ADHD: Treatment with medicationsAADHD: Treatment with medicationsADHD: Treatment with medicationsEnglishPsychiatrySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)BrainBrainDrug treatmentCaregivers Adult (19+)NA2017-06-16T04:00:00ZAlice Charach, MD, MSc, FRCPC;Rosemary Tannock, PhD10.000000000000054.00000000000001214.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Find out how medications can work with behavioural treatment to help a child with ADHD symptoms.</p><p>Medications are often an important part of the treatment plan for ADHD, but they are not recommended for pre-school age children.</p><p>On their own, medications can be very helpful in treating the core <a href="/Article?contentid=1923&language=English">symptoms of ADHD</a>, but they often do not address the range of other possible problems that can contribute to poor functioning, such as irritability, <a href="/Article?contentid=18&language=English">anxiety</a> and <a href="/Article?contentid=1925&language=English">oppositional defiant disorder</a>. These other problems respond best to behavioural treatments in addition to medication.</p><p>Medications also cannot make up for any gaps in learning before a child started ADHD treatment. It is very important that children with ADHD get the <a href="/Article?contentid=1999&language=English">right academic support</a> to help them reach their full potential.</p><h2>Key points</h2> <ul> <li>Medications work well to treat the core symptoms of ADHD but work best with behavioural treatments for any related emotional, learning or behavioural issues.</li> <li>In most cases, ADHD is treated with stimulants. Common, mild side effects include headaches, difficulty falling asleep, irritability and jitteriness. Rare but more serious side effects include allergies, severe agitation, heart problems and suicidal thinking.</li> <li>Your child will be prescribed a low dose of medication that their doctor will monitor and adjust over time to make sure it continues working.</li> <li>Your child’s doctor may change the dose schedule or recommend a "drug holiday" to minimize the side effects.</li> </ul><h2>What types of medications treat ADHD?</h2> <p>In most cases, ADHD is treated with stimulants. These have been widely used for ADHD for more than 40 years. They are effective for at least two-thirds of children with ADHD and have relatively few side effects.</p> <h3>How stimulants treat ADHD</h3> <p>Stimulants increase levels of brain chemicals called dopamine and norepinephrine. These chemicals affect a person’s mood, alertness, memory, level of attention and response to stress. Increasing the levels of these chemicals reduces inattention, hyperactivity and impulsivity. However, symptoms return as the stimulants wear off.</p> <p>There is strong evidence to support the short-term benefits of stimulants for the core ADHD symptoms, but evidence for long-term benefits is more limited. As a result, it is important to monitor ADHD medications closely to make sure that they are still helpful for your child as they grow older. It is also common for ADHD symptoms to return when medications are stopped.</p> <h2>Types of stimulants</h2> <p>There are two main types of stimulant medications:</p> <ul> <li>methylphenidate</li> <li>amphetamines</li> </ul> <p><em>Methylphenidate</em></p> <p>The brands of methylphenidate that are available in Canada include:</p> <ul> <li>Biphentin</li> <li>Concerta</li> <li>Ritalin</li> </ul> <p><em>Amphetamines</em></p> <p>The brands of amphetamines that are available include:</p> <ul> <li>Adderall XR</li> <li>Dexedrine Spansule</li> <li>Vyvanse</li> </ul> <p>Both types of stimulants come in pills or capsules that must be swallowed whole or capsules that can be opened and mixed with food.</p> <h2>How long do stimulants last?</h2> <p>Stimulants fall into two categories: short-acting and longer-acting.</p> <h3>Short-acting stimulants</h3> <p>These stimulants last for three to five hours. They start to take effect usually within 15 to 30 minutes of taking the first dose.</p> <p>The effects of a stimulant taken first thing in the morning may start to wear off before lunchtime. If your child needs these medications for school, they will usually need to take at least one stimulant during the school day.</p> <h3>Longer-acting stimulants</h3> <p>Longer-acting stimulants last for eight to 14 hours. A child can take one dose in the morning and not need to take another dose at school. Longer-acting stimulants can also help children get through after-school activities.</p> <p>The disadvantage of longer-acting stimulants is that they are sometimes slow to take effect and may interfere with sleep.</p> <h2>How does my child's doctor know if the medication is working?</h2> <p>Your child’s doctor will likely start your child on a small dose and gradually increase it until there is an effect on the target symptoms. The doctor might ask you and your child’s teacher to fill in rating scales at various doses of the stimulants to help them compare the effectiveness of different doses on your child's symptoms.</p> <p>If the first stimulant does not have a positive effect or has too many side effects after a few doses, the doctor will try another stimulant. Children can react differently to medications, but most children will respond well to at least one of them.</p> <p>If your child's symptoms still do not improve after trying three or more different medications, the doctor may reassess your child. It is possible that a diagnosis of ADHD may not be correct or that your child may have other conditions with ADHD.</p><h2>Further information</h2> <p>For more information on ADHD, please see the following pages:</p> <p><a href="/Article?contentid=1922&language=English">ADHD: Overview</a></p> <p><a href="/Article?contentid=1923&language=English">ADHD: Signs and symptoms</a></p> <p><a href="/Article?contentid=1997&language=English">ADHD: How to help your child at home</a></p> <p><a href="/Article?contentid=1999&language=English">ADHD: Communicating with your child's school</a></p> <h2>Resources</h2> <p>The following resources offer support and additional information on ADHD.</p> <h3>Websites</h3> <p><a href="http://www.ldao.ca/" target="_blank">Learning Disabilities Association of Ontario</a></p> <p><a href="http://www.caddac.ca/cms/page.php?2" target="_blank">Centre for ADHD Awareness, Canada - CADAC</a></p> <h3>Journal articles</h3> <p>Chang, Z., et al. (2014). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147667/">Stimulant ADHD medication and risk for substance abuse</a>. <em>J Child Psychol Psychiatr.</em> 55: 878–885. doi:10.1111/jcpp.12164.</p> <p>Dalsgaard, Søren, et al. (2014). <a href="http://www.sciencedirect.com/science/article/pii/S0306460313002608?via%3Dihub" target="_blank">ADHD, stimulant treatment in childhood and subsequent substance abuse in adulthood—a naturalistic long-term follow-up study</a>. <em>Addictive Behaviors</em> 39 (1): 325-328. doi:10.1016/j.addbeh.2013.09.002.</p>
TDAH: traitement à l’aide des médicamentsTTDAH: traitement à l’aide des médicamentsADHD: Treatment with medicationsFrenchPsychiatrySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)BrainBrainDrug treatmentCaregivers Adult (19+)NA2017-06-16T04:00:00ZAlice Charach, MD, MSc, FRCPC;Rosemary Tannock, PhD10.000000000000054.00000000000001214.00000000000Health (A-Z) - ProcedureHealth A-Z<p> Découvrez comment la prise de médicaments accompagnée d’une thérapie comportementale peut contribuer à diminuer les symptômes de TDAH chez l’enfant.</p><p>Les médicaments jouent souvent un rôle important dans le plan de traitement du TDAH, mais ils ne sont pas recommandés aux enfants d’âge préscolaire.</p><p>Les médicaments peuvent être très utiles lors du traitement des principaux <a href="/Article?contentid=1923&language=French">symptômes du TDAH</a>, mais généralement, ils ne règlent pas les autres problèmes qui peuvent contribuer au dysfonctionnement comme l’irritabilité, <a href="/Article?contentid=18&language=French">l’anxiété</a> et le <a href="/Article?contentid=1925&language=French">trouble oppositionnel avec provocation</a>. La prise de médicaments accompagnée d’une thérapie comportementale est la façon la plus efficace de traiter ces problèmes.</p><p>Les médicaments seuls ne peuvent pas non plus remédier aux lacunes d’apprentissage existant avant que l’enfant ne commence le traitement. Il est très important que les enfants atteints du TDAH bénéficient d’un <a href="/Article?contentid=1999&language=French">soutien pédagogique approprié</a> pour les aider à donner la pleine mesure de leur potentiel.</p><h2>À retenir</h2> <ul> <li>Les médicaments sont efficaces pour traiter les principaux symptômes du TDAH, mais ils fonctionnent de façon optimale quand ils sont accompagnés d’une thérapie comportementale axée sur les troubles émotionnels, comportementaux ou de l’apprentissage.</li> <li>Dans la plupart des cas, le TDAH se traite à l’aide de médicaments stimulants. Les effets secondaires fréquents et légers sont les maux de tête, les troubles du sommeil, l’irritabilité et la nervosité. Les effets secondaires rares mais plus graves sont les allergies, l’agitation violente, les problèmes cardiaques et les pensées suicidaires.</li> <li>Le médecin prescrira à votre enfant une faible dose de médicament qu’il surveillera et ajustera au fil du temps afin de s’assurer de son efficacité.</li> <li>Le médecin de votre enfant pourra modifier l’intervalle des doses ou recommander une « fenêtre thérapeutique » afin de minimiser les effets secondaires.</li> </ul><h2>Quels types de médicaments sont utilisés pour traiter le TDAH?</h2> <p>Dans la plupart des cas, le TDAH se traite à l’aide de médicaments stimulants. Depuis plus de quarante ans, on utilise sur une large échelle les médicaments stimulants pour traiter le TDAH. Ils sont efficaces dans au moins les deux tiers des cas et ne provoquent que peu d’effets secondaires.</p> <h3>Effets des médicaments stimulants sur le TDAH</h3> <p>Les stimulants augmentent les niveaux de dopamine et de norépinéphrine dans le cerveau. Les substances chimiques qu’ils contiennent affectent l’humeur, la vivacité, la mémoire, le degré d’attention et la réaction au stress. L’augmentation des niveaux de ces substances chimiques permet de réduire l’inattention, l’hyperactivité et l’impulsivité. Toutefois, les symptômes réapparaissent quand l’effet des médicaments stimulants s’estompe.</p> <p>Il existe des preuves solides des avantages à court terme des médicaments stimulants dans le cadre du traitement des principaux symptômes du TDAH, mais les preuves concernant les avantages à long terme sont plus rares. Par conséquent, il est important de surveiller de près l’effet des médicaments sur le TDAH afin de s’assurer de leur efficacité lorsque votre enfant grandit. Il est également fréquent que les symptômes de TDAH réapparaissent après l’arrêt des médicaments.</p> <h2>Types de médicaments stimulants</h2> <p>Il existe deux types principaux de médicaments stimulants:</p> <ul> <li>le méthylphénidate;</li> <li>les amphétamines.</li> </ul> <p><em>Méthylphénidate</em></p> <p>Les marques de méthylphénidate offertes sur le marché canadien sont:</p> <ul> <li>Biphentin</li> <li>Concerta</li> <li>Ritalin</li> </ul> <p><em>Amphétamines</em></p> <p>Les marques d’amphétamines offertes sur le marché sont:</p> <ul> <li>Adderall XR;</li> <li>Dexedrine Spansule;</li> <li>Vyvanse.</li> </ul> <p>Ces deux types de médicaments stimulants se présentent sous forme de comprimés ou de gélules à avaler en entier, sans mâcher, ou de gélules que l’on peut ouvrir et dont le contenu est mélangé à la nourriture.</p> <h2>Durée d’action des stimulants</h2> <p>Les médicaments stimulants se divisent en deux catégories: les stimulants à action brève et ceux à action prolongée.</p> <h3>Stimulants à action brève</h3> <p>L’effet de ces stimulants dure de trois à cinq heures. Ils agissent généralement entre 15 et 30 minutes après l’ingestion de la première dose.</p> <p>Si l’enfant prend ses médicaments tôt le matin, leurs effets s’estomperont possiblement peu avant le repas du midi. Si l’enfant a besoin de stimulants pour l’école, il devra généralement prendre au moins une autre dose pendant la journée à l’école.</p> <h3>Stimulants à action prolongée</h3> <p>Les stimulants à action prolongée durent entre huit et 14 heures. L’enfant peut prendre un comprimé le matin et n’est pas obligé de prendre une autre dose dans la journée. De plus, les stimulants à action prolongée aident à soutenir les enfants durant leurs activités parascolaires.</p> <p>Quelquefois, le stimulant à action prolongé agit plus lentement et ses effets peuvent nuire au sommeil.</p> <h2>Comment le médecin de mon enfant saura-t-il qu’un médicament est efficace?</h2> <p>Le médecin de votre enfant commencera normalement par lui administrer une faible dose qu’il augmentera progressivement jusqu’à ce qu’elle réagisse sur les symptômes ciblés. Le médecin pourra vous demander, à vous ou à l’enseignant de votre enfant, de remplir une échelle d’évaluation de différentes doses de stimulants afin de comparer leur efficacité sur les symptômes de votre enfant.</p> <p>Si le premier stimulant n’a pas d’effet positif ou s’il produit trop d’effets secondaires après quelques doses, le médecin essaiera un autre stimulant. Les enfants peuvent réagir différemment aux médicaments, mais la plupart d’entre eux réagiront bien à au moins un médicament.</p> <p>Si les symptômes de votre enfant ne s’améliorent pas après l’essai d’au moins trois types de médicaments, le médecin voudra probablement le réévaluer. Il est possible que le diagnostic de TDAH soit erroné ou que votre enfant présente des troubles autres que le TDAH.</p><h2>Pour de plus amples renseignements</h2> <p>Pour de plus amples renseignements sur le TDAH, veuillez consulter les pages suivantes:</p> <p><a href="/Article?contentid=1922&language=French">TDAH: présentation générale</a></p> <p><a href="/Article?contentid=1923&language=French">TDAH: signes et symptômes</a></p> <p><a href="/Article?contentid=1997&language=French">TDAH: comment aider votre enfant à la maison</a></p> <p><a href="/Article?contentid=1999&language=French">TDAH: communiquer avec l’école de votre enfant</a></p> <h2>Sources de renseignements</h2> <p>Les sources de renseignements suivantes peuvent vous offrir un soutien et un complément d’informations sur le TDAH.</p> <h3>Websites</h3> <p><a href="http://www.ldao.ca/" target="_blank">Learning Disabilities Association of Ontario</a></p> <p><a href="http://www.caddac.ca/cms/page.php?2" target="_blank">Centre for ADHD Awareness, Canada - CADAC</a></p>

 

 

ADHD: Treatment with medications1998.00000000000ADHD: Treatment with medicationsADHD: Treatment with medicationsAEnglishPsychiatrySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)BrainBrainDrug treatmentCaregivers Adult (19+)NA2017-06-16T04:00:00ZAlice Charach, MD, MSc, FRCPC;Rosemary Tannock, PhD10.000000000000054.00000000000001214.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Find out how medications can work with behavioural treatment to help a child with ADHD symptoms.</p><p>Medications are often an important part of the treatment plan for ADHD, but they are not recommended for pre-school age children.</p><p>On their own, medications can be very helpful in treating the core <a href="/Article?contentid=1923&language=English">symptoms of ADHD</a>, but they often do not address the range of other possible problems that can contribute to poor functioning, such as irritability, <a href="/Article?contentid=18&language=English">anxiety</a> and <a href="/Article?contentid=1925&language=English">oppositional defiant disorder</a>. These other problems respond best to behavioural treatments in addition to medication.</p><p>Medications also cannot make up for any gaps in learning before a child started ADHD treatment. It is very important that children with ADHD get the <a href="/Article?contentid=1999&language=English">right academic support</a> to help them reach their full potential.</p><h2>Key points</h2> <ul> <li>Medications work well to treat the core symptoms of ADHD but work best with behavioural treatments for any related emotional, learning or behavioural issues.</li> <li>In most cases, ADHD is treated with stimulants. Common, mild side effects include headaches, difficulty falling asleep, irritability and jitteriness. Rare but more serious side effects include allergies, severe agitation, heart problems and suicidal thinking.</li> <li>Your child will be prescribed a low dose of medication that their doctor will monitor and adjust over time to make sure it continues working.</li> <li>Your child’s doctor may change the dose schedule or recommend a "drug holiday" to minimize the side effects.</li> </ul><h2>What types of medications treat ADHD?</h2> <p>In most cases, ADHD is treated with stimulants. These have been widely used for ADHD for more than 40 years. They are effective for at least two-thirds of children with ADHD and have relatively few side effects.</p> <h3>How stimulants treat ADHD</h3> <p>Stimulants increase levels of brain chemicals called dopamine and norepinephrine. These chemicals affect a person’s mood, alertness, memory, level of attention and response to stress. Increasing the levels of these chemicals reduces inattention, hyperactivity and impulsivity. However, symptoms return as the stimulants wear off.</p> <p>There is strong evidence to support the short-term benefits of stimulants for the core ADHD symptoms, but evidence for long-term benefits is more limited. As a result, it is important to monitor ADHD medications closely to make sure that they are still helpful for your child as they grow older. It is also common for ADHD symptoms to return when medications are stopped.</p> <h2>Types of stimulants</h2> <p>There are two main types of stimulant medications:</p> <ul> <li>methylphenidate</li> <li>amphetamines</li> </ul> <p><em>Methylphenidate</em></p> <p>The brands of methylphenidate that are available in Canada include:</p> <ul> <li>Biphentin</li> <li>Concerta</li> <li>Ritalin</li> </ul> <p><em>Amphetamines</em></p> <p>The brands of amphetamines that are available include:</p> <ul> <li>Adderall XR</li> <li>Dexedrine Spansule</li> <li>Vyvanse</li> </ul> <p>Both types of stimulants come in pills or capsules that must be swallowed whole or capsules that can be opened and mixed with food.</p> <h2>How long do stimulants last?</h2> <p>Stimulants fall into two categories: short-acting and longer-acting.</p> <h3>Short-acting stimulants</h3> <p>These stimulants last for three to five hours. They start to take effect usually within 15 to 30 minutes of taking the first dose.</p> <p>The effects of a stimulant taken first thing in the morning may start to wear off before lunchtime. If your child needs these medications for school, they will usually need to take at least one stimulant during the school day.</p> <h3>Longer-acting stimulants</h3> <p>Longer-acting stimulants last for eight to 14 hours. A child can take one dose in the morning and not need to take another dose at school. Longer-acting stimulants can also help children get through after-school activities.</p> <p>The disadvantage of longer-acting stimulants is that they are sometimes slow to take effect and may interfere with sleep.</p> <h2>How does my child's doctor know if the medication is working?</h2> <p>Your child’s doctor will likely start your child on a small dose and gradually increase it until there is an effect on the target symptoms. The doctor might ask you and your child’s teacher to fill in rating scales at various doses of the stimulants to help them compare the effectiveness of different doses on your child's symptoms.</p> <p>If the first stimulant does not have a positive effect or has too many side effects after a few doses, the doctor will try another stimulant. Children can react differently to medications, but most children will respond well to at least one of them.</p> <p>If your child's symptoms still do not improve after trying three or more different medications, the doctor may reassess your child. It is possible that a diagnosis of ADHD may not be correct or that your child may have other conditions with ADHD.</p><h2>What are the side effects of stimulants?</h2> <p>Methylphenidate and amphetamine have similar side effects, some of which are very common.</p> <h3>Common side effects</h3> <ul> <li>Loss of appetite</li> <li>Difficulty falling asleep</li> <li>Stomach discomfort</li> <li><a href="/Article?contentid=29&language=English">Headache</a></li> </ul> <h3>Less common side effects</h3> <ul> <li>Irritability, sadness</li> <li>Subdued personality</li> <li>Increased muscle tension</li> <li>Rapid heart rate</li> <li>Increase in blood pressure</li> <li>Jitteriness</li> <li>Social withdrawal</li> </ul> <p>Some of these side effects are temporary. Many can be relieved by reducing the dose or changing the dosing schedule. Taking the medication with food or a glass of milk can help to relieve stomach discomfort. </p> <p><em>Weight loss and delayed growth</em></p> <p>With long-term use, stimulants may cause weight loss and a slowing of growth for some children. Overall adult height may be reduced by up to 2 to 3 cm, especially in children taking high doses of stimulants without a break over a number of years. Your child's doctor should weigh and measure your child regularly while your child is taking stimulants.</p> <h3>Rare but serious side effects</h3> <p>These include:</p> <ul> <li>hypersensitivity or allergy</li> <li>severe agitation and manic/psychotic symptoms</li> <li>prolonged, painful erections in males (if this rare side effect lasts for more than four hours, take your child to a doctor urgently)</li> <li><a href="/Article?contentid=291&language=English">suicidal thinking or behaviour</a></li> </ul> <h3>Very rare side effects</h3> <p>Stimulants have been used safely in millions of children, but there have been very rare cases of severe cardiac events (such as heart attacks), including sudden death. In most of these cases, the child was later discovered to have had an underlying heart problem. Because of this, make sure to have your doctor do a complete review of your child’s health and medical history (including family history of heart problems) before prescribing stimulants. If there are any concerns your child may need to see a cardiologist (heart specialist) for further tests.</p> <p>Many doctors recommend "drug holidays" to minimize side effects. These "holidays" are periods during which your child does not take stimulants, for instance during the summer or school holidays or on weekends. Your child’s doctor may recommend these breaks if your child functions reasonably well at those times without medication and there are concerns about your child’s weight gain or growth.</p> <h2>Do stimulants lead to drug abuse?</h2> <p>Stimulants are a controlled substance (their use is regulated by the government), which means they are prone to abuse by some people. Stimulants are not considered addictive or likely to increase the risk of substance abuse later in life, when they are used as prescribed to treat ADHD in children and teenagers.</p> <h2>Can my child take stimulants with other medications?</h2> <p>As with any prescription drug, stimulants can have potentially dangerous interactions with other medications. Discuss possible drug interactions with your child’s doctor by telling them about all the prescription medications, supplements and over-the-counter medications your child is currently taking.</p><h2>Further information</h2> <p>For more information on ADHD, please see the following pages:</p> <p><a href="/Article?contentid=1922&language=English">ADHD: Overview</a></p> <p><a href="/Article?contentid=1923&language=English">ADHD: Signs and symptoms</a></p> <p><a href="/Article?contentid=1997&language=English">ADHD: How to help your child at home</a></p> <p><a href="/Article?contentid=1999&language=English">ADHD: Communicating with your child's school</a></p> <h2>Resources</h2> <p>The following resources offer support and additional information on ADHD.</p> <h3>Websites</h3> <p><a href="http://www.ldao.ca/" target="_blank">Learning Disabilities Association of Ontario</a></p> <p><a href="http://www.caddac.ca/cms/page.php?2" target="_blank">Centre for ADHD Awareness, Canada - CADAC</a></p> <h3>Journal articles</h3> <p>Chang, Z., et al. (2014). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147667/">Stimulant ADHD medication and risk for substance abuse</a>. <em>J Child Psychol Psychiatr.</em> 55: 878–885. doi:10.1111/jcpp.12164.</p> <p>Dalsgaard, Søren, et al. (2014). <a href="http://www.sciencedirect.com/science/article/pii/S0306460313002608?via%3Dihub" target="_blank">ADHD, stimulant treatment in childhood and subsequent substance abuse in adulthood—a naturalistic long-term follow-up study</a>. <em>Addictive Behaviors</em> 39 (1): 325-328. doi:10.1016/j.addbeh.2013.09.002.</p>https://assets.aboutkidshealth.ca/AKHAssets/ADHD_treatment_with_medications.jpgADHD: Treatment with medications

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