What are the treatment options?
The treatments recommended depend on how severe the condition is as well as the age of the child. Ideally, treatment should involve a team of professionals who are experienced and trained specifically in ADHD and may include a doctor, teacher, nurse, social worker, occupational therapist, mental health care professional or psychologist. Treatments include drug and non-drug treatments.
Non-drug treatments for ADHD
Generally, for pre-school children or for older children with mild to moderate ADHD, the first step is usually for you (parent or guardian) to be referred to a parent training programme. Sometimes your child will also be referred for a group treatment programme aimed at improving behaviour. The parent programme may include such things as:
- Learning skills to manage and reduce problem behaviour.
- Learning more effective ways to communicate with your child.
- Helping you to understand your child's emotions and behaviours.
Your child's school teacher may be invited to be involved in the treatment process. They may be able to use certain techniques in the classroom to help your child learn and function better. Family therapy may also be helpful.
In more severe ADHD, or where the above treatments have not succeeded, medication is usually recommended.
Drug treatments for ADHD
There are three main drugs licensed for the treatment of ADHD in the UK. Methylphenidate (trade name of Ritalin®) is the most commonly used drug. Atomoxetine and dexamfetamine are other drugs that may also be used.
How effective is drug treatment?
The drugs used for ADHD have been used for many years and in many children with good effect. A number of studies have shown that drug treatment with or without intensive behavioural training programs is more effective than behavioural training programs alone.
How does the methylphenidate work?
Methylphenidate is a type of stimulant drug. It works by increasing the amount of a brain chemical called dopamine in certain parts of the brain. The parts that it works on are responsible for self control and attention. Increasing the amount of dopamine in these areas of the brain stimulates them to work better. This then helps to focus your child's attention and improve concentration.
How do I give methylphenidate to my child?
Usually, your child will start on a low dose such as 5mg three times a day and will be carefully monitored for side effects. This dose will be increased gradually to a maximum of 20 mg three times daily according to how well it is working and whether side effects occur. The most common side effects to look out for with methylphenidate are insomnia (difficulty with sleep), loss of appetite and weight loss.
Once the total daily dose has been determined, it may be possible for your child to switch to a once daily long acting version of methylphenidate.
When your child is on medication, they should be reviewed every six months to check that the dose is working and that there are minimal side effects. It is recommended that the doctor also check your child's height, weight and blood pressure. It is good for this review to include feedback from those who are in regular contact with your child such as teachers, family members and other carers.
How quickly does methylphenidate work?
The short acting methylphenidate begins working within about 20 minutes and lasts for 3-4 hours. The longer acting version takes longer to start working but lasts for about 12 hours and gives a more stable level of drug in the bloodstream throughout the day. It may take several weeks to see the full benefit of medication.
How long will my child be on medication?
Most children will need to continue medication through high school. Once children become teenagers, some doctors will recommend a trial off the medication each year. This is to make sure that medication is still necessary.
If the use of methylphenidate causes unacceptable side effects or is not effective, the two other drugs mentioned above may be used. Dexamfetamine is another stimulant and atomoxetine is a different type of drug that works on a chemical called noradrenaline in the brain.
There are other drugs that may be used for ADHD but these are usually only recommended if the above drugs are not effective.
Are the drugs safe?
The use of drugs to treat ADHD is controversial. This is mostly because some people are worried about their effectiveness as well as the possibility of side effects. Also, there is the possibility of the drugs being misused or abused. However, the recent guidelines from the National Institute for Health and Clinical Excellence (NICE) advise that they are still useful and important in the treatment of severe ADHD and in milder forms when other treatments have not been effective.
The drugs do not seem to have an addictive potential when used in children. There are reports of the drugs being abused in teenagers and adults. However, it is likely that the risk of substance abuse with street drugs such as cocaine in someone with untreated ADHD is greater than the risk of abuse of the prescribed drugs.
The controversy is largely unfounded because both scientific studies and years of experience have shown that these drugs are generally safe and effective.
Average rating:
Where to next?
Please leave a comment, tip or story in the box below
julie owen, about 1 year
my two eldest daughter aged 7 and 5 have always been very hard to control, they ruin everything in the house, throw tantrums, screaming fits. i find this all extremely stressful and recently a friend suggested i research ADHD my daughter have alot of the symptoms and 2 of my nephews have been diagnosed so it does run in the family. i am really struggling to cope i do not understand this condition at all. i really need help any tips would be very helpful or just some one to talk to thanks. julie
Report this commenttracey, over 2 years
hi i have 6 year old son and a 4 year old little girli am trying to get help for my son as i think he as got adhd but i am not getting musch support from eney 1 it just seams like i keep geting pusht away with evey thing he as got a consultant but he not mush help as all he keeps saying to me go on a web sit to see if he as got wot thing say on there and then come bk in 3 mouths we have sean him 2 times now but no suckses he as got right bad behvior problems and fight all the time my lttle girl get it most and it is up stting for her and hits me and is dad he dont no danger he users bad word all the time he allways say he hates me and his familey he as hert is nan and grandad but i rely need some help with him it is realt geing me down now and couseing problems with me and my husband if eney 1 nows how i can get more help plz let me no meant thank tracey jordans mum
Report this commenthelen, over 2 years
I have 3 children my eldest stephen 12,daughter 9 and youngest 4 i noticed as a little boy stephen didnt act like other children could not concentrate he was very violent to others but also to himself at the age of three we 1st took him to doctors very concerned for him but was told different stages in his life he would go through things like this,but things got worse and worse. my daughter came along and the violence was extreme making her life hell so we went back again and again.eventually 12 year old after abuse fits and the worse upset and violence stephen was diagnosed with ADHD and takes concerter,plus risperdone do i think its helperd since start of medication may 2007 i dont really know maybe now its easier because we have a name for the past 12years but as far as the medication goes im yet to see vast improvement apart from the school work and concentration.
Report this commentjo, over 2 years
I am a single mum with 4 kids and my 8 yr old has adhd and i have been telling the school 4 so long that they finaly did some thing about it and got him sorted last year in october he is not on any medication yet. We are now getting the support that we need as a family to get through this.
Report this commentali reynolds, over 2 years
My 8 year old son was recently diagnosed with ADHD after many years of me trying to get him diagnosed. For years I couldn't control his behaviour and it was getting me very down and also affecting my other son who is now 11. At the end of last year he was prescribed Ritalin which after just a couple of months seems to be helping a great deal. If you have a child who you think has ADHD push your GP to have a referral made to a Child Psychiatrist to have them assessed as not only will it help you but also the rest of your family too. Good luck!
Report this commentamanda davies, over 2 years
Found site very useful, as my daughter is having trouble, and her classmates, with a pupil who shows symptons of what i have read. School is awaiting results on tests tat have been done.
Report this commentamanda davies, over 2 years
Found site very useful, as my daughter is having trouble, and her classmates, with a pupil who shows symptons of what i have read. School is awaiting results on tests tat have been done.
Report this commentceri, over 2 years
my son byron has been to phychiatrist for a second diagnosis and could take up 2 3 months and his behavour has got alot worse the past couple of days,i'v tried always to calm him down and he's constantly hittin himself and its really gettin me down seeing the way he is , safely restraining him and other techneques don't work just waitin now for an appointment with dr wendy barber can you give me any tips to try until then? please help i'm concerned about my son thanks. ceri byrons mum
Report this comment
leanne, about 1 year
i have ADHD, and take nearley the highest dost of CONCERTA XL. i am now 18 years old and bin taken it for years. for all you who have children like me please please listen to them. the way it makes us think is that 'we have to take medicine to be good..and normale and even at 18 i still think that. i think paernts need to be more understanding that althogh we might be bad and need these tablits sometimes we do it just for are mums and dads, i only take mine because my mum is ill. and i always think 'hang on these tablits i take everyday...what is going to happen in the long run' and no one can tell me the answre... we dont like it as much as parents.. think. your children who have ADHD most probaly feel stupid... vary sad.. all the negative werds you can possible think of i feel and all i can say to you is just encorage your children even when they are bad remeber its not are falt. so many dont understand us...and how hard it is for us... we would never delibrately want to wind you all up or be narsty or embarrasing to those we love.. its so hard and for me who has bad ADHD i shoud no.. people who have ADHD ushually clash and my brother has it so can you imajine how hard it is for my mum... every day i feel like i stick out like a sore thumb..when im in the shops running around hiding and all sorts and when people stare it dont make me feel any better than who ever is with me... all i can say is please tell your child every day that IT AINT THEAR FALT... and to listen to them good luck with your children and hope ive bin abel to help you
Report this comment