ADHD

 


ADHD Medication Options and Side Effects

  
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Should I medicate?

There is a lot of controversy about medicating children for ADHD.  A child who is expected to perform and behave in a way that is near to impossible for them due to brain differences is prone to developing life-long self-esteem problems.  Research indicates that not medicating children who need it results in prolonged problems in school and social functioning.  Those children are more prone to depression, anxiety, and learning delays.  In general, it is suggested that parents try every non-pharmacological method to assist their child including occupational therapy, cognitive-behavioral therapy (performed by a psychologist to teach impulse control), and social skills training.  If those fail, the decision to medicate should be strongly considered.    With proper support, these children have the tools they need to succeed.

   

How is it treated?

ADHD symptoms are thought to be the result of an imbalance/dysregulation of neurotransmitters.  Medications to treat ADHD work by either increasing the availability of the neurotransmitters or increasing production of them.  The following is by no means a comprehensive list, but can provide general information about ADHD medications.

Amphetamines:  this class of medications stimulates the release of norepinephrine and dopamine

Brand name/Generic name

Typical use

Side effects

Adderall/amphetamine

   

Considered the only amphetamine ‘first line treatment’ for ADHD

Sleeplessness, restlessness (akathisia), tremors, dry mouth, anorexia, weight loss, diarrhea or constipation, irritability, and impotence.  Continuous use can cause increased heart rate, palpitations, cardiac dysrhythmias, and increased blood pressure

Dexedrine/dextroamphetamine

   

Second-line treatment if amphetamine-like drugs are ineffective or have disruptive side effects

Sleeplessness, restlessness (akathisia), tremors, dry mouth, anorexia, weight loss, diarrhea or constipation, irritability, and impotence.  Continuous use can cause increased heart rate, palpitations, cardiac dysrhythmias, and increased blood pressure

Desoxyn/methamphetamine

   

Second-line treatment if amphetamine-like drugs are ineffective or have disruptive side effects

Sleeplessness, restlessness (akathisia), tremors, dry mouth, anorexia, weight loss, diarrhea or constipation, irritability, and impotence.  Continuous use can cause increased heart rate, palpitations, cardiac dysrhythmias, and increased blood pressure

   


 

Amphetamine-like drugs:  these block the reuptake (meaning there’s more hanging around) of norepinephrine and dopamine

Brand name/Generic name

Typical use

Side effects

Ritalin/methylphenidate

First line treatment for ADHD

Sleeplessness, restlessness (akathisia), tremors, dry mouth, anorexia, weight loss, diarrhea or constipation, irritability, and impotence.  Continuous use can cause increased heart rate, palpitations, cardiac dysrhythmias, and increased blood pressure

Focalin/dexmethylphendate



 

First line treatment for ADHD

Sleeplessness, restlessness (akathisia), tremors, dry mouth, anorexia, weight loss, diarrhea or constipation, irritability, and impotence.  Continuous use can cause increased heart rate, palpitations, cardiac dysrhythmias, and increased blood pressure

Cylert/pemoline

NOT a first line treatment due to risk of hepatic (liver) failure

Sleeplessness, restlessness (akathisia), tremors, dry mouth, anorexia, weight loss, diarrhea or constipation, irritability, and impotence.  Continuous use can cause increased heart rate, palpitations, cardiac dysrhythmias, and increased blood pressure

Straterra/methylphenidate





 

Long acting form of methylphenidate

Sleeplessness, restlessness (akathisia), tremors, dry mouth, anorexia, weight loss, diarrhea or constipation, irritability, and impotence.  Continuous use can cause increased heart rate, palpitations, cardiac dysrhythmias, and increased blood pressure

   

Other adverse reactions include a slight decrease in overall growth and the development of tics/Tourette’s syndrome (typically a medication change corrects this).

Amphetamine and amphetamine-like drugs also carry very small risk for the development of thrombocytopenia (a life-threatening reduction in blood platelets), uremia (a problem with the kidneys clearing out wastes) and exfoliative dermatitis (lesions and loss of skin).

Wellbutrin/bupropion is another medication that has been found to help children with ADHD.  It is an antidepressant that prevents the reuptake of norepinephrine and dopamine.   In general, this drug should not been given to children with a history of seizures.  It has many side effects.

Children being prescribed medications for ADHD should always have a baseline CBC (complete blood count) and EKG (electrocardiogram) done before the first dose.  Drug holidays, usually over the summer, are recommended to assess the continued need for treatment.