Medicines to Treat ADHD in Children

Children who have attention deficit hyperactivity disorder (ADHD) are often given medicine as part of their treatment plan. Healthcare providers usually prescribe psychostimulants, such as methylphenidate. These medicines help balance chemicals in your child's brain that help to control their behavior and focus their attention.

Healthcare providers also prescribe other psychostimulants. These include dextroamphetamine, a mixture of amphetamine salts, and atomoxetine.

Psychostimulants act quickly. They do their job over the course of 1 to 4 hours. They are then quickly flushed from the body. Newer psychostimulants on the market are designed to be longer acting. They work for up to 9 hours and need to be taken only once a day.

Occasionally, nonstimulant medicines may be used to treat ADHD in children. These include the antidepressants bupropion, desipramine, and imipramine.

Your healthcare provider will determine your child's need for medicine and select the appropriate medicine. This is done after evaluating your child's symptoms, age and health, and your preference.

Possible side effects

Psychostimulant medicines can cause side effects, but most are mild and ease with time. Side effects include insomnia, decreased appetite, stomach ache, headache, and nervousness. In addition, when the medicine's effects wear off, some children's hyperactive behaviors may increase for a short while.

The FDA has ordered that medicine guides for parents be included with prescriptions for psychostimulants. That's because of recent reports of sudden death in children and teens with heart abnormalities who were taking these medicines for ADHD. A slightly increased risk for paranoia, mania, or hearing voices also happens in youngsters who take these medicines.

When to take

The best time for your child to take a long-acting, once-a-day medicine is just after breakfast. Shorter-acting medicines are best taken 30 to 45 minutes before a meal—before breakfast and before lunch. 

Medicine can be taken during the week, with a medicine “vacation” on the weekend. Your healthcare provider can discuss whether this is appropriate for your child. Some children do not tolerate stopping for 2 days, and they develop behavior problems. Medicine also is often stopped during the summer months, when school is out. Your healthcare provider can discuss the appropriate schedule for your child.

Other therapies

Although some experts (and parents) criticize what they see as an overuse of psychostimulants, these medicines have proven to be effective and safe for the treatment of ADHD. Other treatment choices may be harder to follow, less effective, and sometimes not easily available to families. Alternatives to psychostimulants medicines, such as methylphenidate, include behavioral counseling, educational support in the form of smaller classes and individualized attention, tutoring, and training in social skills.

Psychostimulants often are used in conjunction with other therapy. This includes behavioral and psychological treatment. Some parents have turned to such different treatments as biofeedback, megavitamins, and blue-green algae. Discuss any alternative treatments with your healthcare provider before trying them, particularly if your child is also taking medicines at the same time.

Whatever the treatment, if your child has ADHD, he or she may have difficulty concentrating even while growing up. Most children outgrow the hyperactivity and impulsiveness of their younger years. Yet, as adults, they may continue to have difficulty getting organized or completing long-term projects.