ADHD (attention deficit hyperactivity disorder) affects a child's behavior and ability to pay attention. ADHD symptoms are noticed early in a child's life and continue into adulthood.
Children with ADHD tend to be:
It may be hard to know if your child has ADHD or is just misbehaving. It's normal for a child to be inattentive, impulsive, or hyperactive from time to time. But if these behaviors continue or become worse, they may be signs of ADHD.
The exact cause of ADHD is not clear, but it tends to run in families.
Some medical problems have symptoms that look like ADHD, so it's important that your child gets the right diagnosis. Your doctor may do some tests and ask you and your child questions to help rule out other problems, such as depression or an anxiety disorder. Sometimes the symptoms of bipolar disorder and ADHD can be confused.
The symptoms of ADHD can also be confused with a learning disability. A psychologist can do some tests to see if your child is having trouble learning how to read, write, or do math problems.
There is no cure for ADHD. But treatment can help manage your child's symptoms.
Without treatment, your child is more likely to:
Stimulant medicines are most often used to treat moderate to severe symptoms of ADHD. These medicines affect the way your child's brain controls impulses, behavior, and attention.
Stimulant medicines are sorted into two groups:
If these medicines don't help, your doctor may suggest nonstimulant medicines to treat ADHD. These include:
Sometimes antidepressants are also recommended.
Stimulant medicines are the most effective treatment for ADHD. They improve ADHD symptoms in about 70 out of 100 children who take them.1 This means that they don't improve symptoms in about 30 out of 100 children who take them.
Studies have shown that children who take stimulant medicines:1
Studies have also shown that:2
Even though medicine can help reduce your child's symptoms, it can't solve all of your child's behavior problems. Your child may also benefit from counseling, behavior therapy, or social skills training.
Your child will take pills every day for as long as he or she needs them. It's important that your child takes the medicine as prescribed and keeps taking it so it has time to work.
If you don't see any improvement in your child's behavior, talk to your doctor. Your child may need to try several different medicines to find one that works for him or her.
You'll need to closely watch your child after he or she begins to take the medicine. The medicine may cause side effects, but they will usually go away within the first few weeks. If they don't, your doctor may need to lower the dose.
Common side effects include:
Stimulant medicines may be related to slower growth in children, especially in the first year of taking the medicine. But most children seem to catch up in height and weight by adulthood. Your doctor will keep track of your child's growth and watch for problems.2
Studies show that when used for only a short time, medicines for ADHD are safe and can help improve your child's behavior and quality of life. But there are some risks. And the effects of using these medicines over the long term haven't been studied. You'll need to weigh the benefits of your child taking medicine with the possible risks.
There is a small chance that a child may think about suicide when he or she takes atomoxetine or an antidepressant. The U.S. Food and Drug Administration (FDA) doesn't recommend that people stop using these medicines. Instead, people taking these medicines should be watched for warning signs of suicide, such as saying they're going to hurt themselves, talking or writing about death, or giving away their things. This is especially important at the beginning of treatment or when doses are changed.
Studies have found that less than 1 out of 100 children who used atomoxetine thought about suicide, while more than 99 out of 100 didn't.3
Most medicines for ADHD come with an FDA warning about possible heart-related or mental health problems. Be sure to tell your doctor if your child has any heart problems, heart defects, or mental health problems or if there is a family history of these problems.
The FDA has issued an advisory about atomoxetine and the risks of liver injury, orthostatic hypotension, and syncope. Call your doctor if you have nausea or belly pain. Also, call your doctor if you feel dizzy or lightheaded or if your skin is yellowing.
If your child's symptoms are mild, then treatments other than medicine may be enough to help your child improve his or her behavior. Behavior therapies and extra support at home and in school can help your child succeed and feel better about himself or herself.
These treatments work for some children:
Your doctor may suggest that your child take medicine if:
|Have your child take medicine for ADHD||Don't have your child take medicine|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"We thought that our son had a learning disability. He seemed "spacey" at times. When he was little, he couldn't pay attention long enough for me to read an entire book to him. As he got older, he did poorly on standardized tests at school. A psychiatrist finally diagnosed him with ADHD and suggested that medicine might be helpful. We are thinking it over and will probably try it. Our son is old enough to help us with the decision too. I'm sure he would be happy to have some help staying on task at school and with his homework."
— Parents of Michael, age 11
"We thought our son was just a little more energetic than other kids. Then he started preschool. We got a call from the teacher on his second day there. Turns out he was a lot more "energetic" than the other kids. We have been working with his doctor and with the preschool teacher for several months on different ways to get him to sit still and stay on task. He's made some progress, but he is still a handful. We are trying to hold off on trying medicine until he is around age 6. We realize that he may always need more than just a little extra attention in order to succeed in school."
— Parents of Carlos, age 4
"Our daughter Ann Marie doesn't have many friends at school. Her impulsive behavior is so out of control that none of the other kids want to play with her. It is hard for us, because we know what a warm and fun-loving child she is. When our doctor suggested that she might benefit from medicines, we were happy to have an option that might make it easier for her to get along with her classmates."
— Parents of Ann Marie, age 6
"We aren't sure what our daughter's problem is—ADHD, learning disability, depression, or some combination of things. It's a little frustrating that it seems to be taking so long to figure it out, but we like our doctor and she has done a good job of helping us understand why there are no quick and easy answers. Our daughter isn't hyper like a lot of kids with ADHD, but she can't seem to pay attention in class and she's not doing well in school. We work with her most nights at home to help her focus on her homework, and we do not want to put her on any medicine at this point. But if her grades still aren't up at the end of this quarter, we may consider trying medicine to help her focus."
— Parents of Emily, age 7
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons for your child to take medicine for ADHD
Reasons for your child not to take medicine
My child wants to try medicine.
My child doesn't want to try medicine.
My child's ADHD isn't improving with counseling alone.
I want my child to continue counseling, without medicine, at least for a while.
I'm worried that ADHD is affecting my child's schoolwork and relationships with friends and family.
My child's schoolwork and relationships with friends and family don't seem to be affected.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having my child take medicine
NOT having my child take medicine
1. Can medicine cure ADHD?
2. Do ADHD medicines have side effects?
3. Are there other ways to treat ADHD that don't involve taking medicine?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Adam Husney, MD - Family Medicine|
|Specialist Medical Reviewer||Louis Pellegrino, MD - Developmental Pediatrics|
American Academy of Child and Adolescent Psychiatry (2002). Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. Journal of the American Academy of Child and Adolescent Psychiatry, 41(2, Suppl): 26S–49S.
Greenhill LL, Hechtman LI (2009). Attention-deficit/hyperactivity disorder. In BJ Sadock et al., eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3560–3572. Philadelphia: Lippincott Williams and Wilkins.
U.S. Food and Drug Administration (2005). FDA issues public health advisory on Strattera (atomoxetine) for attention deficit disorder. FDA News P05-65. Available online: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2005/ucm108493.htm.