, it was believed that Ritalin and other medications may affect growth. However, research has shown little evidence that ADHD medications have much impact on ultimate height. According to Dr. Larry Silver, Some children who use stimulants may not grow as quickly as their peers, but usually they catch up eventually. Dr. Silver tells parents to honestly consider if hyperactivity, distractiblity or impulsivity will interfere with their child's success in summer camp or other vacation activities.
Why does it sometime appear as if my teen's medication isn't working?
"Before you become alarmed that medication isn't working," says Dr. Larry Silver, "make sure your child is really taking it." Peer pressure to conform increases in early adolescence, and many kids who took medication without any problem when they were younger suddenly feel singled out when they have to leave the classroom to visit the school nurse. They may "forget" to go, or may refuse to take the medication.
If you know that your child is taking medication as prescribed and the medication still appears to be not working, then visit your doctor. Depression and other health problems can make it appear as if medication isn't working.
Why do I have to go to the doctor to get a refill?
Stimulant medications are considered abusable drugs. Because of this, there is a limit on the number of refills per prescription. Stimulants cannot be purchased over the Internet for that same reason.