Video 8: FAQs Medication for Children with ADHD

Hello, my name is Erica. Welcome to this next edition in our series of videos to help caregivers of children with ADHD. I am a caregiver of a child with ADHD myself and today I get to have a conversation with Dr. Zia Gajary to answer some of the most common and important questions about medication for children with ADHD. Let’s get started!

Medication is one of two treatment approaches that are supported by research for youth with ADHD, the other being behavior therapy (see other videos)

Medication is the most common treatment for ADHD, with around 70% of children diagnosed with ADHD taking a medication for ADHD and it is very effective at improving the symptoms of ADHD with around 70-80% of children who take medication for ADHD experiencing improvement in ADHD symptoms.

However, many parents have concerns about having their children take a behavioral health medication and, though reducing symptoms is extremely important, medication does not address all problems related to ADHD.

This video in our series will give you basic information about medication to help in your decision on whether medication for ADHD is right for your child and family.

Should my child with ADHD be on medication?
This is a personal choice that is up to parents and should be discussed with the health care provider. In general, medications are used when a child’s school performance, relationships, or safety are significantly impacted by their ADHD symptoms.

What do medications help with and what don’t they help with?
Medication typically helps to improve symptoms of ADHD such as a short attention span, hyperactivity (like not being able to sit still), or difficulty with impulse control (like interrupting or having difficulty waiting for a turn).

Medication doesn’t cure ADHD. Medication helps while it is being taken and then stops helping when medication stops being taken.

Medication does not teach skills. Problems with study skills, social skills, rule following at home and at school, time management, and planning are examples of skills that are unlikely to improve with medication alone. This is why a combination approach with behavior therapy may be the approach most likely to address a child’s difficulties.

What are the different kinds of medication for ADHD?
Stimulants (Can help impulses, improve attention, time on task) (ex. Adderall, Ritalin, Concerta, Dexedrine)

Majority of children’s symptoms improve on a stimulant
There are slow, intermediate, and long-acting stimulants, impacting how frequently meds need to be taken

Non-stimulant medications can help with concentration and impulse control
(ex. Atomoxetine, Guanfacine, Clonidine)

Non-stimulant medications are commonly used with stimulants and as a secondary option if the side effects of a stimulant are too strong or if symptoms do not improve that much with a trial of stimulant medications

Though each child is different, in general, non-stimulant medications may be less effective than stimulant medication

What are the side effects?
The most common side effects of stimulant treatment for ADHD are decreased appetite (with associated weight loss), sleep difficulties, headaches, stomachaches, and moodiness or irritability.

Some non-stimulants can make children drowsy and others may cause nausea. Unlike stimulants that all tend to have similar side effects, non-stimulants may vary more. It’s best to talk to your doctor about each specific option.

If I think medication for ADHD may be right for my child, what is the process?
Medication can be prescribed by a pediatrician, nurse practitioner, or psychiatrist. Discuss options with your health care provider.

Generally, when your child starts a medication, he or she will be closely monitored with more check-ins during the first part of treatment, as you work together to find the medication type and dose that improves your child’s performance with few or minimal side effects. After that, follow-up visits may occur every 3-6 months.

Children are often prescribed the lowest dose of stimulant to start treatment, with gradual increase in medication over several weeks until benefits are achieved. The first dose is often not the optimal final dose, and PATIENCE is needed. If stimulants are not effective or well-tolerated, non-stimulants may be prescribed. You may be asked to keep track of your child’s behaviors and symptoms to help the health care provider understand your child’s improvement, or lack of improvement. Parent and teacher questionnaires can be a very effective way to track response to treatment over time.

What about long-term? Will my child have to take medication for ADHD forever?
“Some children, depending on the severity of their ADHD symptoms, may be able to manage without medication. Others continue to take medication all through high school and even when they go off to college”.

The hyperactivity symptoms are more likely to improve with age while inattentive and impulsive symptoms are more likely to continue throughout your child’s development. You can work with your doctor to find the right care plan for your child and adjust over time.

Is a medication “holiday”, like taking a break during school breaks, is that ok?
Medication holidays, under your doctor’s supervision, are often necessary in determining if your child still needs medication and to monitor any progress.

Medication holidays should not be done without consulting your clinician. Research shows children who stick to a consistent medication plan year-round achieve better outcomes. This is because children being treated for ADHD can benefit from medication in ways other than just during school hours and may help them find more success with friends, family, and in recreational activities.

Are medications for ADHD addictive?
Medications for ADHD are not considered to have a significant risk of addiction nor is there withdrawal associated with medication for ADHD when they are taken as prescribed.

However, medication can be misused by using more than the prescribed amount, giving the drug to a friend without a prescription to “cram” before a test, attempting to improve alertness for an important presentation or sports event, using medication with alcohol or other drugs or selling medication to others. Parents should make sure they keep track of their child’s medication for these reasons.

In general, taking medication for ADHD during childhood does not appear to be linked to a risk of substance abuse in adolescence and adulthood.