Deb Levy @DebL62

ADHD and Medication: Some Helpful Facts

Was your child diagnosed with ADHD? Here's what you need to know about medication.

When a child is diagnosed with ADHD, the second reaction of many parents is to ask "now what?"  (The first may range from, "No way, not my kid!" to "Gee, all this time I thought I was a bad mother.")

The answer to "now what" involves education, changes in parenting tactics, and more often than not, a prescription for medication.  Yet the decision of whether or not to give your child psychostimulants can be a daunting one, especially given the media explosion warning of a national overdependence on Ritalin.

It's important for parents who do choose to medicate to work closely with a trusted doctor who is well versed in the various treatment options, as there is no one-size-fits-all solution to medicating a child with ADHD.

To Medicate or Not to Medicate

Dr. Ned Hallowell, a child and adult psychiatrist and the founder of The Hallowell Center for Cognitive and Emotional Health, believes medication is advisable the moment a diagnosis is made.  "There is no reason to hold back," he says. "Do you want to squint before trying eyeglasses?"  He says that when used properly, medication is not only safe and effective; it is a godsend.

ADHD medications are known as stimulants, which seems counterintuitive for a child whose condition causes him to bounce off the walls.  But according to the American Academy of Pediatrics, these medications work by "stimulating" the area of the brain that deals with executive function - focusing attention, controlling impulses, organizing and planning, and sticking to routines.  Parents can take comfort in the fact that stimulants have been the widest and most studied of any group of medications for the behavioral and emotional problems of children.

What are the Medications?

These medications come in three classes - methylphenidate, dextroamphetamine and amphetamine compounds.  And within these classes are varying dosages, from short-acting (4 hours) to intermediate (8 hours) to extended release (about 12 hours).  Depending on the needs of the child, doctors can regulate these dosages to suit individual schedules.  For instance, a child may take an intermediate dosage that will last throughout the school day, and then a short-acting booster on days when an afterschool activity might force her to stay up later to do homework.  Stimulants do not build up in the body, but leave the child's system completely as they wear off at the end of each day.

How much of the medication should a child take?  It all depends, and not on the child's weight as is the case with other meds like antibiotics or cold medicine.  The optimal dosage is not the lowest amount that shows some benefit, but rather the one that most helps a child reach his target behaviors.  It is recommended that doctors start low and slowly increase the dosage until either no further improvement is noted, or side effects appear, though this gradual increase may actually help to diminish some of the side effects.

Do Meds Work?

Studies show that when taken correctly, 80% of children respond well to medication. But sometimes the medications don't work.  If there is still no improvement after tinkering with dosages or switching to another class of stimulants, parents may want to consider whether or not ADHD was indeed the correct diagnosis.  There might be another underlying cause, like anxiety or a learning disability that manifests in the same behaviors as a child with ADHD.

As with practically any medication, stimulants do have side effects.  The most common are a decreased appetite (until the medication wears off in the evening and you can expect your child to request a second dinner), stomachaches, headaches, jitteriness, difficulty falling asleep and social withdrawal.  With the exception of a lowered appetite, most of these symptoms disappear as the body adjusts to the medication.

Some children (15-30%) experience motor tics after almost a month of starting medication.  Though disturbing for parents to see, this usually goes away after about three weeks.  This may give pause to parents of children with both Tourette Syndrome and ADHD.  (Nearly half of all children with Tourette's have ADHD as well).  Yet according to the American Academy of Pediatrics, recent studies have shown that stimulants, at moderate doses, have no effect on the severity or frequency of tics, while the benefits to the ADHD symptoms are measurable.

Long-term Impact

Recent studies also show that stimulants have no long-term effect on the ultimate height of a child as had been previously thought.  Finally, in the beginning of treatment, a child may experience rebound as the medication wears off at the end of the day.  This is when behaviors erupt and seem worse than what they had been before medication.  Fortunately, this does not typically last long.

When a child takes medication for ADHD, he or she should be closely monitored - the parents should note daily behaviors, and the prescribing doctor should schedule frequent follow ups to monitor treatment and ensure that the dosage is optimal.

Dr. Hallowell cites the MTA (multi-modal treatment assessment) study, the largest study ever done on the treatment of ADD in children, and says, "While medication makes the biggest difference immediately, as time goes by other factors come significantly into play, including the positive connections within family and elsewhere that make a crucial difference in outcome."

In other words, there is no such thing as a magic pill.  But used properly, medication can lay the foundation for success with other treatments as well.


Oldest comments are listed first

  • Wonderful article. As with ANY medication, it has to be monitored by not just the doctors, but parents. Caretakers may want to take notes for the parents if they notice anything while caring for the child. I'm not one for \

  • My son has had ADHD for some time now he has a twin brother but there is such a size difference between them im starting to wonder if these medication's are affecting his growth he is now 11 years old and when him and his brother are togther people think they are at least 2 years apart not 10 minutes apart . I have tried talking to doctors about this but they look at me like im crazy , i just changed doctors so hopefully i will get some answers ...

  • I get very leery when meds are the go-to option. So much can be done with a change in diet and behavioral therapies that meds may not even be necessary. I think meds should be a last resort option because they do have serious side effects.

  • my son has been on a host of meds off and on since he was 5 and i know it has taken some toll on him when his sister 2 yr younger grew to be the same size and height n weight i knew something was off. i changed dr's and the dr has given him what we call \

  • I would be very leary of medicating my child. I think it's very important for Parents to understand how important they are in protecting their children from these diagnoses and drugs. If you do a little research you will find that there is no actual scientific proof that an active child is an abnormal child at all. Changes in diet, along with proper vitamin in take, can totally change your situation around for the better, without the side effects of drugs.

  • My daughter was very active to the point that she had no \

  • i respect each & everyone of you that have a very active, or ADHD child... my child was the very active one in daycares... the daycare center stated it was too much for them to handle, my thought was no one wanted to take the time with him because of all the other kids there that needed that attention. so i removed my child & i studied early childhood development.. & what i got from it was ATTENTION... a very active child needs LOTS & LOTS OF ATTENTION.. my doctors stated he needs RIDDALINE... no questions ask just ridaline.. i tried as any other mother would do especially when you know your child needs help, but the ending results led my child to being a ZOMBIE... 1 dose did that & that was enough for me.. i want my child to be active, not a ZOMBIE.. so i removed him from taking anymore medication.. I gave attention & i fed his mind with positive things, its hard work, but the end result was PHENOMENUM... he ended up leveling out from the arts, crafts, educational tools that was used...

  • A lot of people use the Feingold diet for ADD/ADHD.

  • My son is high function Aspergers. He's come a long way now 14. Mostly he is struggling the immature level under is age ie; still scared of loud sounds, bright lights, crowds, etc. Medication, I believe, works as well as the child wants to try. My son will try more at tasks that please him. The moment he breaks off task, most say \

  • As a mental health clinician and a parent of a child with ADHD, I have to tell you that new research, pulished in The Lancet by Dr. Pessler indicates that most children's symptoms are caused by diet, aka good additives. You can read more about this on my blog Medication should be a last resort. Research shows that stimulant drugs prescribed to children lead to increased early onset substance abuse. Check the research. See for yourself. Of course, some kids do needs meds, but it is so easy, inexpensive, and safe to first rule out diet. Please give this some serious thought.

  • While I appreciate and respect everyone's opinions about medicating a child with ADHD, I sincerely believe that if you do not have a child who is struggling with the the symptoms of Attention Deficit and Hyperactivity Disorder, you have no business commenting on what should or should not be the method of treatment. It is not enough to be a textbook expert or a caregiver who has experienced other people's children with such symptoms. To truly understand the magnitude of what these children are going through, I believe you have to live with, and love one of them unconditionally as a parent. Only then can you truly understand the complexity of making such a serious decision for a child you love more than yourself, that will no doubt have lifelong consequences, positive or negative, on them. No parent wants to medicate their child. But when you see your child \

  • I am a parent of an ADHD 17 year old son. Of course, as a child he was an extreme handful and we went the medication route. We'e tried so many vitamins, diet changes and even magnetic therapy. None of which worked for him. Every child is different. Wheither your a parent of an ADHD child, teacher or even just someone giving their opinion about the condition, its important to not judge parents for the choices they make. Whats right for you and your child might not be right for the other person and their child. I always said regarding my sons condition, if a parent has a child like my son and they can function normal on cetain diets or vitamins, then they are extremely blessed or not ADHD at all, lol. God bless.

  • Yellow number and Red number food color, and current diet concerns more health wise choices for kids even out. In the past years even the 1920-60's food was coked in lard, Pepsi-Coke Coke has actual stimulant in it, and other foods we have come far. Your blog seems a lot like Scientology which is quite out there. I guess blood pressure meds, Bi-polar, and other very important conditions should be thrown out. Shonda the zombie mode I personally suffered through that for a year. It made a difference in grades, and the way things were done then my Dr. decided to try a different approach. If it were truly adhd or add it is not a pure attention thing even adults have it as proof. I am on adderall and have had positive effects. I am able to focus more, clean, have a want to be productive and have been on it long enough to know the side effects are very low to none for me.

  • I was the child with ADHD. I was (and still am) an extremely overactive person. As a child it was impossible for me to focus on anything because I constantly had my thoughts and brain moving at 1000 miles an hour. I couldn't cope easily at school with this. Finding the right type of ADHD medication was important for me and my family. My poor parents, trying to get me to sit still for homework or anything that wasn't fun was near to impossible. We went through three different medication choices. We started with Adderall, which was great. I focused in school, I was more aware of things in the classroom and not just reacting to everything, not paying attention. Except it lowered my appetite when I was on it. Weekends I'd be med-free and I would try to bring myself under control by myself. (Which is a hard thing for an 8-yr-old to do.) We eventually found a medication that worked for me and let me keep my appetite and didn't interrupt my sleep schedule. As I got older, and got to know myself and my ADHD tendencies better, I could go off of my medication completely and feel like I could think in a straight line, and stay at task, and like my brain wasn't going to overload on me. ADHD is real, and I feel like I wouldn't have been able to become what I am if I hadn't had help, medication-wise, when I was younger.

  • I can tell you that if your child has not been diagnosed by a licensed psychologist that you have no real vision of what a parant with a child with ADHD goes through on a daily basis. I can tell you that my son was diagnosed at the age of 3 and I can also tell you that I knew from the time he started walking there was something special about him. I was a parent against any kind of medication. By the time he was three we had been asked to leave 3 child care providers for impulse biting. We took him through right and wrong time after time after time. Immedately after it happend he was remorseful. He knew right from wrong that wasn't the issue. Shortly after that we found out from a psychologist that he definately had ADHD not just hyper, but impulse too. He couldn't control the impulses even if he knew it was wrong. For me, it was a matter of keeping my job or not. I put him on medicine and our lives began to make incredible changes! All of a sudden the papers he was doing in preschool came home looking 100% better. There was focus, and control of his actions. A very well mannered child emerged, still age appropriate things happen but that was expected. He is nine now and he get good grades in school, loves to read and is a great kid! I would not change the decision I made to medicate him for anything. We have a psychiatrist that closely monitors his medication. I would encourage any parent struggling with ADHD to seek the help of first a psychologist then a psychiatrist. Your child WILL BENEFIT from the medicine. With the proper fit, sometimes you have to try a couple, but keep going. We tried a few that didn't work, we saw it not working and simply stopped giving it to him and went back to the dr. With medication a child will be successful and have a great feeling of pride. Sure there are struggles with the appetite thing, but it is worth the battle every time he comes home so proud of his success at school, or church or cub scouts or any activity that he chooses. Good Luck

  • I am a mom of a child with mild autism and one who has to deal with ADD-ADHD. None of these are a fun thing to deal with but I honestly believe it's great to see how unique my children are. Two of my boys have these special characters, but they are a joy to always be around and there is never a dull moment with all of my kids. When Anthony was in 1st grade, I got called by his teacher because she felt he was \

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