When considering medication for ADHD, child benefits must be carefully weighed by parents. Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood, estimated to affect around 9.4% of children in the US. With rising rates of diagnosis, more parents are faced with the difficult decision of whether or not to put their child on medication to manage symptoms. They must weigh the potential benefits of medication in improving their child's focus, impulsivity and hyperactivity against worries over side effects and long-term impacts. Concerns over stunted growth, appetite loss, sleep troubles and personality changes lead many parents to initially resist medication. However, untreated ADHD can also negatively impact a child's life, disrupting learning, relationships and emotional health. Navigating these options is confusing and highly personal for each family.
Should you medicate ADHD child or not? There are many doctors, parents, teachers, psychologists, and complete strangers who will give you their experiences and opinions about medication for Attention Deficit Hyperactivity Disorder (ADHD). There are those who swear by medication and those who believe it is tantamount to child abuse. Either way, it is an extremely personal decision that cannot be made for you. Every experience is unique with those who choose a natural or medical approach to treating ADHD. It is important to look at evidence from medical or scientific journals instead of the holistic mom’s blog or the rave reviews from amped up college students. Get unbiased information from your family doctor or pediatrician. Speak to your local pharmacist about common side effects they have been made aware of and about which medication might work best for you. Only after becoming fully informed will you feel confident in your choice, no matter the outcome.
Before considering treatments, an accurate diagnosis is essential, though identifying ADHD can be challenging. There are no definitive medical tests, so clinicians conduct psychological evaluations and checklists to assess symptoms. Many conditions share similarities, so ruling out learning disabilities, mood disorders and more ensures proper diagnosis. If concerned your child may have ADHD, you can start by taking our free online screening test that gauges if symptoms may indicate ADHD, giving you initial insight ahead of any formal assessment. Getting clear on the root causes of troubles will guide you in finding appropriate solutions and confidence you are targeting the right disorder.
ADHD Medications for Children: Types and Effects
First, let us take a look at what medications are available and how they treat ADHD. Thankfully, there is a multitude of medications that can be used for both the hyperactive, inattentive, or mixed form of ADHD.
Stimulant Medications for ADHD
The medications most heard about are stimulants. Stimulants, similar to the caffeine in coffee or some sodas, elicit different reaction in people who have been diagnosed with ADHD. Instead of creating a more excitable and agitated persona, the person actually becomes able to calm down and gain more focus. Stimulant medications can be short term, fast or extended release, formulas. They are considered to be very helpful and effective for most people who have ADHD. Some stimulant medications are considered safe for children as young as 3 years old with most being available to those 6 and older. Around 70-80% of patients who are on some form of medication for ADHD are using stimulant medications. They are usually preferred because you can use them as needed, they work immediately, and most side effects will subside after discontinuing medication.
Specific stimulant medications include methylphenidate (Ritalin, Concerta) and amphetamines (Adderall, Vyvanse). Methylphenidate works by increasing dopamine levels in the brain which helps improve focus and concentration. Amphetamines also target dopamine but have an additional effect on norepinephrine levels which helps regulate hyperactivity and impulsive behaviors. These medications can work within 30-60 minutes after taking them and the effects typically last for several hours, allowing them to be taken as needed around periods of school or studying. Extended release versions are available to provide longer coverage throughout the day.
Non-Stimulant Medications for ADHD
Other medications used to treat ADHD include antidepressants, high blood pressure medication, and non-stimulant medications. Unlike stimulants, these medications are normally taken daily, take longer to begin working (i.e. days or weeks instead of an hour), and cannot be stopped abruptly due to dangerous side effects. Because these medications work to treat ADHD on a neurological and not just behavioral level, they are much more complex and could possibly be used for other disorders such as depression or obsessive-compulsive disorder. These medications can be used on their own or in conjunction with stimulant medication. Usually the preference for these medications are based on the unwanted side effects of stimulants or the ease of taking one pill a day that can help many symptoms.
For those looking to start with a mild ADHD medication before trying stimulants, non-stimulants like Strattera or Intuniv may be an option. Atomoxetine works by regulating norepinephrine levels. Clonidine and guanfacine were originally developed as blood pressure medications but have been found to also calm ADHD symptoms by targeting norepinephrine. These types of medications may cause less appetite or sleep issues but often take several weeks to reach full effect.
To Treat or Not to Treat ADHD in Children: Weighing the Pros and Cons
Now, how do you decide whether or not to try medication for your child?
The Positive Effects of ADHD Medication on Children
Those who use medication to treat ADHD usually have wonderful results. Grades and focus increase, impulsiveness and outbursts decrease, and their child stops getting disciplinary notes from school. This can absolutely be the case for some children and some can continue use without severe side effects.
Possible Side Effects of ADHD Medications in Children
Be aware that ADHD child medication side effects can vary greatly and close monitoring is crucial for detecting any worrisome changes. If you choose to begin medication, and this is worth repeating, get educated about the medication from unbiased sources. Side effects can include slowed physical development, the development of tics or uncontrolled movements that won’t go away once the medication has stopped, heart palpitations, anxiety, energy crashes, mood changes, unhealthy and rapid weight loss, lack of appetite, and addiction. The list of side effects for each medication will be a lot to remember but is important to be aware of.
It is crucial to consider potential long-term impacts of these medications on a developing child. Stimulants have been associated with slightly slowed growth rates that stabilize in adulthood. However, the effects on final adult height are generally small. More concerning is evidence linking stimulants to an increased risk of psychiatric issues like depression and substance abuse problems later in life. The reasons for this are unclear but highlight the need for careful monitoring and open dialogue with children about emotions and behaviors.
It is not necessary to tell your child all of the possible side effects but make them aware that they need to report any changes in health, behavior, or emotions. Often, knowing what side effects will occur can lead to psychosomatic reactions not related to the medication itself, in other words the child might exhibit the symptoms they were told to watch for. Some side effects can range from mild to severe and it will be up to the child’s report and your observations to determine if it is time to make a change. In some cases the positive effects of the medication outweigh the negative. Still, speaking to your doctor about all side effects is important because there may be a similar medication that can have the same effectiveness with less negative side effects.
When starting medication, advise children of potential side effects and have them report any new symptoms or troubles. Monitoring height, weight and cardiovascular health is also important. While some side effects like appetite loss tend to resolve within the first year, others may emerge or worsen over time. Ongoing check-ins allow detecting concerning changes so medications and dosages can be adjusted. Your child’s doctor should assess their treatment plan on a regular basis. Finding the most effective option with the fewest side effects is key to supporting health and success.
Non-Medication Approaches for ADHD in Children
Many parents first want to try treating ADHD without medication before considering pharmaceutical options. A benefit of the non-medication methods is the possibility of treating ADHD without stimulants during key developmental windows. While medications can be quite effective for managing ADHD symptoms, parents understandably have concerns about putting their child on stimulants or other psychiatric drugs at a young age. Thankfully, various non-pharmacological approaches offer additional options to try before or alongside medications. These alternatives range from changes in diet and nutrition to behavioral and lifestyle adjustments.
Natural and Behavioral Approaches to Treat Child with ADHD
Those who do not medicate their child will have to put the same amount of energy into research as the parent who does. Treating ADHD with vitamins, supplements, or diet can be an uphill and daily struggle in the beginning. It is still necessary to obtain testing from your doctor to see if the behavior could be due to a vitamin deficiency, food allergy, or other medical condition that can be managed without medications. Unfortunately, all that parents can do to evaluate the advertized natural remedies is to use anecdotal evidence from the internet which can be dangerous. Most “natural” or homeopathic remedies are nothing more than random and unregulated substances. Because non-prescription medications are not regulated there is no way to know what you are giving your child, what the actual dose is, or if it is harmful. If there is a nutritional imbalance, it is advisable to first change the diet to accommodate for the deficiency or use medical grade supplements or vitamins prescribed by your doctor.
Specific dietary changes like eliminating artificial food dyes, reducing sugar intake, and upping protein consumption may help reduce hyperactivity. Omega-3 fatty acid supplements support brain development and ability to focus. Multi-vitamins help fill any nutritional gaps that could worsen symptoms. Probiotics support gut health and digestion since gastrointestinal issues often accompany ADHD.
There are those who are able to manage ADHD without medication, especially those who have mild symptoms. It is common that there will be eventual self-medication by the overuse of caffeinated beverages, cannabis, and illegally obtained stimulants.
Integrative Approaches: Combining Medication and Therapy for ADHD
Research clearly shows that the best outcome in managing ADHD is achieved by a combination of therapy and medication. It is also important to remember that medication cannot teach your child new forms of behavior, such as self-control and conflict resolution; it can only create an ability to learn, but the actual teaching is better done by a counselor or therapist.
For example, a study in the Journal of Consulting and Clinical Psychology found that children ages 7-9 with ADHD showed significant improvements when medication was combined with an intensive behavioral intervention over 14 months. The integrated approach outpaced either treatment on its own in improving attention, impulse control, compliance and academic productivity. The gains were still evident 6-8 weeks after discontinuing all treatments.
Similarly, a review in Harvard Review of Psychiatry looked at outcomes for different ADHD therapy styles used alongside stimulant medication. While stimulants alone improved core symptoms, adding CBT or social skills training taught strategies for relationships and goal-directed behaviors. Combining medication with family therapy helped parents better support their child’s needs. Integrating multiple evidence-based therapies provides comprehensive skills for success.
The right combination should be tailored to the strengths and challenges of each unique child. But research clearly demonstrates that medication plus behavioral training and support equips children to actively apply new skills in sustaining focus, controlling impulses and relating well to others. The synthetic ability from stimulants then enhances real-world practice of these critical skills. This multi-pronged approach sets children up for the best long-term outcomes.
Evaluating ADHD Treatment Progress in Children: Medication and Beyond
In either case, don’t feel as though you have to make one choice or the other and stick with it for life. Usually, families will move between medicating and not medicating to determine which one fits best at that time. Keep in mind, that while good results can be achieved with the use of either medication or therapy alone, it is the integrative approach that produces the best results. Finally, the child’s environment should also be adjusted both, at school and at home.
It is crucial that any interventions or medication regimens are evaluated regularly to gauge their effectiveness and adjust as needed. Children's brains rapidly develop and life circumstances change, meaning their ADHD treatment plan must flex to match their evolving profile and needs. Track behavioral symptoms, academic performance, emotional regulation and social relationships to catch concerning regressions. Maintain open dialogue to incorporate children’s input on what works or causes issues.
Medication effectiveness should be assessed about 2 to 3 times per year by the prescribing doctor. Dosages often need fine-tuning as children grow and side effect risk changes. Adapting formulations or switching medications may become necessary if focus, hyperactivity or impulse control worsen. Discuss any usage obstacles like remembering to administer pills.
Similarly reevaluate therapy techniques every few months ensure they still target relevant skills gaps. If fixated habits reemerge or meltdowns increase, refresh approaches or try more intensive treatment. Updating school supports is also key amid shifting academic expectations.
While finding optimal treatments takes effort and perseverance, keeping interventions aligned with your child’s needs is the best way to provide consistent support. With attentive reassessments and a willingness to make adjustments, you can help your child thrive through every phase of their development.
Conclusion: Finding the Right ADHD Meds for Kids
The success of your child’s treatment will depend on your persistence in finding what is right and what works. If nothing seems to work, there is always the option of alternative education that caters to children who need a more flexible and engaging environment to thrive.
There is unfortunately no one-size-fits-all approach to managing ADHD. The diversity of symptoms and comorbid conditions means that every child responds differently to interventions. What works wonders for some may provide no relief to others. Even with expert guidance predicting outcomes is extremely difficult.
As such, support your child with patience and understanding as you actively investigate options. Be willing keep adjusting medications or swap therapy styles if something fails to help. Track different tangible metrics to decipher what moves the needle in daily functioning. While searching for optimal treatments can feel defeating at times, focus on celebrating small wins and embrace setbacks as teaching moments.
Most importantly provide your child reassurance that you are by their side through it all. With compassion and resilience, keep trying new avenues until discovering the customized formula that empowers their best self to shine through. Help them know that no matter the obstacles, you see their beautiful potential and will go to the ends of the earth to nurture it with them. Your unwavering support is often the lifeline that inspires children to believe brighter days ahead are possible, even when the path there feels unclear.
With dedication and care, the treatments are out there to help your child thrive. Stay determined in the search to find them.
Further Resources Treatment for ADHD
For more information about ADHD please visit Mental Disorders and Conditions page. For more information on approved ADHD medications and research summary on effects of ADHD medication please visit Research on ADHD Medication in Children page.
References:
- American Academy of Pediatrics. Clinical Practice Guideline: Treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics. 2001;108(4):1033-1044.
- Greenhill LL, Pliszka S, Dulcan MK, Bernet W, Arnold V, Beitchman J, et al. Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. J Am Acad Child Adolesc Psychiatry. 2002;41(2 Suppl):26S-49S.
- Faraone SV, Biederman J, Spencer TJ, Aleardi M. Comparing the efficacy of medications for ADHD using meta-analysis. MedGenMed. 2006;8(4):4.
- Charach A, Dashti B, Carson P, Booker L, Lim CG, Lillie E, et al. Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence, diagnosis, and treatment. Comparative Effectiveness Review No. 44. (Prepared by the McMaster University Evidence-based Practice Center under Contract No. 290-2007-10060-I.) AHRQ Publication No. 12-EHC003-EF. Rockville, MD: Agency for Healthcare Research and Quality. October 2011.
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