Attention Deficit Hyperactivity Disorder (ADHD) was formerly known as Attention Deficit Disorder (ADD). The name was changed to reflect the presence of three types of ADHD, the inattentive type, hyperactive/impulsive type, and the combined type. It is a disorder diagnosed in childhood where a child demonstrates significant difficulties in sustaining attention and/or controlling hyperactive and impulsive behaviors. While children can be treated with behavioral therapy, many are being treated with medication. Stimulant medications, such as Ritalin, Concerta, Adderall, and Dexedrine, work to minimize the symptoms of ADHD, both inattentiveness and hyperactive/impulsive behavior. The National Resource Center for ADHD reports that between 70 and 80 percent of children who use stimulant medications show significant reduction in their symptoms. A newer form of medication, a non-stimulant known as Strattera, was introduced on the market in 2002 and is also demonstrating efficacy in treating the symptoms of ADHD.
Ritalin and Concerta
Both Ritalin and Concerta are methlyphenidate preparations of stimulant medication used to treat ADHD. Ritalin is available in short acting, long acting, and extended release forms. The short acting form begins working within 20 minutes, but remains effective for about four hours. The long acting form of Ritalin releases half of its dosage initially, and another four hours later, allowing it to provide symptom relief for eight hours. The extended release form releases half of the medication after one hour, and the other half three and a half hours afterward, providing coverage for between six and eight hours. Concerta was developed and approved in 2000 as an extended release form of methylphenidate. It differs from other forms in its release system. The capsule initially releases a dose of medication, but then gradually administers the rest of the medication over the course of a day, providing symptom relief for up to 12 hours.
Adderall and Dexedrine
Adderall and Dexedrine are both amphetamine preparations of stimulant medications. Adderall is available in generic and extended release preparations. The generic form is available in varying doses and can be effective for anywhere from three to eight hours, depending on the individual. Extended release Adderall releases half its dosage within an hour of being taken, and the remainder three and a half hours later. It provides symptom relief for about 10 hours. Dexedrine can be obtained in short acting and sustained release forms. The short acting form begins working within 20 minutes and remains effective for up to five hours. The sustained release form of Dexedrine is similar to Adderall's extended release in that it releases half its dose after an hour, and the second half of its dose after another three-and-a-half hours have passed. It usually remains effective for six to eight hours. According to the National Institute of Mental Health, the general forms of Adderall and Dexedrine, along with Dextrostat, another amphetamine stimulant, are the only stimulant medications approved for children under the age of 6.
Strattera
Although stimulant medications are more commonly used to treat ADHD, a non-stimulant medication was approved in 2002 for the treatment of ADHD. Strattera acts on norepinephrine in the brain to minimize symptoms of inattention, hyperactivity, and impulsiveness. Because it is not a "controlled substance," like stimulants, there is less risk of abuse. However, Strattera takes a few weeks to begin demonstrating effects on the child, whereas stimulants begin working almost immediately. Strattera can provide symptom relief for 24 hours when children are given the correct dosage one or two times each day. Research has been conducted that demonstrates the efficacy of Strattera as a treatment for ADHD. For those children who do not respond to stimulants, or have some complication in taking them, this medication provides a good alternative.
Possible Side Effects
While stimulant medications have been well researched and are considered very safe, there are risks for potential side effects. Common side effects include difficulty sleeping, decrease in appetite, headache or stomachache, irritable behavior, feelings of anxiety, and potential weight loss. A less common side effect is the development of tics or changes in the child's personality. Rare side effects that are noted are heart problems, mainly in persons with preexisting conditions, or psychiatric problems, such as hearing voices. In Strattera specifically, there is an increased risk for thoughts of suicide. These side effects are rare, but should be carefully monitored in any child taking medication for ADHD.
