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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
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Brand name/Generic name
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Typical use
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Side effects
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Adderall/amphetamine
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Considered the only amphetamine ‘first
line treatment’ for ADHD
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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
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Dexedrine/dextroamphetamine
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Second-line treatment if amphetamine-like
drugs are ineffective or have disruptive side effects
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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
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Desoxyn/methamphetamine
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Second-line treatment if amphetamine-like
drugs are ineffective or have disruptive side effects
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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
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Amphetamine-like drugs:
these block the reuptake (meaning there’s
more hanging around) of norepinephrine and dopamine
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Brand name/Generic name
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Typical use
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Side effects
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Ritalin/methylphenidate
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First line treatment for ADHD
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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
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Focalin/dexmethylphendate
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First line treatment for ADHD
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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
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Cylert/pemoline
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NOT a first line treatment due to risk
of hepatic (liver) failure
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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
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Straterra/methylphenidate
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Long acting form of methylphenidate
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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
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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.
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