Deciding whether or not to medicate an ADD child is a personal, private decision made between parents, the child, and a qualified medical professional. The decision should be made after considering many factors, including the child’s behavior in school, his academic performance, his ability to listen and follow instructions, his social skills, and the degree to which ADD has impaired his daily activities.
Medication should be a last resort after parents have not had success when working with the child’s school, with counselors, or with relaxation techniques. If medication is the chosen route, it should be in conjunction with other interventions. There are a variety of medications to choose from, and their uses and side effects must all be carefully evaluated.
How ADD Medication Works
According to ADDitude Magazine, ADD medication reduces the overwhelming symptoms of hyperactivity, impulsivity, and inattentiveness that plague ADD patients. Medication can improve their ability to concentrate and help them think their thoughts through more carefully. It is important to note that no medication is a cure-all for ADD. Parents will still need to be diligent about discipline and forging relationships with teachers and counselors. In addition, children may still sometimes suffer symptoms of ADD, even while taking medication. It may also take several different tries before the most effective medication is found. Medication use must always be carefully monitored and constantly re-evaluated.
Stimulant Medication to Treat ADD
Description: Stimulants are the most common medications prescribed to ADD patients. They come in both short-acting and long-acting dosages. Stimulants increase dopamine levels in the brain. Dopamine is responsible for motivation, attention, and movement, and dopamine levels are often significantly lower in ADD patients. Stimulants can boost concentration and reduce hyperactivity and impulsivity.
Name Brands: Ritalin, Adderall, Dexedrine, Concerta, Metadate, Daytrana, Dextrostat, Cylert, Desoxyn, Focalin, Methylin, Vyvanse
Side Effects: Restlessness, feeling jittery, difficulty sleeping, irritability, mood swings, poor appetite, abdominal pain, or depression. Stimulants may also make some people feel less talkative, and less like themselves. Researchers are studying the long-term impact of stimulants, which could include abnormal brain development, heart related problems, psychiatric problems, and potential drug abuse. Stimulants should never be used on children with heart defects or abnormalities.
Non-Stimulation Medication: Strattera
Description: Strattera is a non-stimulant, which boosts the levels of norepinephrine in the brain, a chemical that also causes ADD symptoms. Strattera is longer acting than most stimulants and also has anti-depressant properties. However, it may not be as effective as stimulant medications.
Side Effects: Decreased appetite, headache, abdominal pain, dizziness, nausea, irritability, sleepiness, and insomnia. Strattera is being researched as possibly causing an increase in suicidal thoughts and actions in some children and teenagers. Rarely, liver problems may occur in those taking Strattera.
Blood Pressure Medications That Treat ADD
Description: When other medications fail, high blood pressure medication can be used to treat ADD. While these medications can ease hyperactivity and aggression, they are not useful for treating attention problems.
Name Brands: Catapres, Tenex
Side effects: Dizziness, drowsiness, headache, constipation, gas pains, loss of appetite, and fatigue.
Anti-Depressants That Treat ADD
Description: For people who suffer from both ADD and depression, certain specific anti-depressants can be useful at targeting multiple neurotransmitters in the brain. Other anti-depressants called selective serotonin reuptake inhibitors (SSRIs) are NOT effective for ADD and may even increase hyperactivity.
Name Brands: Wellbutrin, Edronax, Effexor, Norpramin, Pertofrane, Janimine, Tofranil
Side effects: Dry mouth, sleepiness, excessive sweating, and constipation.
Medical Management of ADD
Parents must realize that using medication to treat ADD is an ongoing process that requires constant assessment and reassessment. Some things to consider are:
- Will the doctor give the child a thorough examination to rule out any medical conditions that could interfere with medication? Additionally, the child should be tested for any conditions which could cause inattention or focusing problems, such as a vitamin deficiency.
- Parents need to make the doctor aware of what specific behaviors need targeting.
- Doctors should begin by using the lowest possible dose initially.
- Parents should be prepared for frequent office visits to assess the response of the medication and to warn of damaging side effects.
- Parents should be ready to accept alternative treatment other than medication, such as counseling, interventions at school, or reinforced discipline at home.
- Parents need to ask how long their child will need to be on medication.
After the child is started on medication, parents will want to observe:
- Does the medication seem to be working? If so, what behaviors have changed?
- Does the medication seem to work, but at too low of a dose?
- Did the medication start to work, but seem to wear off too quickly?
- Does the medication seem to have made little impact?
- Is the child experiencing any side effects?
If parents find that side effects are too pervasive, they can try a number of things. They can make sure their child never takes his medication on an empty stomach, and they can fight weight loss or lack of appetite by feeding the child smaller meals more often. If the child has difficulty falling asleep, parents can give the dose earlier in the day to prevent insomnia. If the child seems to have mood changes that are uncharacteristic of his normal self, he may need to have his dose lowered.
Conclusion
In deciding whether or not to medicate an ADD child, parents need to consider the risks of not treating the disorder. The child is at a higher risk for not doing well in school, and becoming dependent on drugs or alcohol as an adult. Parents should ensure that they are treating the ADD at every level: in school, at home, and in the social sphere. If the ADD behavior is worsening or interfering with a child’s life, it may be time to consider medication.
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