According to the National Institute of Mental Health, there isn't a cure for attention deficit hyperactivity disorder. However, the NIMH states that treatments may help reduce ADHD symptoms, which can include wandering off task, extreme restlessness, acting without considering long-term consequences -- or a mix of these behaviors. "Treatments include medication, psychotherapy, education or training, or a combination of treatments," the NIMH notes.
When it comes to ADHD medications for children, Dr. Rebecca A. Baum, chief of developmental behavioral pediatrics at Nationwide Children's Hospital and a clinical associate professor of pediatrics at The Ohio State University, explains that there are two main groups of medications -- stimulants and non-stimulants -- which are both FDA-approved.
Stimulants, she explains, "stimulate the part of the brain that deals with attention and focus" and are considered to have the best evidence showing efficacy. "Nowadays, there are several different stimulant medications to choose from, so people are able to find one that works well with minimal side effects." Examples of commonly-prescribed stimulants include Ritalin, Evekeo, Adderall and Concerta.
As for non-stimulant medications, she says they're typically less effective and therefore not as frequently used. For example, it's been found that one type, atomoxetine, is only about two-thirds as effective as stimulant medicines.
Medication Side Effects
As with all medications -- ADHD or otherwise -- side effects can occur. Baum explains that with stimulants, a child may experience a decrease in appetite, social withdrawal or become more agitated or emotional. "We work with parents," Baum says, "to understand any newly observed behaviors or other changes in an effort to achieve ideal dosing."
Non-stimulant side effects, according to Baum, may be more alarming to parents. She says there are two groups of non-stimulants: atomoxetine, which is known by the brand name Strattera, and alpha agonists, which are known by the brand names Kapvay and Intuniv. Atomoxetine includes a warning that suicidal thoughts may occur, while alpha agonists, she explains, can lower heart rate and blood pressure, leading to a sedation risk in which a person may become sluggish.
The challenge, according to Baum, is that different medications may work well for one child, but not the other. "It's a matter of trial and error," she says, adding that it's also necessary to determine if a child truly has ADHD or if he or she has an underlying disorder.
Recommendations for Children
For preschool-aged children, Baum says that underlying factors such as sleep deprivation and learning difficulties are common and may create ADHD-like symptoms. "Medication is usually not recommended at this age," she says. "Instead, behavioral therapy is often the first line of treatment."
Medications or behavioral therapy, or both, are usually treatments for children in elementary school, Baum says. Behavioral therapy at this stage, she explains, typically involves intervention with parents to teach them ways to encourage and shape their child's behaviors.
As for adolescents, the nonprofit organization and national ADHD resource Children and Adults with Attention-Deficit/Hyperactivity Disorder, or CHADD, says that "successful treatment generally involves a combination of education, behavioral therapy and medication."
Adults With ADHD
According to Dr. L. Eugene Arnold, professor emeritus of psychiatry and behavioral health at the Nisonger Center at Ohio State University's Wexner Medical Center, adults are often given the same medications used for children. "The majority of what's used are stimulants," he says.
However, he says that none of them are 100 percent effective. Echoing Baum's comment, he says each individual has to find what works best.
Furthermore, he stresses that antipsychotics should be used as a last resort since they've been shown to have neurological and metabolic risks. The NIMH says that according to the FDA, "Antipsychotic medications are often used in combination with other medications to treat delirium, dementia and mental health conditions," including ADHD. The FDA notes that weight gain can be a risk of taking such medications, as can the onset of tremors, blurred vision and seizures.
Arnold says that cognitive behavioral therapy -- a method to help change behaviors or thought patterns believed to contribute to a person's life struggles -- is beneficial for adults. CHADD also notes its importance. "Whereas medication helps to control the core symptoms of distractibility, short attention span and impulsivity," CHADD states, "CBT is more effective at increasing the habits and skills needed for executive self-management and may also serve to improve emotional and interpersonal self-regulation."
Exercise, too, is something Arnold feels may be helpful for people with ADHD, as it's helpful for the brain. Proper nutrition should also be a part of the picture -- for both children and adults -- he notes, referring to evidence suggesting that omega-3 fatty acids may be helpful for someone with ADHD. Baum agrees that diet, exercise and meditation may be beneficial. However, she points out that there's not a lot of evidence these areas help ADHD specifically, but since it's well-established that healthy eating and regular exercise is ideal for the population in general, it can't hurt either way.
Sleep should also be addressed, Arnold says. "Sleep deprivation can mimic ADHD symptoms," he says. Young school-aged children should get 10 hours, adolescents nine hours, adults eight or more. In reality, he explains, people are sleeping an average of one hour less than what they should be. "If we solve the sleep deprivation issue, I think we'd see a decrease in the prevalence and severity of ADHD."
Finding Balance, Accentuating Positives
Arnold says treating ADHD often boils down to people finding a balance that works best for each person. "People with ADHD have to develop habits," he says. "For a person without ADHD, this is second nature, but a person with the disorder has to go about systematically developing one good habit at a time to overcome ADHD."
Baum stresses the importance for parents to become involved in their child's educational setting. "Engage with the teacher, get feedback from them, create parent-teacher goals and set a consistent approach in behavioral expectations in home and at school," she says. For example, if school has a "keep your hands to yourself" rule, then Baum explains the same notion should be applied and reinforced at home. Additionally, she encourages parents to learn more about special education services which may help their child, saying that wrightslaw.com may be a helpful resource.
Overall, she says it's essential to focus on the good aspects of ADHD. "It's important to note strengths and positive qualities for all children, but especially among those with ADHD," she says. "There's often so much negative feedback, so it's good for a child to hear when they're doing well and to celebrate and highlight their successes."
Jennifer Lea Reynolds is a Health freelancer at U.S. News. She draws on her life and career experiences, including losing 70 pounds and writing copy at health-centric advertising agencies. Her articles have been published online in Smithsonian, Reader's Digest, Woman's Day and The Huffington Post. She's also the owner of FlabbyRoad.com, where she writes about weight loss, fitness, nutrition and body image. You can follow her on Twitter @JenSunshine.