So, your child or teenager has just been diagnosed with ADHD, and you’re probably wondering what to do now. Or maybe, your child has been treated for ADHD for a while and you are wondering if you have any other options. The good news is that there are indeed many options for treating ADHD. The bad news is that like many other conditions it may take a little time to find the right treatment plan for your child.
The first decision that you and your child’s doctor have to make is whether or not to use medications for the ADHD. Many parents are concerned about putting their son or daughter on medications for behavioral problems. So, it is very important that you talk with your child’s doctor about the treatment options and to understand the pros and cons of using whichever treatment you decide to use. There are many other treatments besides medications that can be useful, but keep in mind they usually work much better when you combine them with meds.
As far as medications go, the main choice is between a stimulant and a non-stimulant. There are two main types of stimulants, which include the methylphenidates and the dextroamphetamines. Don’t worry about the chemical names. Just know that they are slightly different chemicals that work in very similar ways in the brain. Sometimes a child will have better results from one type of stimulant than from the other. So, your child’s doctor may switch to the other type if your child doesn’t seem to improve on one type of medication.
For each type of stimulant there are also other options to think about. Basically, some types of medications work faster or longer than others. For example, the methylphenidate form of stimulant has immediate release (Ritalin, Methylin), extended release (Ritalin SR, Metadate ER, Methylin ER), and long acting (Ritalin LA, Metadate CD, Concerta). There is also a patch version (Daytrana) that your child would wear for nine hours a day, which just slowly releases the medication over that time period. The dextroamphetamine stimulant includes Adderall and also comes in short acting and long acting versions.
These days, the long acting medications are being used more often for convenience and safety. Using a long acting drug means that your child won’t have to visit the school office at lunchtime to take his med. Also, you may have heard about stimulants being abused by people to get a high. This is much, much less likely with a long acting stimulant because it works more slowly and doesn’t give the “high” feeling when people try to abuse it. So, you don’t have to worry as much about other people stealing the long acting medications from your child. This means they are also safer to keep in your medicine cabinet if you have concerns that anyone in your house that may abuse medications.
If your child is put on a stimulant medication, the doctor will want to monitor blood pressure, pulse, weight and height on a regular basis. Stimulants can cause kids to eat less, and therefore gain less weight and height. They can also cause increased blood pressure and heart rate just like caffeine. So, we monitor these things at every visit. The nice thing about stimulants is that they often give pretty fast results. Many parents notice changes right away with the stimulant medications and can even tell as soon as the medication has worn off!
The other main type of medication is a non-stimulant. The most common non-stimulant is atomoxetine (Straterra). This medication works a little differently than the stimulants, but can work well for the right patient. Some doctors feel that it works better than a stimulant when your child with ADHD also has anxiety or depression symptoms. Or, sometimes we will start with atomoxetine when parents are really against using a stimulant for various reasons or if the doctor knows other reasons why a stimulant would not be a good choice. Atomoxetine can take four to six weeks to see results, so it can take a little longer to get the right dosage figured out if you choose this option. There are also other non-stimulants that are used much less often, but we won’t go into those here.
It can take a while to find the right medication for your child, so remember to be patient. Usually your child will have to be rechecked every four weeks to see how the medication is working and to monitor for any side effects. After you find the right medication and dosage for your child, the doctor may not need to see him quite as much. But, since kids are growing and changing so rapidly we like to keep a closer eye on them. Also, the FDA regulates how we prescribe the stimulant medications because some people abuse them. This means that we can only write for so many pills at a time.
There are also many other options for treating ADHD. As we said before, they usually work best when you use them with medications. But, sometimes parents are really against using medications or maybe the ADHD symptoms are really mild and aren’t interfering too much with the child’s life. Sometimes in those cases your doctor would be willing to try these other things by themselves.
Basically, these other treatment options include cognitive therapy, behavioral therapy, and social skills training. Usually a psychologist or clinical social worker will help you and your child through these therapies. They are usually a little time consuming because you have to visit the therapist every week or every other week. The therapist will give you and your child things to work on in between visits, which will help change how your child thinks and acts on a day-to-day basis. The skills that the therapist teaches can be very beneficial for the whole family in learning how to cope with ADHD symptoms and can really help the child long term. No matter how you feel about using medications for your child’s ADHD, it is definitely worth the time and money to find a good therapist for your child, especially if your insurance is willing to cover it.
Lastly, if a kid is having problems with school because of their ADHD, the school will usually put together an educational plan. These educational plans usually require regular meetings with parents to make sure everyone is on the same page. You will sit down with your child’s teachers and aides to figure out what your child needs help with. These plans include a list of goals for your child and the steps that you and the school will take to help your child reach the goals.
Of course, the most important part of helping any child with ADHD is for you to learn as much as you can about the condition and how it affects your child. Your doctor should be able to answer any questions you have about ADHD and why a certain medication is being used. Don’t ever be afraid of asking a dumb question. There’s no such thing! And, depending on how old your kid is, they should also be included in discussions about their ADHD symptoms and treatments. Teenagers often have strong feelings about taking medications. So, it’s especially important that both you and the doctor pay attention to what teens are thinking talk to them about why they may need treatment. ADHD is a very treatable condition. With the help of your doctor, you and your child should feel very comfortable with whichever treatment option you decide to use.
