Medication for ADHD
- How does medication help?
- How will it change my child?
- How long does medication last?
- What are drug holidays?
- Safety and side effects
- Is there any risk of addiction?
Medication is only offered after a specialist assessment by a Paediatrician or Child Psychiatrist. It is not licensed for children under 4 years of age and it is only normally advised for children of 5-6 years or older. It is worth trying if a child has serious difficulties both at home and at school. For those children who respond, the effect can be immediate and dramatic. However, medication will always only be a small part of a treatment strategy for ADHD.
Stimulant medications affect the brain by making it more alert, active and awake. In children with ADHD this has the effect of improving control over attention and behaviour enabling them to be calmer, less restless, impulsive and demanding. With this comes better organisation, behaviour and relationships.
Medication is short acting and not a permanent cure. It provides a few hours of opportunity for children to concentrate better and can reduce hyperactivity and impulsivity. This can allow children to learn, practice new skills, get on with others, understand instructions and feel more in control. Most children do not report any noticeable changes to themselves or to their personalities.
The most common medications used are methylphenidate (brand names include Ritalin, Concerta, Medikinet, and Equasym) or dexamphetamine. They are usually effective within 30 minutes of being swallowed and wear off after 3-4 hours. A child may need 2-3 doses a day of a short acting medication to get the best result. There are also “slow release” longer acting preparations which wear off after 8-12 hours so can be taken once daily. The exact dose of either type of medicine needs to be adjusted and monitored initially by a specialist doctor. These medications are known as ‘controlled drugs’ and only available on prescription (because they can be abused by adults.)
We would recommend that most children and adolescents taking ADHD medication should have periods where they do not take the medicine. These breaks are useful to see how significant symptoms are without medication – once a child, parent and school have had a chance to implement particular strategies. These breaks are often best left for school holidays. This explains the term ‘drug holidays’. In some children who may also have had significant side-effects with weight loss, it gives them a chance to regain some weight. The planning of any medication breaks should be discussed with the prescribing doctor.
The most common side-effects are insomnia and loss of appetite. The effects of the latter can be reduced by taking the medicine with food. Height and weight are generally monitored on a 3-6 monthly basis to ensure normal growth. Some children experience wakefulness but this can be improved by reducing the last dose of medication. Less common side effects include; emotional ability, nausea, headache, dizziness, abdominal pain and tics. For some particularly vulnerable children there is a small risk of epilepsy and hallucinations.
No. And there is no evidence that taking medication will cause a child to take illicit drugs when they are older. In fact the opposite might be true because the person is less likely to try to manage their symptoms with illicit drugs.