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How stimulants work

Talk with your health care professional about what medications may be best for your child. In addition to medication, some children with ADHD receive behavioral therapy to help manage symptoms and provide added coping skills. FDA-approved medications currently on the market have been tested for safety and effectiveness in clinical trials of children 6 and older. But once a drug has been approved and is on the market, FDA is now asking for clinical trials with participants of children as young as 4 and 5.

Left untreated, ADHD can have serious consequences. A child may fall behind in school, encounter difficulties in friendships, and have conflicts with parents, according to the American Academy of Child and Adolescent Psychiatry. Studies show that children with untreated ADHD have more emergency room visits and are more likely to have self-inflicted injuries than those treated for the disorder.

Untreated adolescents with ADHD are more likely to take risks, such as drinking and driving. And they have twice as many motor vehicle accidents as those who are treated. A parent should always request basic screening of their child before starting medication for ADHD. We also asked parents about other things they wished their prescribing physician had done. Parents didn't rate doctors well for managing their child's medication. He offers these additional tips:. Always call the doctor with questions. Even if all is well, check in by phone two weeks after beginning medication and schedule a visit one month after for a follow-up.

After that, return visits will depend on the success of the treatment and side effects. In general, children doing well can be seen every six months.

Reassessment should consist of a physical examination and direct questioning of the child and family member s. Teacher evaluations are also helpful. A complete re-evaluation with the family and input from others including teachers should be considered every year, although waiting two to three years is common. Side effects are a major area of concern for many parents considering medication for their child's ADHD.

Indeed, side effects might add to the overall stress of managing a child's condition.

Common ADHD Medications & Treatments for Children -

Our survey found that parents of children taking amphetamines and methylphenidates reported a high frequency of side effects. Overall, 84 percent of the children who tried amphetamines and 81 percent who tried methylphenidates experienced side effects. And among those who reported no longer taking a specific medication, 35 percent said it was because of side effects.

Decreased appetite, sleep problems, weight loss, irritability, and upset stomach were the side effects most frequently reported by parents for both types of medication. Amphetamines and methylphenidates were equally likely to produce these side effects with the exception of irritability, which was more likely to be reported as a side effect by parents whose children tried amphetamines.

Who gets ADHD?

Although elevated mood or excessive energy wasn't among the more frequently reported side effects, it was more commonly reported by parents whose children were taking amphetamines compared with methylphenidates. Talk with your doctor if irritability, anger, or manic behavior become an issue.

Side effects such as a loss of appetite are very common but usually not significant, and they tend to improve over time, Michael L. Other problems children have after taking medication might not be due to the drugs at all. Sleep problems might have occurred before starting medication, for example. And taking medication at the correct time is another factor in determining side effects. Although many parents reported side effects, they can often be managed. For example, some children have problems later in the day and a long-acting formulation is best, but sometimes the effect might persist into the evening, suppressing appetite for dinner and delaying bedtime.

Parents should also note that a child might begin to show withdrawal symptoms when a dose wears off, and might need tips for avoiding this. These management skills are something that can be developed with the doctor responsible for prescribing the medication.

For more help understanding ADHD and what you can do to help your child, including whether to medicate, see HealthPoint. Taking all this into consideration, how satisfied are parents with medications their children are taking for ADHD? Overall, only 41 percent were highly satsfied 16 percent were "completely satisfied" and 25 percent were "very satisfied".

About one-third 29 percent were dissatisfied and the remainder were fairly satisfied 30 percent. There were no differences in overall satisfaction between those groups trying amphetamines or methylphenidates. Most amphetamines and methylphenidates are available in standard doses and extended- or sustained-release forms.

Standard release means that the medication will be in your child's system for a given period of time usually about three hours , at which point another dose needs to be administered to maintain the effect. Extended- or sustained-release medications are usually given in the morning and slowly release the effective component of the medication throughout the day.

Parents were more likely to report that the extended-release formulations were "very helpful" with academic performance, behavior at school, behavior at home, and social relationships. With extended-release formulas, parents don't have to rely on their child's school to give the medication. If you're considering medication for your child with ADHD, ask your treatment provider about this option. We asked parents how strongly they agreed with a number of statements about having their child take medication.

While most agreed strongly that if they had to do it over again they would still have their child take medication 52 percent , 44 percent agreed strongly that they wished there was another way to help their child besides medication, and 32 percent agreed strongly that they worried about the side effects of medication.

Hansa on Medicine: Treating ADHD Without Medication

Overall, the process of having a child take medication for ADHD is one of constantly weighing the costs and benefits. As described above, parents reported that side effects are common. And the two major classes of medication amphetamines and methylphenidates were not "very helpful" in many of the areas we asked about. For example, they were only "very helpful" with behavior at home in 30 percent of the cases. But when compared with other common strategies used to manage ADHD , having a child take medication was the most helpful one for parents in managing ADHD.

So in many cases, medication might be something a parent could try to help his or her child with ADHD. If your child is going to try medication, first establish a baseline of behavior and academic performance so that you'll be able to make sure it is indeed working—especially since our results found that for some children, they don't work very effectively at all.

And once he or she starts medication, make sure that the person prescribing it is aware of the degree of improvement you notice, along with any side effects.

Attention deficit hyperactivity disorder (ADHD)

Rappaport who praise the use of stimulants as treatment for classic A. Reported side effects of the drugs have included growth suppression, increased blood pressure and, in rare cases, psychotic episodes. The disorder, which is characterized by severe inattention and impulsivity, is an increasingly common psychiatric diagnosis among American youth: about 9. The reported prevalence of the disorder has risen steadily for more than a decade, with some doctors gratified by its widening recognition but others fearful that the diagnosis, and the drugs to treat it, are handed out too loosely and at the exclusion of nonpharmaceutical therapies.

Long-term effects of extended use are not well understood, said many medical experts. Some of them worry that children can become dependent on the medication well into adulthood, long after any A. According to guidelines published last year by the American Academy of Pediatrics , physicians should use one of several behavior rating scales, some of which feature dozens of categories, to make sure that a child not only fits criteria for A.

However, a study in the Journal of Attention Disorders suggested that at least 20 percent of doctors said they did not follow this protocol when making their A. Anderson: Adderall for Alexis, 12; and Ethan, 9; Risperdal an antipsychotic for mood stabilization for Quintn and Perry, both 11; and Clonidine a sleep aid to counteract the other medications for all four, taken nightly. Quintn began taking Adderall for A. He immediately settled down and became a more earnest, attentive student — a little bit more like Perry, who also took Adderall for his A.

View all New York Times newsletters. The problem was, they were not; Quintn was seeing people and hearing voices that were not there, a rare but recognized side effect of Adderall.

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After Quintn admitted to being suicidal, Dr. Anderson prescribed a week in a local psychiatric hospital, and a switch to Risperdal. While telling this story, the Rocaforts called Quintn into the kitchen and asked him to describe why he had been given Adderall. Why not? William Graf, a pediatrician and child neurologist who serves many poor families in New Haven , said that a family should be able to choose for itself whether Adderall can benefit its non-A. Anderson said that every child he treats with A. Anderson said. Anderson cited William G. Hasty Elementary School here in Canton as one school he deals with often.

Several educators contacted for this article considered the subject of A.