Medications Used To Treat ADHD

Attention deficit hyperactivity disorder (ADHD) is one of the most common neuro-behavioral conditions in children. According to the latest statistics made available by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the DSM, three to seven percent of school age children in the US have ADHD. However, parental surveys reveal that the true numbers are even higher, and almost 9.5 percent of children between the ages of 4 and 17 years (5.4 million) have been diagnosed as having ADHD.

The likelihood of boys being diagnosed with ADHD is much higher than the likelihood of girls being diagnosed with the condition (13.2 percent boys compared to 5.6 percent girls). The most common, and defining, symptoms of ADHD involve difficulty in staying focused or in paying attention, unruly behavior and hyperactivity. The symptoms usually start during the period of early childhood but continue through the person's adolescence and into adulthood.

There are three different categories of ADHD based on the symptoms, namely:

• Predominantly hyperactive- impulsive
• Predominantly inattentive
• Combined hyperactive- impulsive and inattentive

It has been seen that the majority of children belong to the category of combined hyperactive- impulsive and inattentive type. To be diagnosed with ADHD, a child must have the symptoms of the condition for 6 months or more and the degree of symptoms should be greater than other children belonging to the same age group. In other words, some degree of hyperactivity is considered developmentally appropriate among children, and these kids will not be diagnosed with ADHD. At the same time, many children fail to focus on lessons they find boring, and that won't get them an ADHD diagnosis either. To be diagnosed with ADHD, the child's behavioral patterns have to be atypical.

Symptoms of inattention may include

• Getting distracted easily leading to switching from one activity to another within no time
• Difficulty in concentrating
• Difficulty in completing the task at hand
• Difficulty in turning in homework assignments on time
• Slowing of reflexes
• Difficulty in following instructions clearly and rapidly

Symptoms of hyperactivity include

• Constantly fidgeting or squirming
• Constantly in motion
• Talking relentlessly
• Touching and playing with anything in sight

Symptoms of impulsivity include:

• Blurting out whatever they have in mind without considering about the feelings of others
• Difficulty in waiting for their turn
• Interrupting others in their conversations

As this neurobehavioral disorder is fairly common, scientists have been constantly trying out different methods to cure it. However, at present, there is no permanent cure for ADHD. But there are numerous medications available to take adequate care of the symptoms. After taking these medications, children suffering from ADHD can achieve success in their academic lives. Apart from the routine medications, scientists are trying to find out other means of treating ADHD. For this, they are using innovative tools like brain imaging to understand better the changes taking place in the brain in people with ADHD. This would help them to treat the condition better.

Commonly Prescribed Medications For Treating Symptoms Of ADHD

There are various types of medications used in the treatment of ADHD. They vary in their nature, or duration of action, or dosage. As no two patients of ADHD are identical in the nature of their symptoms, similarly, the treatment of ADHD also varies from one patient to the other.

Even in one patient, it takes time to find the ideal medication in its correct dosage and schedule to show results. Moreover, the treatment is continually changing due to change in the severity of the symptoms or because of side effects of the medications.

Stimulants

The most promising of all medications available for the treatment of ADHD symptoms are the stimulants. They are considered as the first line of treatment for ADHD and are believed to be effective in 70% to 80 % of the children who have it. While some stimulants have been approved for use in children above 3 years, others can only be used in children who are six years old or above.

These medications are particularly useful for the symptoms of inattention. They help in improving the attention span so that the child does not lose focus of the activity in hand and is able to block his mind off all distractions. Stimulants are also effective in decreasing the symptoms of hyperactivity and impulsivity in hyperactive children, while they would have the opposite effect on typically developing individuals.

Stimulants also improve upon the child’s ability to follow commands and obey orders. They are found to minimize the exaggerated emotional responses of the patients. Because of these properties, stimulants are very helpful in improving the academic performance of the child, and help in improving his relationship with his classmates and his parents.

Stimulants used in present day treatment of ADHD are usually of two types:

• Methylphenidate
• Dextro-amphetamine

Both the groups have short acting, medium acting and long acting medicines. Both the groups are equally effective in managing the symptoms of ADHD as results of almost 22 studies show. The only difference is that individual children may be responsive to one group of medicines and do not show any response to the other group.

Although studies claim that stimulants can be effective for as long as 14 months, they are most effective when used for short term duration. The dosage of stimulants is not dependent on the weight of the child. Hence, the physician can start from low dose and increase it gradually till optimal response is seen. One should be vary of the side effects of stimulants. These include reduced appetite, problems with sleep, headache, stomach ache and social withdrawal. These side effects are usually seen initially during the course of treatment and are short term. They can be taken care of by either changing the dose of the medicine or its schedule. For example, if medicines have been prescribed for problems the child faces in the school, the schedule to be followed should be 5 days a week. About 15% to 30% of the children also experience motor tics which are again transient in nature.

Apart from stimulants, the other drugs that can be used in the treatment of ADHD include:

• Tricyclic antidepressants
• Bupropion
• Clonidine has been used occasionally with some success, especially in children with ADHD and sleep disturbances

Non-stimulants

Although stimulants are the drugs of choice in the treatment of ADHD, non-stimulants may be used in certain cases where stimulants fail to bring about the desired results. One such medication is Strattera. It is the first non-stimulant approved by the FDA for use in the treatment of ADHD in children, adolescents as well as adults. Intuniv is another non-stimulant approved by the FDA for treating children above the age of 6, and adolescents below the age of 17. Non stimulants are mainly important as they are known to improve the concentration power and control the impulsive behavior.