How Should I Treat My Child's ADHD?

When Medicating ADHD Isn’t an Option

The Republic of Georgia and other nations have banned the use of stimulants as treatment for ADHD in children, keeping them from getting the help they need.

A student with ADHD backpacks across Europe during her gap year between high school and college.
A student with ADHD backpacks across Europe during her gap year between high school and college.

To medicate or not to medicate children diagnosed with ADHD? In the United States, many parents anguish over this agonizing question. In a handful of countries around the world, however, governments have made this question moot, banning the use of stimulant medications. Luis Augusto Rohde, professor of child psychiatry at Brazil’s Federal University of Rio Grande do Sul, and president of the World Federation of ADHD, says these nations include Algeria, Egypt, Kuwait, Jordan, Morocco, and Russia.

In the former Soviet Union Republic of Georgia, stimulant medications for ADHD have been banned for the past decade, as part of a crackdown on drug abuse that was rampant before former President Mikheil Saakashvili’s rise to power.

As awareness has grown throughout the world about ADHD and measures to treat it, some Georgian parents worry that they’re lacking a powerful option to help their kids.

“School teachers in Georgia are not well prepared to deal with these kinds of children,” says Nino Jakhua, the mother of a six-year-old diagnosed with ADHD. “The same problem exists in society as well. In most cases, mental disorders are seen as a stigma in Georgia.”

Jakhua’s son, Nikoloz Aleksidze, was diagnosed with ADHD this year when his teacher recommended that he see a psychologist for hyperactivity and restlessness. The psychologist prescribed occupational therapy, which according to Jakhua, has helped him a lot, but not enough.

Nikoloz often gets into conflicts with other children, doesn’t follow the rules, and can’t sit for more than 10 minutes straight. He has been prescribed butyric acid, glycine, glutamine, magnesium, and other holistic treatments with marginal, if any, proven effectiveness for treating ADHD symptoms.

In Georgia, Nikoloz is comparatively lucky. Although his ADHD is not being effectively treated and causes him problems, he has caring and affluent parents. Mental health experts here say other children from lower socioeconomic classes with ADHD, who are disruptive at school and at home, are often prescribed psychotropic drugs that don’t address ADHD symptoms.

According to Tamar Gagoshidze, the acting dean of Tbilisi State University of Neurology and Neuropsychology, in Georgia, some of the most common drugs prescribed for ADHD are phenazepam, diazepam, and risperidone. Phenazepam and diazepam are heavy sedatives, of the benzodiazepine class, used to treat anxiety disorders and alcohol withdrawal syndrome. Risperidone is an anti-psychotic drug mainly used to treat schizophrenia and the mixed and manic states of bipolar disorder. These drugs are used to tranquilize children with moderate to severe ADHD instead of treating them.

While everyone agrees that sedatives and anti-psychotics are the wrong approach to treating ADHD, staunch advocates of behavioral therapy, like Gagoshidze, prefer the current situation to lifting the ban on stimulants.

“I am very against stimulants,” says Gagoshidze. “Thank God for the control [ban].”

Many ADHD experts in the U.S. caution that medication, by itself, is rarely enough to treat ADHD, and that adding behavioral therapy to the treatment plan is always a good idea. For the time being, however, children like Nikoloz will not get the chance to find out if stimulants would give them the help they need.