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Common ADHD Medications & Treatments for Children

ADHD Treatments ADHD Treatments

For most children, stimulant medications are a safe and effective way to relieve ADHD symptoms. As glasses help people focus their eyes to see, these medications help children with ADHD focus their thoughts better and ignore distractions. This makes them more able to pay attention and control their behavior.

Stimulants may be used alone or combined with behavior therapy to treat children with ADHD.

Studies show that about 80% of children with ADHD who are treated with stimulants improve a great deal once the right medication and dose are determined.

Two forms of stimulants are available:

  • Immediate-release (short-acting) medications usually are taken every 4 hours, when needed. They are the cheapest of the medications. Extended-release medications usually are taken once in the morning.

  • Extended-release (intermediate-acting and long-acting) medications are usually taken once in the morning. Children who take extended-release forms of stimulants can avoid taking medication at school or after school. It is important not to chew or crush extended-release capsules or tablets. However, extended-release capsules that are made up of beads can be opened and sprinkled onto food for children who have difficulties swallowing tablets or capsules.

Non-stimulant ADHD medication can be tried when stimulant medications don't work or cause bothersome side effects.

Common ADHD Medications

Brand name

Generic Name

Duration

Short-acting amphetamine stimulants

Adderall

Mixed amphetamine salts

4 to 6 hours

Dexedrine

Dextroampheta mine

4 to 6 hours

Dextrostat

Dextroampheta mine

4 to 6 hours

Short-acting methylphenidate stimulants

Focalin

Dexmethylphenidate

4 to 6 hours

Methylin

Methylphenidate (tablet, liquid, and chewable tablets)

3 to 5 hours

Ritalin

Methylphenidate

3 to S hours

Intermediate-acting methylphenidate stimulants

Metadate CO

Extended-release methylphenidate

6 to 8 hours

Ritalin LA

Extended-release Methylphenidate

6 to 8 hours

Long-acting amphetamine stimulants

Adderall-XR

Extended-release amphetamine

10 to 12 hours

Dexedrine Spansule

Extended-release amphetamine

6+ hours

Vyvanse

Lisdexamfetamine

10 to 12 hours

Long-acting methylphenidate stimulants

Concerta

Extended-release methylphenidate

10 to 12 hours

Daytrana

Extended-release methylphenidate (skin patch)

11 to 12 hours

Focalin XR

Extended release dexmethylphemdate

8 to 12 hours

Quillivant XR

Extended-release methylphenidate (liquid)

10 to 12 hours

Long-acting non-stimulants

Intuniv

Guanfacine

24 hours

Kapvay

Clonidine

12 hours

Strattera

Atomoxetine

24 hours

Products are mentioned for informational purposes only and do not imply an endorsement by the American Academy of Pediatrics. Your doctor or pharmacist can proside you with important safety information for the products listed.

Which ADHD medication is best for my child?

It may take some time to find the best medication, dosage, and schedule for your child. Be patient with the process. Your child may need to try different types of stimulants or other medication. Some children respond to one type of stimulant but not another.

  • What dosage? The amount of medication (dosage) that your child needs also may need to be adjusted. The dosage is not based solely on his weight. Your pediatrician will vary the dosage over time to get the best results and control possible side effects.

  • When to give it? The medication schedule also may be adjusted depending on the target ­outcome. For example, if the goal is to get relief from symptoms mostly at school, your child may take the medication only on school days.

  • Is it working? It is important for your child to have regular medical checkups to monitor how well the medication is working and check for possible side effects.

Is there a shortage of Adderall?

The U.S. Food & Drug Administration recently announced a shortage of immediate release formulation of amphetamine mixed salts. These are often referred to by the brand name Adderall or Adderall IR. Amphetamine mixed salts, including Adderall, are FDA-approved for the treatment of ADHD and narcolepsy. Talk with your pediatrician about alternative therapies available, such as the extended-release version of amphetamine mixed salts. They can advise which may work best for your child until the shortage eases.

What side effects can stimulants cause?

Side effects occur sometimes. These tend to happen early in treatment and are usually mild and short-lived, but in rare cases they can be prolonged or more severe.

The most common side effects include:

  • Decreased appetite/weight loss

  • Sleep problems

  • Social withdrawal

Some less common side effects include:

  • Rebound effect (increased activity or a bad mood as the medication wears off)

  • Transient muscle movements or sounds called tics

  • Minor growth delay

The same sleep problems do not exist for atomoxetine, but initially it may make your child sleepy or upset her stomach. There have been very rare cases of atomoxetine needing to be stopped because it was causing liver damage. Rarely atomoxetine increased thoughts of suicide. Guanfacine and clonidine can cause drowsiness, fatigue, or a decrease in blood pressure.

Most side effects can be relieved by:

  • Changing the medication dosage

  • Adjusting the schedule of medication

  • Using a different stimulant or trying a non-stimulant

Monitoring the effects of your child's medication

Close contact with your pediatrician is needed until you find the best medication and dose for your child. After that, periodic monitoring by your doctor is important to maintain the best effects.

To monitor the effects of the medication, your pediatrician will probably have you and your child's teachers fill out behavior rating scales, observe changes in your child's target goals, notice any side effects, and monitor your child's height, weight, pulse and blood pressure.

Stimulants, atomoxetine, and guanfacine may not be an option for children who are taking certain other medications or who have some medical conditions, such as congenital heart disease.

More than half of children who have tic disorders, such as Tourette syndrome, also have ADHD.

Tourette syndrome is an inherited condition associated with frequent tics and unusual vocal sounds. The effect of stimulants on tics is not predictable, although most studies indicate that stimulants are safe for children with ADHD and tic disorders in most cases. It is also possible to use atomoxetine or guanfacine for ­children with ADHD and Tourette syndrome.

Are children getting high on stimulant medications?

When taken as directed by a doctor, there is no evidence that children are getting high on stimulant drugs such as methylphenidate and amphetamine. At therapeutic doses, these drugs also do not sedate or tranquilize children and do not increase the risk of addiction.

Stimulants are classified as Schedule II drugs by the US Drug Enforcement Administration because there is abuse potential of this class of medication. If your child is on this medication, it is always best to supervise the use of the medication closely. Atomoxetine and guanfacine are not Schedule II drugs because they don't have abuse potential, even in adults.

Are stimulant medications gateway drugs leading to illegal drug or alcohol abuse?

People with ADHD are naturally impulsive and tend to take risks. But patients with ADHD who are taking stimulants are not at a greater risk and actually may be at a lower risk of using other drugs. Children and teenagers who have ADHD and also have coexisting conditions may be at ­higher risk for drug and alcohol abuse, regardless of the medication used. See ADHD and Substance Abuse: The Link Parents Need to Know for more information.

Unproven ADHD Treaments:

There is no scientific evidence that the following methods work and they are not recommended.

  • Megavitamins and mineral supplements

  • Anti–motion-sickness medication (to treat the inner ear)

  • Treatment for candida yeast infection

  • EEG biofeedback (training to increase brain-wave activity)

  • Applied kinesiology (realigning bones in the skull)

  • Reducing sugar consumption

  • Optometric vision training (asserts that faulty eye movement and sensitivities cause the behavior problems)

Always tell your pediatrician about any alternative therapies, supplements or medications that your child is using. These may interact with prescribed medications and harm your child.

More information

Last Updated
10/20/2022
Source
American Academy of Pediatrics (Copyright © 2019)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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