ADHD Medication
There is no cure for ADHD but there are medicines which control and minimise the symptoms. However it is has been proven that medicine alone is not enough. Instead it should be used in conjunction with relevant support mechanisms, which will vary from child to child, such as anger management, parenting classes for parents and self-esteem building therapies and activities.
Types of Medicine
Stimulant medications such as the following have been used to treat ADHD for over 30 years:
Methylphenidates: – Concerta XL, Equasym, Equasym XL, Medikinet, Medikinet XL and Ritalin
Dexamfetamine (Dexedrine)
In May 2004 a non-stimulant medicine Atomoxetine (Strattera) was licensed. This medication is slower acting than those listed above and therefore medicine breaks* are so effective or advisable.
How they Work
These medicines all work by affecting the chemicals nor adrenaline and dopamine in the areas of the brain which are responsible for controlling attention and behaviour. These are underactive in people with ADHD and therefore the medicine controls the symptoms of ADHD. They can improve attention span and lead to calmer and less hyperactive, impulsive or aggressive behaviour.
Therefore people on medication: -
- listen to others better
- concentrate and focus better
- think more clearly
- think before acting
- stay interested in a subject
- sit still without fidgeting
- behave better
As a result, your child may: -
- be more likely to understand school work
- be less likely to become bored, restless and disruptive
- no longer need to act impulsively to feel interested or stimulated
- learn better and show an improvement in results at school
- find it easier to make friends and interact with people
“I kept my son off medication as long as I could but when I started to get complaints at school and new he was at risk of being suspended I decided that it was worth trying. The school saw a marked improvement, he felt much better about himself and I was less stressed as a result.” (parent)
All of this can help improve your child’s self-esteem and behaviour in the long-term. Unfortunately they do not work for everyone and a very small percentage are unable to tolerate the medicine due to other conditions, such as Tourette’s Syndrome.
Once a diagnosis has been made medication will be discussed with parents. In the Northern Health Board area medication is prescribed only by the psychiatrist at the Child and Adolescent Mental Service or occasionally by a consultant paediatrician.
The effectiveness of the medication varies with some showing instantaneous improvement and others not showing any improvement at all. A very small dose is given to start with and this is increased gradually and according to the size of the child.
If one particular medicine is not working other options should be discussed with the doctor. Our parents report that what may work for one child does not necessarily work for another.
“The effect of the medication on my son was very quickly noticed at home and at school. He could concentrate better, do his sports better and his behaviour was much better.” (parent)
Some doctors recommend that after about a year the child takes a break in order to reassess his ADHD. Although the behaviours do not deteriorate immediately most parents find that before long the old behaviours return and are keen to resume the medication as soon as possible. There are of course some cases were parents see little to no improvement when the medication is resumed. In this case doctors will likely recommend that it is stopped completely.
Every child is different and some may show signs of maturity and manage okay without their medication once they reach puberty, while others find that problems escalate at this stage and the medication needs to be increased.
Side-effects
Like all medicines these have side-effects, although it does not follow that these will affect everyone and that the side effects are the same for everyone.
If side-effects are a problem, they may improve by reducing the dose. Side-effects sometimes improve after several weeks of ongoing treatment. If parents suspect a side effect they can stop the medication for a few days or more until the problem settles down, then start it again to see if it returns.
The most common side-effects associated with the stimulant medicines are a reduced appetite and difficulty getting to sleep. However many parents all report sleep problems whether on medication or not.
The most common side-effect are a reduced appetite and stomach ache.
A doctor or nurse should check your child’s weight and height regularly to make sure growth is not affected by the medicine’s effect on appetite.
Your child’s heart rate and blood pressure should also be checked regularly to make sure the medication doesn’t increase them to unacceptable levels.
Medicine Breaks*
Most parents prefer to only give their child medication during the school week and don’t give it at the weekend or during holidays, except perhaps on special occasions, such as weddings or family events.
For those children for whom the medication suppresses their appetite they will suddenly become very hungry after their afternoon dose wears off and make up for it over the remainder of the evening.
“My son did most of his eating at suppertime once his medication had worn off. During holidays I could not fill him and at these times he had growth spurts.” (parent)
One parent reported that one night she could not get to sleep and remembered she had forgotten to take her antidepressants before retiring to bed. She went to where medication is stored in the house and accidentally took her son’s Ritalin. She spent the rest of the night wide awake and could not even shut her eyes. She eventually got up and got started on the housework. She found that her concentration for a few hours was much better than usual and she felt motor driven. This would have been a good thing had she taken it in the morning but not so good as it kept her awake at night.
Overcoming the sleep problems with Melatonin (Circadin)
These tablets contain the active ingredient melatonin, which is a type of hormone that is produced naturally in the body.
More information about medication can be found on the netdoctor website. www.netdoctor.co.uk/adhd/adhdmedication.htm