A combination
of medication and ADHD-focused counseling is generally the
most successful treatment for ADHD. For decades, medications
have been used to treat the symptoms of ADHD. Three medications
in the class of medications known as psychostimulants seem
to be the most effective in both children and adults. These
are:
Methylphenidate
(Ritalin, Metadate, Methylin and long-acting forms of methylphenidate,
Concerta, Metadate CD, Ritalin LA and Focalin)
Dexedrine, Dextrostat, Adderall
and the long-acting form of amphetamine salts, Adderall XR.
Pemoline (Cylert) This medication
is rarely used because of its potential to cause liver damage.
Strattera (atomoxetine), the
first non-stimulant medication to treat ADHD. Unlike stimulant
medications, Strattera is classified as a "selective
norepinephrine re-uptake inhibitor" and works only on
blocking receptors in the brain that increase norepinephrine.
For many people these medicines dramatically reduce the hyperactivity
and inability to focus, work and learn.
Other types of medications are sometimes used to treat the
condition if stimulants don’t work or if the ADHD occurs
with another disorder. As useful as these medications are,
Ritalin and the other stimulants
have sparked a great deal of controversy. Most health care
providers feel the potential side effects, such as weight
loss, slow growth, and addiction, should be carefully weighed
against the benefits before prescribing the medications. However,
side effects that do occur can often be handled by reducing
the dosage.
Studies published in 2002 seem to contradict many of the concerns
about stimulant use. The Journal of the American Medical Association
reported on a 10-year study by the National Institute of Mental
Health found that while the brains of children and adolescents
with ADHD are three to four percent smaller than those of
children who don't have the disorder, medication is not the
cause. In fact, researchers suggest medication may actually
help the brain mature.
There
has also been concern that long-term use of stimulants might
lead to substance abuse, with one study showing a small correlation.
The other eleven studies conducted on this issue found the
opposite to be true. They found ADHD children medicated with
stimulants were less likely to engage in subsequent substance
abuse. Two studies published in the January 2003 issue of
Pediatrics, one that followed 146 children for 13 years, should
put an end to the debate, with neither study finding any greater
risk of substance abuse in children who used stimulant medication
to treat their ADHD.
There
has also been concern that stimulant medication affects children's
growth, with some studies showing a correlation. There has
also been concern about tics occurring as a side effect of
stimulant medication. However, a two-year follow-up of children
and adolescents treated with Concerta (which is not a stimulant)
found that tics improved in 20 percent of the participants,
did not change in 80 percent and worsened in only 20 percent.
This finding suggests that the presence of tics may not be
a reason to withhold stimulant medication when indicated for
ADHD.
Remember,
medication doesn't cure the disorder; they only control the
symptoms while you're taking it. Stimulants have only immediate
benefit; once a dose wears off the symptoms immediately return.
Interestingly enough, patients with ADHD who have an associated
sleep disturbance may report improvement in sleep when taking
stimulant medication. This may be true even if the stimulant
is a once-daily preparation taken in the morning. Also, although
the medications may help you pay better attention and complete
your work, they can't increase your knowledge or improve your
(or your child's) academic skills.
Medications alone cant make you feel better about yourself
or cope with problems. These issues require other kinds of
treatment and support and therapy by a therapist or psychologist
who is familiar with ADHD. For lasting improvement, clinicians
recommend that medications should be used along with treatments
that aid in these other areas. Many experts believe that the
most significant, long-lasting gains appear when medication
is combined with behavioral therapy, emotional counseling
and practical support.
Behavioral
Therapy
Though ADHD primarily affects a person's behavior, the disorder
has broad emotional repercussions. Scolding is the only attention
some people with ADHD ever get while growing up. They may have
few positive experiences that build their sense of worth and
competence. Facing the daily frustrations that can come with
having ADHD can make people fear that they are strange, abnormal
or stupid. In group counseling, for example, people learn that
they are not alone and that others want to help. Sometimes,
just the person with ADHD needs counseling support. But because
the problem affects the family as well as the person with ADHD,
the entire family may need help. A good therapist can help you
find better ways to handle any disruptive behaviors and promote
change.
Psychotherapy
works to help people with ADHD like and accept themselves despite
their disorder. In psychotherapy, patients talk with the therapist
about upsetting thoughts and feelings, explore self-defeating
patterns of behavior and learn alternative ways to handle their
emotions. As they talk, the therapist tries to help them understand
how they can change. However, people dealing with ADHD usually
want to gain control of their symptomatic behaviors more directly.
The following intervention can provide that help. Read "Self-esteem"
for self-esteem issues.
Support
groups connect people who have common concerns. Many adults
with ADHD and parents of children with ADHD find it useful to
join a local or national support group. Many groups deal with
issues of children's disorders, and even ADHD specifically.
Ineffective or Unproved
Alternative Treatments
Allergy
treatments
High
doses of vitamins
Chiropractic
adjustments
Yeast
infection treatments (oral medications)
Eye
training
Special
colored glasses
EEG
biofeedback
Find supportive
friends. Many women with ADHD envy friends or neighbors whose
houses are immaculate, whose children are always neat and
well-behaved, and who make them feel terrible by comparison.
Don't put yourself in situations that lead you to impossible
expectations and negative comparisons. You are who you are
-- an unique individual.
