ADHD medications & treatments

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Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that is characterized by difficulty paying attention, impulsiveness, and/or hyperactivity. It is the most commonly diagnosed mental disorder condition in children. According to the Centers for Disease Control and Prevention (CDC), about 11% of children aged 4-17 have been diagnosed with ADHD at some point in their lives. While the exact cause of ADHD is unknown, it is believed to be a result of genetic and environmental factors. Treatment for ADHD often includes medication, therapy, and/or education, and behavior management strategies. With proper treatment, people with ADHD can lead successful and productive lives.

What is Attention-Deficit/Hyperactivity Disorder (ADHD)?

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental conditions of childhood. According to the Centers for Disease Control and Prevention (CDC), as of 2016, more than 6.1 million children in the US have been diagnosed with ADHD at some point in their lives. Boys are more than twice as likely as girls to be diagnosed.

Although usually diagnosed between the ages of 6 to 12, ADHD often continues throughout a person’s life. About 4% of the American population over the age of 18 live with this condition.

ADHD symptoms can include inattention, impulsivity, and hyperactivity. There are effective treatment options available, including medication and psychological therapy.

Mental health professionals have identified three types of ADHD, based on the main symptoms involved:

• Predominately Inattentive type ADHD
• Predominately Hyperactive-impulsive ADHD
• Combined type ADHD

The symptoms of ADHD can vary from person to person depending on the type and they may change as you get older.

Children with ADHD may also have challenges paying attention, controlling impulsive behaviors, or being overly active.

People with ADHD often have other conditions, such as anxiety disorders, learning disabilities, conduct disorders, depression, and substance abuse.

ADD is the old name for ADHD.

RELATED: ADD vs ADHD

Predominately Inattentive Type

This involves issues with focus, concentration, and the completion of tasks. Symptoms may also include:

• Making careless mistakes while struggling to pay close attention to details
• Failing to complete tasks or responsibilities such as schoolwork assignments, homework, or chores at home
• Poor organizational skills
• Forgetfulness
• Avoiding tasks that require mental effort or patience
• Appearing not to listen
• Misplacing items
• Appearing easily distracted or sidetracked

Predominately Hyperactive-Impulse Type

This is the least common type of ADHD. It is characterized by impulsive and hyperactive behaviors without inattention and distractibility. Symptoms may also include:

• Difficulty sitting still
• Frequent squirming, fidgeting, or tapping your hands, feet, or other body parts
• Trouble playing or participating in leisure activities quietly
• Talking excessively
• Interrupting others
• Appearing restless in inappropriate situations
• Difficulty waiting

Combined Type

This, the most common type of ADHD, is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.

How is ADHD diagnosed?

Attention deficit hyperactivity disorder is the most commonly diagnosed behavior disorder in childhood. A pediatrician, child psychiatrist, or qualified mental health professional usually identifies ADHD in children or adolescents. A detailed history, as well as observations of the child’s behavior from parents and teachers and psychoeducational testing, contribute to making the diagnosis of ADHD.

Children need to have 6 or more symptoms (5 or more for adult ADHD diagnosis) for at least 6 months and

• Present with symptoms before the age of 12
• Present with symptoms in at least two different settings, including at school, home, work, with friends, or during other activities
• Present with symptoms severe enough to interfere with daily life at school, work, or in social situations and impact quality of life

ADHD treatment options

There are two types of medications that are FDA approved for the treatment of ADHD: stimulants and non-stimulants. Treatment for adult ADHD is similar to the treatment for childhood ADHD.

Stimulants increase levels of dopamine, a neurotransmitter in the brain, which helps improve attention and motivation. Doses of stimulant medications will need to be taken at an appropriate time to match the child’s school schedule in order to assist the child to pay attention for a longer period of time and improve their performance in the classroom. Some commonly prescribed stimulants for ADHD include:

• Short-acting stimulants such as Adderall (mixed amphetamine salts), Focalin (dexmethylphenidate), Ritalin (methylphenidate)
• Intermediate and long-acting stimulants such as Focalin XR, Adderall XR, Ritalin LA, Vyvanse (lisdexamfetamine), Mydayis (mixed amphetamine salts), Concerta (methylphenidate), Quillivant XR (methylphenidate), Daytrana (methylphenidate)

Non-stimulant medications affect the brain in different ways than stimulant medications. Some of these non-stimulant medications include:

• Strattera (atomoxetine) is a selective norepinephrine reuptake inhibitor that is approved to treat ADHD in adults and children.
• Intuniv (guanfacine), as well as Kapvay (clonidine), are approved to treat ADHD in children.

There are also several medications prescribed off-label in adults for the treatment of ADHD, including Provigil (modafinil), and antidepressants such as Wellbutrin (bupropion), Provigil (modafinil), Norpramin (desipramine), and Effexor (venlafaxine). These provide possible alternatives to patients who cannot take stimulants due to the side effects.

Non-pharmaceutical treatment options include:

• Behavioral therapy is an important part of ADHD intervention for both children and their parents. It can help strengthen and reward positive behaviors, improving the child’s self-esteem, while reducing or eliminating unwanted behavior. Including the parents, other family members, and teachers in these support groups gives them guidance and skills training on how to manage the condition and address behavior at home and school.
• Adults can also benefit from Cognitive Behavioral Therapy (CBT). This psychotherapy can teach you how your behavior affects those around you. Once you have this understanding, you can alter these negative behaviors. In this therapy, you are also taught organization and time management skills, as well as strategies that can help improve your focus.

What is the best medication for ADHD?

The best medication for ADHD will depend on the individual’s specific health conditions, medical history, medications that the individual is already taking that may potentially interact with ADHD medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes an ADHD medication list of the most prescribed ADHD medications as well as common starting dosages and side effects.

Best medications for ADHD

Your healthcare provider will determine the dosage which is right for you based on your response to the treatment, medical condition, weight, age, and side effects experienced.

What are the most common side effects of ADHD medications?

As with the majority of medications, there are a number of possible side effects with ADHD medications. Here is a list of some of the associated side effects for the different drug classes that are commonly prescribed to patients with ADHD. Please note that this is not a comprehensive list and you should always talk with your doctor or pharmacist for a complete list of side effects and how these drugs may interact with your current medications/supplements and preexisting health conditions.

Side effects of stimulants:

• Insomnia
• Weight loss
• Headache
• Increased blood pressure
• Nausea
• Upset stomach
• Dizziness
• Irritability
• Addiction risk

Side effects of non-stimulants:

• Nausea
• Upset stomach
• Fatigue
• Irritability
• Headache
• Dizziness
• Mood swings
• Suicidal thoughts

Alternative approaches to treating ADHD

Although medication therapy is the usual first-line treatment for patients with ADHD, there are other natural, alternative treatments to help reduce their symptoms. These may be used alone or can be combined with medication and therapy.

• Vitamins and supplements. Although the research is not conclusive to the effectiveness of these as treatments, the common recommendations include zinc, magnesium, vitamin B6, fish oil, and L-carnitine.
• Exercise. This includes any physical activity that burns calories such as walking, running, yoga, weight lifting, and playing sports. Exercise can help improve memory, focus, and mood. Research shows that it can help improve symptoms in children and adults.
• Diet. As with vitamins and supplements, the research is mixed. However, studies suggest eating a diet consisting of complex carbohydrates, proteins, and essential fatty acids such as nuts, seeds, and fish can help improve some ADHD symptoms. There might also be some benefits to avoiding certain food colorings and preservatives that might exacerbate hyperactive behavior in children and adolescents.
• Spending time outside. Spending time outside may benefit children with ADHD. There is strong evidence that spending even 20 minutes outside can benefit them by improving their concentration. Greenspace and nature settings are the most beneficial.

Frequently asked questions about ADHD

What is the most common treatment for ADHD?

The most common treatment for ADHD is a combination of stimulant medication and behavioral therapy. However, everyone is different and your doctor will determine the best ADHD treatment plan that’s personalized for you.

Can you be cured of ADHD or grow out of it?

There is no cure for ADHD and you don’t typically grow out of it. This disorder commonly changes over time and for some adults, the symptoms diminish to where it does not significantly affect their day-to-day life.

Is ADHD medication safe?

As with any medication, there are associated risks and potential side effects, so we strongly recommend you speak to your doctor. That being said, drugs prescribed for ADHD are considered relatively safe psychiatric medications.

Can you get addicted to ADHD meds?

There is addiction and substance abuse potential with some of these medications if they are not taken exactly as prescribed. As always, ANY medication should only be taken as prescribed and never without a valid prescription.

Are there any supplements that help treat ADHD?

As of today, there is little clinical evidence to support the effectiveness of natural supplements to treat ADHD. Always talk with your doctor before starting any supplements as they may interact with your current medications and medical conditions.

Related resources for ADHD

• Attention Deficit Hyperactivity Disorder. National Alliance on Mental Illness
• The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review. National Library of Medicine
• The Effects of Physical Exercise on Functional Outcomes in the Treatment of ADHD: A Meta-Analysis. ResearchGate
• Complementary and Alternative Medical Therapies for Children with Attention-Deficit/Hyperactivity Disorder. Janice Pellow
• Children With Attention Deficits Concentrate Better After Walk in the Park. Andrea Faber Taylor