Seventy to 80 percent of children with ADHD respond to treatment with stimulants, so this is often the first line of defense. Doctors sometimes prescribe nonstimulants for the approximately 20 to 30 percent of children with ADHD who don’t respond to stimulant treatment.
There are over a dozen stimulant medications on the market, but here are the most common.
- Methylphenidate (Ritalin, Concerta, Daytrana, Metadate, Methylin, Focalin): The most widely-used drug therapy for ADHD and still the most common.
- Dextroamphetamine-amphetamine (Adderall)
- Dextroamphetamine (Dexedrine)
- Lisdexamfetamine dimesylate (Vyvanse)
It seems strange that giving stimulants to an already hyper child could help, but researchers believe they may help adjust the levels of neurotransmitters in the brains of ADHD children. Stimulants can be prescribed in short-acting and long-acting forms, so your child may take medication as often as three times a day or perhaps only once a day. Medications come in pill, liquid, capsule and patch forms.
Most children experience some side effects, the most common being insomnia, decreased appetite, or weight loss. Occasionally, kids will experience irritability or a “rebound” effect when the medication wears off. Very rare side effects can include facial tics, which most often disappear with a lower dose or change in medication, and a reduced growth rate. Kids should be screened for any pre-existing heart conditions before starting stimulants.
There are two nonstimulants specifically for ADHD treatment in children.
- Atomoxetine (Strattera): Strattera increases the levels of the neurotransmitter/hormone norepinephrine to the brain. Researchers think this chemical plays a key role in focus and attention. This drug may also reduce anxiety. Strattera can cause some rare but very serious side effects, including jaundice and other liver problems, and suicidal thinking.
- Guanfacine (Intuniv): This newer form of Tenex, a drug for high blood pressure, was approved for ADHD treatment in fall 2009. Again, doctors are not really certain why it works, but it may help control behavior by affecting the prefrontal cortex, the area of the brain that serves as a check on our impulses. The most common side effects of Intuniv are tiredness and sleepiness. Other side effects may include low blood pressure and low heart rate, dizziness, fainting episodes and nausea.