Attention-deficit hyperactivity disorder is a common disorder that affects behavior, cognition and emotions. In the United States, between 5 and 8 percent of children have been diagnosed with ADHD. The exact cause of ADHD is not known; it is thought that genetics plays a large role. Additionally, certain family environments (chronic stress) and even maternal factors (smoking during pregnancy) may be risk factors for developing ADHD. It is a serious condition that may put children at risk for developing a variety of other disorders, including anxiety and substance-use disorders. Fortunately, a number of medications are available to help treat ADHD.
Stimulants
Stimulants are the most commonly prescribed group of drugs for ADHD. About 75 percent of children prescribed stimulant medications will feel an improvement in their attention span, a decrease in their hyperactivity, and less impulsivity. If one stimulant is prescribed and doesn't work, another stimulant may be more effective--it is worth trying different medications before deciding that the whole group of stimulants do not work.
Methylphenidate-containing stimulants include Concerta, Metadate, Methylin, Ritalin, Ritalin LA, Ritalin SR, Daytrana, Transdermal, Focalin, and Focalin XR.
Amphetamine-containing stimulants include Adderall, Dexedrine, Dextrostat, Adderall, and Adderall XR.
Both methylphenidate and amphetamine stimulants are short-acting (start working within 30-60 minutes and last around two to five hours). However, a newer class of longer-acting stimulants has made a big difference in the treatment of ADHD because there is no need to re-administer the medicine in the middle of a school day. So for instance, a parent could give her child Adderall XR and it would last for 12 hours. Similarly, a medication such as Ritalin LA lasts eight hours, so giving the medicine right before school allows the child to be focused throughout the school day.
Temporary side effects include a lack of appetite, insomnia, feeling on-edge, and upset stomach.
Strattera: A Specific Norephinephrine Reuptake Inhibitor
Atomexetine (Strattera) belongs to a new class of medicine called specific norephinephrine reuptake inhibitors (SNRIs); it is the only non-stimulant medication approved by the FDA for the treatment of ADHD. This medication works by increasing levels of a chemical in the brain called norephinephrine. In cases in which stimulants have been tried but have not helped the child with ADHD, Strattera may be an alternative.
Antidepressants
While certain medicines used to treat depression may also work to treat ADHD, two important points to note are, first, these are not the first choice for ADHD treatment in children, and secondly, only certain types of antidepressants are useful. For instance, tricyclic antidepressants may be effective in treating ADHD because they increase levels of certain chemicals in the brain, including norephinephrine. An antidepressant called bupropion (Wellbutrin) also does this, and may work to treat ADHD.
Antihypertensives
The blood pressure medications clonidine (Catapres) and guanfacine (Tenex) have been used to treat ADHD in children and may be especially helpful in younger children, and to help deal with some of the specific symptoms of ADHD such as aggression. Clonidine is less sedating than guanfacine but is shorter acting.
References
- "Current Diagnosis and Treatment: Pediatrics"; William Hay et. al.; 2007
- "Current Diagnosis & Treatment: Psychiatry"; Michael Ebert et. al.; 2008
