Treating Your Child

8 Vital Questions About ADHD Medications for Children: Side Effects, Med Breaks & More

Top questions and concerns from ADDitude readers about ADHD medication in children — from side effects and the medication selection process to refills and medication vacations.

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ADHD Medications for Children: Your Top Questions

Decades of research establish that medication, particularly stimulant medication, effectively treats attention deficit hyperactivity disorder (ADHD) in children. Still, questions and concerns about ADHD medications for children abound — and for good reason. For one, the process of finding the right medication, formulation, and dosage for a child is rarely straightforward. Side effects, medication rebound effects, and coexisting conditions must all enter the equation. But the list of key factors doesn't stop there.

During Dr. Walt Karniski's recent webinar on ADHD medications for children, we asked nearly 1,000 attendees, "What is the biggest obstacle to starting or managing ADHD medication for your child?" Here are the answers they gave:

  • Side effects (e.g., loss of appetite, sleep problems): 43.13%
  • Little to no improvement in symptoms: 13.06%
  • Stigma surrounding medication use: 10.2%
  • Medication rebound when it wears off: 9.93%
  • Resistance from child: 6.67%
  • Taking medication consistently: 5.85%
  • Refilling prescription: 5.03%
  • Titration process: 4.35%
  • Cost: 1.77%

Comments and questions from webinar attendees provide deeper insight into caregivers' myriad concerns and questions regarding the use of ADHD medication to treat children.

ADHD medications - illustration of different medication formulations
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1. How Do We Find the Best Medication Among So Many Options?

"How do we, as parents, select an ADHD medication that would work best for our child?"

"Why do we have to experiment with several drugs in order to find the right medications for the specific issues for our children?"

"Is it common to not have success with the first medication prescribed?"

"I see many patients who have tried three or more stimulants, still searching for the 'right one.'"

The Best ADHD Medications for Kids: Next Steps

Lettered dice arranged to spell "ADHD" with generic medication pills around
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2. How Do We Know If the Medication Is Working?

"How do you know when a medication is working? When do you throw in the towel?"

"How do we know if we need to just up the dosage or try a new medication?"

"What changes in behavior should I be looking for in order to deem a medication effective?"

"If medications do not seem to help with symptoms even after allowing time for them to take effect, what other types of medications or interventions do you suggest?"

"My son started taking ADHD medication about a month ago. He has shown minor improvement, but not what we were expecting. How long should we wait to expect better results? Should he try other medications and see which one works better?"

Is the ADHD Medication Working? Next Steps:

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3. How Can We Minimize Side Effects?

"How can we minimize side effects? And how long do you have to stick with a new med to see if the side effects are temporary or will always be a part of using this drug?"

"We are not sure if my son's 'sad moments'  are hormone related or medication related."

"My son says the medicine makes him anxious."

"Medication has been transformative, but appetite suppression is ongoing. We can’t back fill calories enough in evening to keep my son's weight up..."

"Since decrease of appetite is a very common side effect, should we lower the dose based on that side effect alone?"

ADHD Medication Side Effects: Next Steps on Appetite Loss, Sleep Problems, Etc.

Blurred view of pharmacists behind counter in modern pharmacy
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4. Prescription Hurdles, Refills, and Medication Shortages

"My pharmacy said there is a shortage of the main ingredient for amphetamine, which is affecting all medications in the amphetamine class. Same thing with methylphendiate."

"Adderall is sometimes unavailable. What are good alternatives?

"With the current shortage of Adderall and other ADHD medications, are some of the other stimulant medications more readily available? Would they be good substitutes to the ones not available?"

"My daughter was doing great on brand name Concerta. My insurance refused to cover it, so we had to switch to the generic, which hasn't worked as well as the brand name. Why does the generic not work as well?"

ADHD Medication Shortages and Refills: Next Steps

Girl teenager in a hat with a yellow bike walks through the summer city. Traveling around the city by bike.
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5. Can My Child Take Breaks from ADHD Medication?

"Do you recommend medication breaks? My 6-year-old son takes Quillivant and guanfacine. Unfortunately, he struggles with a loss of appetite. Would a break outside of school days be beneficial to allow him to eat more? What do you recommend?"

"What are your thoughts about medicating children with ADHD only during the school year and giving a break during the summer vs. medicating all year round?"

"Our doctor told us that side effects like reduced appetite will go away if you don't take vacations. Another doctor said that wasn't true. What does the research show about medication vacations and their effect on side effects?"

ADHD Medication Vacations: Next Steps

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6. How Do We Deal with Medication Rebound?

"We tried other short-acting stimulants to help with homework after school when the medication wore off, but nothing works."

"We are happy with the effects of the meds on school, but the evening medication wind downs are horrible. We feel like it’s hard to do family activities in the evening because of it."

"When my son's Concerta wears off, he says he feel awful. So it's not an issue of doing his homework that we're concerned about, but his mood."

"Do you think guanfacine is a good option for supporting a child who may have a hard time finding balance after their medication wear off at the end of the day?"

ADHD Medication Rebound and Wear Off: Next Steps

Father and adhd son time, child won't talk
Father and adhd son time
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7. How Do We Handle Stigma and Resistance?

"How do we explain the purpose of ADHD medication to a child in a way that won't affect their self-esteem?

"How should I talk to my child about why they are starting ADHD medication?"

"What about when your child doesn't want to take their medication because they say they can't 'be themselves?'"

"Any recommendations for getting a kid to take medication if he absolutely hates taking medication of any kind?"

ADHD Medication Resistance and Stigma: Next Steps

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8. What If My Child Has Coexisting Conditions?

"My daughter suffers from anxiety along with her ADHD. Is there a medication that would target both?"

"Are ADHD meds effective on autistic children?"

"Is there a medication that helps with the dual diagnosis of ADHD and ODD?"

Treating ADHD and Coexisting Conditions: Next Steps

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ADHD Medications for Children: Next Steps

To learn more about ADHD medications for children, listen to the ADDitude Expert Webinar “ADHD Medication Options and Benefits for Children" by Walt Karniski, M.D., which was broadcast live on January 19, 2023.


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