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Treating ADHD at Steps : Medication - SCFMH
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Treating ADHD at Steps : Medication - SCFMH
Treating ADHD at Steps : Medication Category: ADHD
Types of ADHD Medication There are several kinds of ADHD medications. They affect the way parts of
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the brain communicate with each other. This can help to increase alertness, improve working memory, and reduce hyperactivity.
Stimulant medications
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Stimulants are the most-prescribed medications to treat ADHD in children.
ADHD
They’ve been used to treat ADHD since the 1960s. They are some of the most-researched of all types of drugs used with kids and adults. Stimulant
OCD
medications target a neurotransmitter (brain chemical) called dopamine, which plays a key role in motivation and maintaining arousal (interest). A good way to understand how stimulants work is to think of coffee/tea or other caffeinated beverages (Red Bull). Essentially, stimulants make the under-stimulated brain optimally stimulated so that things that were otherwise understimulating and boring seem less tedious and puts them in the category of “let’s just get it done with”. An emotion a lot of people associate with sipping tea or coffee at 3 PM to power through the remainder of the work in the day.
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Treating ADHD at Steps : Medication - SCFMH
An understimulated mind typically copes by creating physical stimulation by fidgeting , leg shaking, hair twirling activities or mental stimulation like daydreaming, using multiple tabs or multiple devices, watching videos on fast forward et cetera. Once stimulant is taken, for the duration that it is in the body, it becomes much easier to complete the task at hand without the necessary hyperactivity, impulsivity or distractibility. 1. Stimulant medications don’t work 24 7 like blood pressure medications. They work for a certain number of hours depending on if they are immediate acting or delayed release. 2. The effects of some stimulants begin within about 30 minutes of taking the dose. Others take 60 to 90 minutes before they kick in. 3. The dose of a stimulant that will be effective for a person isn’t necessarily related to that person’s age, weight, or how severe the symptoms are. It’s more related to how sensitive that person’s body is to the particular medicine. 4. Stimulants can be shorter acting, meaning the pills are usually taken two or three times a day. Or they can be longer acting, meaning the pills are usually taken once a day. 5. Once ADHD medication is started, it requires observation around duration of action of medication. If the child is on the right dose (5 mg, 10 mg or 15 mg for example), and if the child takes ADHD medication, it’s important to work closely with the doctor to adjust the medication, dosage, or timing to best suit the child’s needs. For instance, some kids may need one long-acting dose followed by one shorter-acting one to get through the day and homework time.
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Treating ADHD at Steps : Medication - SCFMH
Non Stimulant Medication Non-stimulant medications include atomoxetine (Straterra), Clonidine which do not have either the side effect profile of the stimulant medications however, they also don’t have a superior effect on symptoms. For example, atomoxetine takes more than a month to take effect and even then the impact on core ADHD symptoms is limited. This medication is used only when a child has failed a stimulant trial. On the other hand, Clonidine works primarily on Hyperactivity and impulsivity in younger children home again, who have poor tolerance to stimulants.
Side effects of ADHD medication All classes of ADHD medication have side effects that may or may not occur. These are often temporary and can be helped by either. Giving time for the body to adjust to them Reducing the dose or changing the timing of the dose or Using strategies to offset side effects Before discussing specific side effects, it is important to note that there is a side effect of not using the medication. This can include the onset of low self esteem, low self concept, blaming themselves for things that they want to do but cannot do, anxiety and depressive symptoms that are poorly responsive to medications (because ADHD symptoms lead to academic and social difficulties that can then cause secondary anxiety and depressive states) https://www.scfmh.com/blogs/adhd/treating-adhd-at-steps-medication/
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Treating ADHD at Steps : Medication - SCFMH
Stimulants can cause Decreased appetite Sleep problems Transient headache Transient stomach ache Behavioral rebound This is directly related to their mechanism of action. Stimulants increase stimulation which also means increased arousal which is achieved by increasing overall anxiety states. Most side effects of ADHD medications are not serious. Some of the rare side effects includeWeight loss Increased heart rate, blood pressure Dizziness Growth suppression Hallucinations/mania Exacerbation of tics and Tourette syndrome (rare) But any side effects should be discussed so that there is an understanding of the benefits that are outweighing the risks. Incase of any side effects please discuss these with the prescribing psychiatrist or therapist for your child.
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Treating ADHD at Steps : Medication - SCFMH
Managing medications and reactions to medication ADHD medications as noted above are very well understood and researched. Once medication has been recommended for a child, the parent will be provided all the necessary information to make this decision together with your child and the doctor. At no point in time should the parent feel pressured to start the medication. It is our belief that only when the family is on the same page that the response to the medication is optimal. Side effects are better understood. The small changes that the medication might bring (which could lead to significant changes in quality of life for both the child and the family) will be best appreciated when the decision to start medication is a joint decision. The side effects of the medications are pretty straight forward. Medication increases your overall stimulation so that tasks that are otherwise experienced as tedious feel less so and hence, difficulty with task initiation and task sustenance become less. The medication achieves this by creating a sense of anxiety in the body. Naturally, for this to happen, one might experience mild increase in heart rate, dry mouth, decrease in appetite, mild fullness in the head as one is constantly focusing. These are the common side effects of the medication but happen because this is how the medication produces its effect. The good news is that in most cases after a few weeks, the side effects are better tolerated and sometimes disappear in entirety while the intended https://www.scfmh.com/blogs/adhd/treating-adhd-at-steps-medication/
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effects remain.
What if parents or family don’t want to take medication? Not every child is prescribed stimulant medications. Medication has a certain role in the treatment but the role of medications can never be more than understanding the difficulties of ADHD and supporting the child through them. If a family/child is not willing to take medications, we are willing to work with the family to use other strategies and approaches. However, in some cases, when it is in our professional opinion that without medications, we will not be able to provide relief, we will make that known to the family. In such circumstances we may refer the family to another provider as we would not be positioned to provide the best care for their child.
What if my child is not able to sleep? While there is a lot of information and data around insomnia caused by stimulant medications, clinically we see that for an equal number of children and adolescents, taking stimulants actually helps sleep because they have been engaged and focused throughout the day and their brain is tired. The reason medications cause insomnia is, just like coffee, sometimes even after the focus and concentration wanes away, the mind is still alert and unable to fall asleep.
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There are many ways to circumvent this problem for example taking the medication a little bit earlier in the day, switching to a shorter acting formulation and other ideas that might be applied on a case to case basis.
Starting and Stopping Medication ADHD medications are safe to be started and stopped. So even if it happens in error, stopping medications suddenly is just fine, but not recommended. This is because we would like to have that trust between the provider and the family.
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