Attention deficit hyperactivity disorder, or ADHD, starts during childhood and can affect children's ability to pay attention and control their behavior. Some patients manage their symptoms using medications. The Centers for Disease Control and Prevention notes that 56 percent of ADHD patients between the ages of four and 17 use medication as of 2003. Several types of medications exist to manage the symptoms of the disorder, though they have different features and side effects that parents and patients should know about.
Types
The U.S. Food and Drug Administration approved two types of medications for ADHD: stimulant medications and nonstimulant medications. Also called psychostimulants, stimulant medication options include dextroamphetamine, methylphenidate, amphetamine-dextroamphetamine, dexmethylphenidate and lisdexamfetamine. One nonstimulant medication is on the market: atomoxetine. Some patients may take it off-label medications for ADHD, which means the U.S. Food and Drug Administration has not approved its use for the disorder but the medication may help with symptom control. Off-label medications for ADHD include antidepressants and alpha-2 agonists. The University of Maryland Medical Center lists bupropion, nortriptyline and imipramine as antidepressants for ADHD and clonidine and guanfacine as alpha-2 agonists for ADHD. Antidepressants may help patients who do not respond to stimulant or nonstimulant medications or who have a mood disorder, such as depression. Alpha-2 agonists may decrease some of the side effects of ADHD medications, as well as treat aggressive symptoms.
Function
Each of these medications for ADHD work by affecting certain neurotransmitters in the brain. For example, the University of Maryland Medical Center explains that methylphenidate and dexmethylphenidate increase dopamine levels, while dextroamphetamine, amphetamine-dextroamphetamine and lisdexamfetamine affect the reabsorption of both norepinephrine and dopamine. Nonstimulant medication also affects dopamine and norepinephrine, while alpha-2 agonists affect norepinephrine. The neurotransmitters that antidepressants affect depend on the specific antidepressant. For example, bupropion affects three neurotransmitters: dopamine, serotonin and norepinephrine.
Time Frame
The MayoClinic.com points out that stimulant medications come in both short-acting and long-acting forms. For example, short-acting stimulant medications last for about four hours, while the long-acting stimulant medications last between six and 12 hours. If a patient takes a short-acting stimulant medication, he may need to take his medication two to three times a day. Helpguide.org adds that nonstimulant medication lasts for over 24 hours per dose. Antidepressants may take up to six weeks to start working.
Side Effects
All the medications for ADHD cause some side effects. Stimulant medications may cause irritability, an upset stomach, a racing heartbeat, sleeping problems and a loss of appetite. Other side effects include tics, dizziness, depression and headaches. The MayoClinic.com warns that stimulant medications may cause heart problems in some patients. Side effects of nonstimulant medication include mood swings, headaches, nausea, abdominal pain and sleepiness. Warnings for nonstimulant medication include possible liver problems and an increase in suicidal thoughts. Antidepressants may cause agitation, headaches, stomach problems and restlessness. A warning of increased suicidal thoughts also exists for antidepressants, particularly in younger users. Sleepiness may occur with an alpha-2 agonist.
Considerations
Arthur Schoenstadt, M.D., author of the eMedTV article "ADHD Medications," points out that 80 percent of the children with ADHD continue to use medication as teenagers and over 50 percent continue to use them into adulthood. While medication may help with symptoms, they do not cure the disease. If a child takes a stimulant medication, parents may need to watch the number of pills to make sure that the patient or her friends are not abusing it. A child's doctor may suggest combining the medication with a non-pharmacological treatment, such as behavior therapy.
References
- MayoClinic.com: Attention-Deficit/Hyperactivity Disorder (ADHD) -- Treatment and Drugs
- Helpguide.org: ADD/ADHD Medications
- EMedTV: ADHD Medications
- University of Maryland Medical Center: Attention Deficit Hyperactivity Disorder -- Medications
- Centers for Disease Control and Prevention: ADHD, Data and Statistics
