Attention deficit/hyperactivity disorder (ADHD) occurs in both children
and adults. ADHD is commonly treated with stimulants, such as:
- Methylphenidate
(Ritalin, Metadate, Concerta, Daytrana)
- Amphetamine (Adderall)
- Dextroamphetamine
(Dexedrine, Dextrostat).
In 2002, the FDA approved the
nonstimulant medication atomoxetine (Strattera) for use as a treatment
for ADHD. In February 2007, the FDA approved the use of the stimulant
lisdexamfetamine dimesylate (Vyvanse) for the treatment of ADHD in
children ages 6 to 12 years.
What are the side effects?
Most
side effects are minor and disappear when dosage levels are lowered. The
most common side effects include:
- Decreased appetite.
Children seem to be less hungry during the middle of the day, but they
are often hungry by dinnertime as the medication wears off.
- Sleep
problems. If a child cannot fall asleep, the doctor may prescribe a
lower dose. The doctor might also suggest that parents give the
medication to their child earlier in the day, or stop the afternoon or
evening dose. To help ease sleeping problems, a doctor may add a
prescription for a low dose of an antidepressant or a medication called
clonidine.
- Stomachaches and headaches.
- Less
common side effects. A few children develop sudden, repetitive
movements or sounds called tics. These tics may or may not be
noticeable. Changing the medication dosage may make tics go away. Some
children also may appear to have a personality change, such as appearing
"flat" or without emotion. Talk with your child's doctor if you see any
of these side effects.
How are ADHD medications taken?
Stimulant
medications can be short-acting or long-acting, and can be taken in
different forms such as a pill, patch, or powder. Long-acting, sustained
and extended release forms allow children to take the medication just
once a day before school. Parents and doctors should decide together
which medication is best for the child and whether the child needs
medication only for school hours or for evenings and weekends too.
ADHD
medications help many children and adults who are hyperactive and
impulsive. They help people focus, work, and learn. Stimulant medication
also may improve physical coordination. However, different people
respond differently to medications, so children taking ADHD medications
should be watched closely.
Are ADHD medications safe?
Stimulant
medications are safe when given under a doctor's supervision. Some
children taking them may feel slightly different or "funny."
Some
parents worry that stimulant medications may lead to drug abuse or
dependence, but there is little evidence of this. Research shows that
teens with ADHD who took stimulant medications were less likely to abuse
drugs than those who did not take stimulant medications.14
FDA
warning on possible rare side effects
In 2007, the FDA required
that all makers of ADHD medications develop Patient Medication Guides.
The guides must alert patients to possible heart and psychiatric
problems related to ADHD medicine. The FDA required the Patient
Medication Guides because a review of data found that ADHD patients with
heart conditions had a slightly higher risk of strokes, heart attacks,
and sudden death when taking the medications. The review also found a
slightly higher risk (about 1 in 1,000) for medication-related
psychiatric problems, such as hearing voices, having hallucinations,
becoming suspicious for no reason, or becoming manic. This happened to
patients who had no history of psychiatric problems.
The FDA
recommends that any treatment plan for ADHD include an initial health
and family history examination. This exam should look for existing heart
and psychiatric problems.
The non-stimulant ADHD medication
called atomoxetine (Strattera) carries another warning. Studies show
that children and teenagers with ADHD who take atomoxetine are more
likely to have suicidal thoughts than children and teenagers with ADHD
who do not take atomoxetine. If your child is taking atomoxetine, watch
his or her behavior carefully. A child may develop serious symptoms
suddenly, so it is important to pay attention to your child's behavior
every day. Ask other people who spend a lot of time with your child,
such as brothers, sisters, and teachers, to tell you if they notice
changes in your child's behavior. Call a doctor right away if your child
shows any of the following symptoms:
- Acting more subdued or
withdrawn than usual
- Feeling helpless, hopeless, or worthless
- New
or worsening depression
- Thinking or talking about hurting
himself or herself
- Extreme worry
- Agitation
- Panic
attacks
- Trouble sleeping
- Irritability
- Aggressive
or violent behavior
- Acting without thinking
- Extreme
increase in activity or talking
- Frenzied, abnormal excitement
- Any
sudden or unusual changes in behavior.
While taking
atomoxetine, your child should see a doctor often, especially at the
beginning of treatment. Be sure that your child keeps all appointments
with his or her doctor.