Drug Treatments for ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a common, yet often unrecognised condition that appears in early childhood and is often a lifelong condition. It isn’t a condition that can be cured, but it can be managed so that day-to-day living and relationships are able to be maintained with minimal disruption.

There are two main camps of thought on how best to manage or ‘treat’ ADHD: there are those who believe that since it is a neurobiological condition, medication to correct the disorder in the brain is the best course of treatment; and there are those who believe that behaviour management techniques are more appropriate for children. There are many who favour a combination, of course, and who believe that education is key to helping the child and their family to understand the condition and manage it appropriately: indeed, studies have shown that children who receive a combination of therapy and drugs fare better and develop better social skills.

But here we will look at medication and behavioural interventions in turn. This week we will focus on medicinal treatment of ADHD..

Medicine for childhood ADHD

As strange as it may seem, considering that children with ADHD seem to be so over-stimulated, the drugs normally prescribed to children with ADHD are actually stimulants.

Such medicines include methylphenidate and dexamfetamine work by allowing the child to concentrate and not be distracted by irrelevant stimuli. They work well for about 70 – 80% of people who take them.

However, since these medicines – these stimulants – are actually Class A drugs, there is concern about whether they should be used at all. They have known side-effects including damage to the heart and nervous systems.

An alternative drug is atomoxetine, which isn’t a stimulant which has so far shown nearly as high a success rate as the above-mentioned drugs at managing ADHD symptoms. However, the Medicines and Healthcare Products Regulatory Agency in 2005 warned of the increased risk of suicidal thoughts in children and young people who were taking this drug, and it can also cause damage to the liver.

As with all drugs, it can take time and experimentation by the GP to find the right treatment at the right dose for the individual. Side-effects may affect one child and not another. Side-effects can be serious, as above, but more commonly they are more mild (yet inconvenient) like insomnia and loss of appetite. If the child is also suffering from depression and/or anxiety related to their condition, then medication should be combined with talking and behaviour therapies.

Most drug therapies haven’t been around for long enough to be able to be assessed as to their long-term effect and efficiencies. Since most people will need to be on them for many years, time will tell whether they are a long-term solution.

The National Institute for Health and Clinical Excellence (NICE) recommends that drugs are only used for the treatment of ADHD in children over the age of six years. Before that age, most therapy work is aimed at educating and supporting parents. Even after the child reaches six years, drugs are not normally prescribed straight away (unless the child’s condition is ‘severe’); counselling and therapies and education is offered first and foremost.

Next week we will look at behaviour therapies for ADHD.