ADHD Medications

For decades, medications have been used to treat the symptoms of ADHD. Which medications are best, what dosage to take, who should take what, etc. has been long debated. One of the things that is important to understand about ADHD medications is that they treat symptoms, they do not cure you of ADHD.

There are pros and cons to ADHD medications. Some people feel that behavioral therapy is a better option, while others have found that medications are the best solution for them. Before we take a look at specific types of ADHD medications, let's take a look at some general information:

Medications

The medications that seem to be the most effective for treating the symptoms of ADHD are a class of drugs known as stimulants. These drugs have some side effects, as they are stimulating the body. Stimulants primarily work on dopamine, a neurotransmitter that has been shown to pay a role in ADHD. There are some drugs that have recently come out for ADHD that do not fit in this class, and treat an altogether different nuerotransmitter.

The U.S. Food and Drug Administration (FDA) recently approved a medication for ADHD that is not a stimulant. The medication is called Strattera, or atomoxetine. It works on the neurotransmitter norepinephrine, instead of dopamine. It toois believed to play a role in ADHD. More studies will need to be done on this, but to date most children who use this non-stimulant medication have see significant improvement in their symptoms.

However, despite the positive results of atometine, stimulants are still the number one medication choice for ADHD. The following is a list of some of the trade name and generic name stimulant medications offered, as well as what age of child can use them:

Trade Name, Generic Name, Approved Age

• Adderall, amphetamine, 3 and older
• Concerta, methylphenidate, 6 and older
  
• Cylert,  pemoline, 6 and older
  
• Dexedrine, dextroamphetamine, 3 and older
  
• Dextrostat, dextroamphetamine, 3 and older
  
• Focalin, dexmethylphenidate, 6 and older
  
• Metadate ER (extended release),  methylphenidate,  6 and older 
  
• Metadate CD, methylphenidate, 6 and older
  
• Ritalin, methylphenidate, 6 and older
  
• Ritalin SR,  methylphenidate, 6 and older
  
• Ritalin LA (long acting), methylphenidate, 6 and older

Side Effects

In general, side effects of stimulants, which are what ADHD medication typically are, can include a decreased appetite, headaches, stomachaches, trouble getting to sleep, jitteriness, and social withdrawal. For some people such medications suppress their personalities, and they feel like they are more in a trance like state, others are over-focused and as a result become very dull.

Many of these side effects can be managed by adjusting the dosage or when (meaning the time of day) the medication is given. In some cases you may need to switch types of medication.

Most side effects of the stimulant medications are minor and as mentioned previously are directly related to the dosage of the medication being taken. Higher doses produce more side effects.

The most common side effects, regardless of the choice of medication, are decreased appetite, insomnia, increased anxiety, and irritability. So basically you are trading the ability to focus for being not hungry and unable to sleep.

In many people appetites fluctuate, but it is important to recognize that decreased appetite is a side effect of this medication type, and thus, the right amounts of nutritious foods should be consumed regardless of whether you feel like eating or not.

If difficulty falling asleep is your side effect there are several options you can try. For example, you can lower the dosage, or take it earlier in the day, or take an adjunct medication.

A few children develop tics during treatment, and sometimes this can be taken care of simply by changing dosage, but in some cases the child simply can not tolerate stimulants, and in those cases, an antidepressant is often used in its place.

Things you should know

Often times parents get really excited because they put their child on medication, and then they see improvements in school. This leads to the thinking that they just need to keep their child on medication and everything will work out fine. However, it is critical to understand that while it can help control the symptoms, ADHD medications are not a cure, and only work when they are taken. So, for better long term results, behavioral therapy should be combined with the medications.

Behavioral therapy, emotional counseling, and practical support will help ADHD children cope with everyday problems and feel better about themselves, so on days that they forget to take their medication, or should they choose to go off of it, they will not crash and burn.

Results

So what do ADHD medications do exactly? Well, it varies some from person to person, but in general, the stimulants dramatically reduce hyperactivity and impulsivity and improve ability to focus, work, and learn. The medications may also improve physical coordination, such as that needed in handwriting and in sports.

Some people get better results from one medication, some from another. It is important to work with your doctor to figure out which medication, and what dosage is going to work best for you or your child.  If the child does not show symptom improvement after taking a medication for a week, the doctor may try adjusting the dosage. If there is still no improvement, the child may be switched to another medication.

This leads to the next question many parents want answered.are stimulant drugs safe? The answer is much like that to any drug, if used with medical supervision, at the right times, and in the right dosage, they are considered very safe. If abused, they can cause problems.

Stimulants do not make the child feel "high," although sometimes they will say they feel funny, this is often a result of depressed personality. It is believed that stimulants will not cause a drug dependence, but it is still important not to overuse, or abuse these drugs.

Facts to Remember

Although you may be opposed to giving your child drugs, it is important to realize that medications for ADHD help many children focus and be more successful at school, home, and play. This success means avoiding negative experiences, which usually means a happier child, and one with a higher self esteem and fewer problems later in life.

About 80 percent of children who need medication for ADHD still need it as teenagers. Over 50 percent need medication as adults. So, if you do not want your child taking medication for ADHD forever, be sure to start them on behavioral therapy as well.

Money Saving Tip

The prices of stimulants is usually based more on the number of pills in the prescription, rather then on the total number of milligrams. So, if possible, buy pills with bigger dosage amounts, and cut them in half. For example, instead of taking one 10mg pill twice a day (60 pills), it is usually less expensive to get a prescription for, and take, one-half of a 20mg pill twice a day (30 pills).

Based on the average wholesale price for Adderall and Ritalin, doing this could save you about 15-30% a month.

Medication options:

The stimulant drugs come in long- and short-term forms. The newer sustained-release stimulants can be taken before school and are long-lasting so that the child does not need to go to the school nurse every day for a pill.

Long Acting Stimulants Options

The long acting stimulants generally have a duration of 8-12 hours and can be used just once a day. They are especially useful for children who don't want to take a dose at school.

Adderall XR

Adderall XR is approved for use in children over the age of six years, although regular Adderall can be used in younger children from 3-5 years of age. Adderall XR is a sustained release form of Adderall, a popular stimulant which contains dextroamphetamine and amphetamine. It is available as a 10mg, 15 mg, 20mg, 25 mg and 30mg capsule, and unlike many of the other sustained release products, the capsule can be opened and sprinkled onto food, or drink if your child can't swallow a pill.

Concerta

Concerta is a sustained release form of methyphenidate (Ritalin). It is available as a 18mg, 36mg and 54mg tablet and is designed to work for 12 hours. Like Adderall XR, it is only approved for children over the age of six years.

Metadate CD

This is also a long acting form of methylphenidate (Ritalin).

Ritalin LA

This is a newer long acting form of methylphenidate (Ritalin). It is available in 10mg, 20mg, 30mg, and 40mg capsules. It too can be opened and sprinkled on something if your child can't swallow the capsules whole.

Short/Intermediate Acting Stimulants Options

While the long term medications are convenient, for those who just need short bursts of focus, such as to take a test, or only need it during the afternoons, etc. short term stimulants are a great option.

Short/Intermediate acting stimulants include:

• Ritalin (Methylphenidate HCl)
• Ritalin SR
• Methylin Chewable Tablet and Oral Solution New!
• Metadate ER
• Methylin ER
• Focalin
• Dexedrine (Dextroamphetamine sulfate)
• Dextrostat
• Adderall
• Adderall (generic)
• Dexedrine spansules

Short acting Ritalin, Adderall and Dexedrine do have the benefit of being available in a generic form, which are usually less expensive then all of the other stimulants. And the new Methylin Chewable Tablet and Oral Solution are great for children with ADHD that can't swallow pills.