Hundreds of controlled studies involving more than 6,000 children, adolescents and adults have been conducted to determine the effects of psychostimulant medications-far more research evidence than is available for virtually any other medication. The “booster” dose may provide better coverage for doing homework or other late afternoon or evening activities and may also reduce problems of “rebound” when the earlier dose wears off. Although there is little research on utilizing short-acting and long-acting medications together, many individuals, especially teenagers and adults, find that they may need to supplement a longer-acting medication taken in the morning with a shorter-acting dose taken in the mid to late afternoon. Longer-acting medications may cause fewer “ups and downs” over the day and may eliminate the need for taking additional doses at school or during work.
Since effective longer-acting formulations of stimulants became available, many children, adolescents and adults have found these preferable.
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In all cases, the appropriate dose must be tailored to the individual patient and monitored by the prescribing medical professional to make any needed adjustments. For children, observations are collected from parents and teachers, even coaches and tutors, and parent and teacher rating scales are often used. In addition, the individual is monitored both on and off the medication. It is common for the dosage to be raised several times during the trial.
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The trial usually begins with a low dose that is gradually increased at 3–7 day intervals until clinical benefits are achieved. A medication trial is often used to determine the most beneficial dosage. However, there are no consistent relationships between height, age and clinical response to a medication. The specific dose and timing of medication must be determined for each individual. Of course, there can be wide individual variation that cannot be predicted and will only become evident once the medication is tried. Short-acting preparations generally last about 4 hours long-acting preparations are more variable in duration-with some preparations lasting 6–8 hours and newer preparations lasting 10–12 hours. Methylphenidate, amphetamine and mixed salts of amphetamine are now available as both short- and long- acting preparations. Thus, it is not like an antibiotic that may cure a bacterial infection, but more like eyeglasses that help to improve vision only during the time the eyeglasses are actually worn.Ĭommon psychostimulant medications used in the treatment of ADHD include methylphenidate (Ritalin, Concerta, Metadate, Focalin) mixed salts of a single-entity amphetamine product (Adderall, Adderall XR) and dextroamphetamine (Dexedrine, Dextrostat). Medication does not cure ADHD when effective, it eases ADHD symptoms during the time it is active. Relationships with parents, peers and teachers may also improve.
Some children also demonstrate improvements in frustration tolerance, compliance and even handwriting. Attention span, impulsivity and on-task behavior often improve, especially in structured environments. For some, the benefits are extraordinary for others, medication is quite helpful and for still others, the results are more modest. In some instances, the first medicine tried may not be the right one, or perhaps a higher dose may be needed. Between 70–80 percent of children with ADHD respond positively to these medications. Instead, they help important networks of nerve cells in the brain to communicate more effectively with each other. Despite their name, these medications do not work by increasing stimulation of the person.
Psychostimulant medications were first administered to children with behavior and learning problems in 1937. Psychostimulant compounds are the most widely used medications for the management of ADHD symptoms. Research shows children and adults who take medication for symptoms of ADHD usually attribute their successes to themselves and not to the medication. Medication, which can only be prescribed by medical professionals, is used to improve the symptoms of ADHD so that the individual can function more effectively.Įach family must weigh the pros and cons of choosing medication as part of the treatment plan for ADHD. Treatment should be tailored to the unique needs of each child and family.įor most children with ADHD, medication is an integral part of treatment. This comprehensive approach to treatment is often called “multimodal” and consists of parent and child education about diagnosis and treatment, behavior management techniques, medication, child and/or family counseling, and school programming and supports. Treating ADHD in children requires medical, educational, behavioral and psychological interventions.
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