Medications for ADHD

Medication is often an important component of the treatment plan. Stimulant medication has been used to treat children with ADHD for over 40 years.

For most children, medication is very effective for:

  • treating inattention, hyperactivity, and impulsivity
  • improving behaviour in the classroom and in social situations
  • improving the child's ability to follow rules
  • reducing emotional overreaction

In turn, medication often improves children's relationships with their peers and parents. However, medication alone is not the whole answer:

  • Medication improves behaviour, but does not always make it fully "normal."
  • Usually, children with ADHD have missed out on a lot of instruction by the time they are diagnosed and treated.
  • Medication does not solve learning problems such as dyslexia.
  • It is not clear whether medication improves academic achievement over the longer term.

As a result, children usually need extra help with academic and social skills from teachers and parents, even if they are taking medication. This is discussed in more detail in the "Behavioural Treatment" pages in this section, as well as in the "At Home and At School" section.

Two main types of medications are used to treat ADHD:

  • stimulant medication
  • non-stimulant medication

For more information about each type of medication, please click the links on the left.

Usually one medication is all that is needed to treat ADHD, unless the child has other co-existing conditions that also need treatment, or if the more commonly used medications for ADHD are not effective.

Choosing a medication

Before prescribing a medication, your child's doctor will need to consider:

  • the goals of treatment
  • when and where your child has symptoms that need to be treated
  • any other medical conditions your child has

The answers to these questions will help the doctor decide:

  • what type of medication to prescribe
  • whether to prescribe a short-acting or long-acting formulation
  • the dosing schedule

For example, if your child only needs symptom relief while he is at school, the doctor may prescribe medication that only needs to be given on school days.

The dose of medication that will be prescribed depends on your child's response. Different children react differently to the same drug. The amount of medication in your child's body should be high enough to prevent symptoms, but not so high that it causes excessive side effects.

For many medications, your child's doctor will start with a low dose and gradually increase it. This is sometimes called titration. This gradual introduction helps to reduce the risk of side effects.

What to do if medication does not work

Medication will work for most children. However, some children may respond better to one medication than to another. The doctor will suggest trying another medication if:

  • your child's symptoms do not improve with a particular medication
  • your child has sleeping difficulties, decreased appetite, or other side effects that are bothersome

If your child's symptoms still do not improve after trying three or more different medications, the doctor may reassess your child. The diagnosis of ADHD may not be correct, or your child may have other conditions as well as ADHD.

Note, however, that a response to medication does not necessarily confirm that the diagnosis of ADHD is correct.

Questions about medication for your child's doctor

Here are some questions you may want to ask when the doctor prescribes medication for your child:

  • What are the chances that this medication will improve my child's symptoms?
  • Which symptoms might the medication improve, and which symptoms are not likely to be improved?
  • What dose is my child taking? 
  • What is the dosing schedule (once a day, twice a day, three times a day)?
  • How rigid is the dosing schedule? If my child takes the medication half an hour early or an hour late, will that be a problem?
  • Will the medication interfere with sleep if my child takes it too close to bedtime?
  • Does the dose need to be titrated (that is, gradually increased over time)?
  • What can I expect while my child is taking this medication?
  • How long will it take before we know if the medication is working?
  • What kinds of physical side effects might there be?
  • What kinds of cognitive or learning side effects might there be? 
  • What kinds of behavioural side effects might there be?
  • How long can we expect the side effects to last?
  • Does this medication have any serious side effects, for which we would need to contact a doctor or emergency services? How can we recognize those side effects? 
  • Does this medication interfere with other medications?
  • What should we do if my child misses a dose of this medication?
  • What should we do if my child accidentally takes too much of this medication?
  • How often should my child come in for a follow-up appointment while taking this medication? 
  • What should I tell my child's school about this medication?
  • How long will my child be taking this medication?

Tara McAuley, PhD, CPsych

Peter Chaban, MA, MEd

Rosemary Tannock, PhD

10/14/2009


Notes: