Medications for Attention Deficit Disorder

The American Academy of Pediatrics estimates that ADHD (attention deficit hyperactivity disorder) affects 4 to 12 percent of school-aged children. Fifty percent of those children will experience symptoms into adulthood. The decision to medicate ADHD is not an easy one, but there are several medications available for ADHD that improve the quality of life for millions of Americans.

Stimulants

Although it sounds counter-productive to give stimulants to someone already struggling with inattention and impulse control, stimulants have been the most widely used medications for ADHD since the 1960s. Stimulants increase the amounts of the neurotransmitters dopamine and norepinephrine in the brain. These neurotransmitters increase alertness, which helps the patient focus and pay attention. Stimulants decrease other symptoms like fidgeting and incessant talking as well.

Methylphenidate (Ritalin) is the best known drug in this class. It comes in many different strengths and dosage forms, including a transdermal skin patch and slow-release tablets and capsules. Dexedrine, Adderall, Desoxyn, Vyvanse and Cylert are other stimulants used for ADHD. Provigil, a drug developed for narcolepsy, has also shown some promise for use in ADHD, but should not be used in children. Because stimulants are often abused, they are classified as controlled substances, and their use is kept under tighter control than most prescription drugs.

Stimulants can cause insomnia and decrease appetite. They sometimes slow growth, but children eventually catch up to their genetically predetermined height. Doctors usually encourage parents to give their children drug holidays, or breaks from the medication, during weekends and school vacations.

Stimulants increase blood pressure and heart rate. The American Heart Association recommends that patients undergo a ECG (electrocardiogram) to check for any underlying heart conditions before they begin taking stimulants.

Norephinephrine Reuptake Inhibitors (NRI)

Atomoxetine (Strattera) was approved by the FDA in 2002. It increases norepinephrine in the central nervous system. Atomoxetine does not have the potential for abuse that is found with stimulants. Its side effects are dry mouth, trouble sleeping, upset stomach and increased heart rate. In 2005, the FDA issued a black box warning for Strattera, informing physicians of an increased risk of suicidal thinking in children and teenagers taking this drug.

Antidepressants

The tricyclic antidepressants imipramine and desipramine, along with the atypical antidepressant bupropion (Wellbutrin) have shown to help with ADHD. They are not FDA approved for use in ADHD, but their use for ADHD treatment is well known among doctors. Tricyclics increase levels of the neurotransmitters norepinephrine and serotonin. Side effects of these drugs are dry mouth, blurred vision and constipation.

Alpha-2 Agonists

Clonidine and guanfacine are classified as high blood pressure medications, but they also are prescribed off-label to treat ADHD. They are mostly used to offset the undesirable side effects of stimulant drugs, like insomnia and agitation, but they also improve impulse control in children with ADHD. Clonidine and guanfacine can cause drowsiness and dizziness. Patients wishing to stop taking alpha-2 agonists should taper off under the guidance of their physicians, since stopping the drug suddenly can cause a dangerous spike in blood pressure.