MedicationsFor decades, medications have been used to treat the symptoms of ADHD.
The medications that seem to be the most effective are a class of drugs known as
Stimulants. Following is a list of the stimulants, their trade (or brand) names, and their generic names. “Approved age” means that the drug has been tested and found safe and effective in children of that age.
| Trade Name | Generic Name | Approved Age |
| Adderall | amphetamine | 3 and older |
| Concerta | methylphenidate
(long acting) | 6 and older |
| Cylert* | pemoline | 6 and older |
| Dexedrine | dextroamphetamine | 3 and older |
| Dextrostat | dextroamphetamine | 3 and older |
| Focalin | dexmethylphenidate | 6 and older |
| Metadate ER | methylphenidate
(extended release) | 6 and older |
| Metadate CD | methylphenidate
(extended release) | 6 and older |
| Ritalin | methylphenidate | 6 and older |
| Ritalin SR | methylphenidate
(extended release) | 6 and older |
| Ritalin LA | methylphenidate
(long acting) | 6 and older |
| *Because of its potential for serious side effects affecting the Liver, Cylert should not ordinarily be considered as first-line drug therapy for ADHD. |
The U.S. Food and Drug Administration (FDA) recently approved a medication for ADHD that is not a stimulant. The medication, Strattera®, or atomoxetine, works on the neurotransmitter norepinephrine, whereas the stimulants primarily work on dopamine. Both of theses Neurotransmitters are believed to play a role in ADHD. More studies will need to be done to contrast Strattera with the medications already available, but the evidence to date indicates that over 70 percent of children with ADHD given Strattera manifest significant improvement in their symptoms.
Some people get better results from one medication, some from another. It is important to work with the prescribing physician to find the right medication and the right dosage. For many people, the stimulants dramatically reduce their Hyperactivity and impulsivity and improve their ability to focus, work, and learn. The medications may also improve physical coordination, such as that needed in handwriting and in sports.
The stimulant drugs, when used with medical supervision, are usually considered quite safe. Stimulants do not make the child feel “high,” although some children say they feel different or funny. Such changes are usually very minor. Although some parents worry that their child may become addicted to the medication, to date there is no convincing evidence that stimulant medications, when used for treatment of ADHD, cause drug abuse or dependence. A review of all long-term studies on stimulant medication and substance abuse, conducted by researchers at Massachusetts General Hospital and Harvard Medical School, found that teenagers with ADHD who remained on their medication during the teen years had a lower likelihood of substance use or abuse than did ADHD adolescents who were not taking medications.
The stimulant drugs come in long- and short-term forms. The newer sustained-release stimulants can be taken before school and are long-lasting so that the child does not need to go to the school nurse every day for a pill. The doctor can discuss with the parents the child’s needs and decide which preparation to use and whether the child needs to take the medicine during school hours only or in the evening and on weekends too.
If the child does not show symptom improvement after taking a medication for a week, the doctor may try adjusting the dosage. If there is still no improvement, the child may be switched to another medication. About one out of ten children is not helped by a stimulant medication. Other types of medication may be used if stimulants don’t work or if the ADHD occurs with another disorder. Antidepressants and other medications can help control accompanying Depression or Anxiety.
Sometimes the doctor may prescribe for a young child a medication that has been approved by the FDA for use in adults or older children. This use of the medication is called “off label.” Many of the newer medications that are proving helpful for child mental disorders are prescribed off label because only a few of them have been systematically studied for safety and efficacy in children. Medications that have not undergone such testing are dispensed with the statement that “safety and efficacy have not been established in Pediatric patients.”
