What are the medications used in treatment of
Medications used to treat ADHD are broadly
divided in two groups:
- Stimulants like methylphenidate and dexamphetamine
- Non stimulants like atomoxetine.
Stimulants have the effect of
making people feel more alert, energetic, and awake. In a person
suffering ADHD, they can improve attention and reduce
hyperactivity. The stimulants used in the treatment of ADHD include
methylphenidate (previously commonly known by the name ‘ritalin’)
Methylphenidate is available as different
forms. Immediate release methylphenidate is short-acting. It is
used for its flexibility in dosing and can be used to determine the
correct level of dose during dose changes. Slow or modified release
methylphenidate work for 8 – 12 hours and can be given once a day.
They are more convenient, and as the child or young person need not
take a dose in school, reduces stigma attached to this
Non stimulant medications by nature do not
make people alert or active. However, in ADHD, they can improve
symptoms of inattention and hyperactivity. These include
medications like atomoxetine.
Sometimes other medications may be
used to help with problems with sleep and challenging
behaviours that are associated with ADHD.
How do they work?
Medications act on certain chemicals in the
brain called ‘noradrenaline’. They seem to affect the parts of the
brain that control attention and organise our behaviour.
They do not cure ADHD. They help to control
the symptoms of poor attention, overactivity or impulsivity.
Which medication will be used for my child?
Stimulant medication methylphenidate is
usually prescribed first. The type of stimulant prescribed will
depend on a number of things like the symptoms your child has, your
choice of treatment, the ease of giving the medication and even
availability/cost of the medication.
If methylphenidate causes unpleasant
side-effects or does not work, other stimulant (dexamphetamine) or
non stimulant medications may be prescribed. Sometimes a child may
respond to a different form of methylphenidate.
How do I know it is working?
You will find that:
- your child’s concentration is better
- their feelings of restlessness or over-activity are less
- they control themselves better.
Sometimes school or teachers notice the
improvement before you do.
What are the side-effects?
As with most medications, there may be some
unwanted effects. However, not everyone gets side effects and most
side effects are mild and disappear with continued use. Side
effects are less likely if the dose is increased gradually when the
tablets are started. Some parents worry about addiction, but there
is no good evidence to suggest that this is a problem.
Some of the common side effects of
- loss of appetite
- difficulty falling asleep
- light headedness
Less common side effects to look out for
- being ‘over-focused’, quiet and staring- this may be a sign
that the dose is too high
- anxiety, nervousness, irritability or tearfulness
- tummy pains or feeling sick
- headache, dizziness or drowsiness
- tics or twitches.
In the long term, sometimes growth slows down
when children are on methylphenidate. Research shows that the total
adult height may be reduced by 2.5 cm when on methylphenidate.
This list of side-effects is not exhaustive.
If you notice anything unusual,
it is important to contact your
Is there anything I need to know before giving the
Before you give any medication do tell your
- allergies your child might have
- any other medicines they take, including vitamins or
- for older girls if they are likely to become pregnant
- if you or anyone in your family suffers from physical health
problems, especially high blood pressure, heart problems and
repeated movements (called tics).
Are there any special tests before or while taking the
Before taking the medication, your child
should be physically checked up especially for their heart rate,
blood pressure, growth and any other medical problems. Sometimes
they may need blood test or heart tracing test to measure the
electrical activity of the heart called an electrocardiogram
While taking the medication, your doctor will
monitor your child’s heart rate, blood pressure, weight and height
on a regular basis along with checking for any side effects.
What do I need to know about giving the
Some helpful things to know:
- Give the medication at the times you were told by your doctor
- Keep appointments for regular review of medication
- Store the medication safely
- Ensure your child swallows the medication, not chew or crush
- Make sure your child drinks enough, especially in hot
weather and while exercising.
- Double the dose if they miss a dose of medication
- Stop giving the medication without discussing with the
- Give the medication to anyone else, even if you feel
their difficulties are similar to your child’s.
How long do they need to be on the
Most children and young people need the
medication at least until they finish their education or schooling.
A few might need to take it even when they grow up. Some children
need medications only at specific times, like for example while
attending school, and do not have to take it on weekends or on
Your doctor would regularly check, at least
once a year, if they need to continue the
Taking these medications can affect driving,
and even certain careers like joining the army. It is important
that the child is aware this and will need to discuss it with their
doctor as they grow up.
Young people may need explanations and support
as they grow up about taking their medication. Stopping medication
can cause symptoms to return, and some young people can put
themselves at risk in terms of their education, their work, and
socially by being impulsive and taking alcohol or drugs.
Remember: if you have any further
questions regarding this medication, do not hesitate to contact
your doctor or pharmacist.