Attention deficit hyperactivity disorder (ADHD) - Treatment 

Treating ADHD 

CBT expert

Professor David Clark explains how cognitive behavioural therapy (CBT) works and who could benefit from it.

Media last reviewed: 24/04/2013

Next review due: 24/04/2015

Tips for parents

  • be sure your GP or specialist helps you understand the difference between ADHD and other problems your child may have
  • think about who else needs to know about your child’s ADHD, such as their school or nursery
  • find out the side effects of any medication your child takes and what you need to look out for
  • getting to know people at local support groups can stop you feeling isolated and unable to cope
  • for information on local support groups contact Attention Deficit Disorder Information and Support Service (ADDISS) or call 020 8952 2800

Read more about living with ADHD.

There is no cure for attention deficit hyperactivity disorder (ADHD), but treatment can help relieve the symptoms and make the condition much less of a problem in day-to-day life.

ADHD can be treated using medication or therapy, but a combination of both is often the best way to treat it.

Treatment will usually be arranged by a specialist, such as a paediatrician or psychiatrist, although your condition may be monitored by your GP. 

Medication

There are four types of medication licensed for the treatment of ADHD:

These medications are not a permanent cure for ADHD, but they can help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practise new skills.

Some medications need to be taken every day, but some can be taken just on school days. Treatment breaks are occasionally recommended, to assess whether the medication is still needed.

In the UK, all of these medications are licensed for use in children and teenagers. Atomoxetine is also licensed for use in adults who had symptoms of ADHD as children.

If you were not diagnosed with ADHD until adulthood, your GP and specialist can discuss which medications and therapies are suitable for you.

If you or your child is prescribed one of these medications, you will probably be given small doses at first, which may then be gradually increased. You or your child will need to see your GP for regular check-ups, to ensure the treatment is working effectively and to check for signs of any side effects or problems.

Your specialist will discuss how long you should take your treatment but, in many cases, treatment is continued for as long as it is helping.

Methylphenidate

Methylphenidate is the most commonly used medication for ADHD. It belongs to a group of medicines called stimulants that work by increasing activity in the brain, particularly in areas that play a part in controlling attention and behaviour.

Methylphenidate can be used by teenagers and children with ADHD over the age of six. Although methylphenidate is not licensed for use in adults, it may be taken under close supervision from your GP and specialist.

The medication can be taken as either immediate-release tablets (small doses taken two to three times a day), or as modified-release tablets (taken once a day in the morning, and they release the dose throughout the day).

Common side effects of methylphenidate include:

  • a small increase in blood pressure and heart rate
  • loss of appetite, which can lead to weight loss or poor weight gain
  • trouble sleeping
  • headaches
  • stomach aches
  • mood swings

Dexamfetamine

Dexamfetamine is also a stimulant medication that works in a similar way to methylphenidate, by stimulating areas of the brain that play a part in controlling attention and behaviour.

Dexamfetamine can be used by teenagers and children with ADHD over the age of three. Although it is not licensed for use in adults, it may be taken under close supervision from your GP and specialist.

Dexamfetamine is usually taken as a tablet once or twice a day, although an oral solution is also available.

Common side effects of dexamfetamine include:

  • decreased appetite
  • mood swings
  • agitation and aggression
  • dizziness
  • headaches
  • diarrhoea
  • nausea and vomiting

Lisdexamfetamine

Lisdexamfetamine is a similar medication to dexamfetamine, and works in the same way.

It can be used by children with ADHD over the age of six if treatment with methylphenidate hasn't helped. You may continue to take it into adulthood if your doctor thinks you are benefitting from treatment.

Lisdexamfetamine comes in capsule form, which you or your child usually take once a day.

Common side effects of lisdexamfetamine include:

  • decreased appetite, which can lead to weight loss or poor weight gain
  • aggression
  • drowsiness
  • dizziness
  • headaches
  • diarrhoea
  • nausea and vomiting

Atomoxetine

Atomoxetine works differently to other ADHD medications.

It is known as a selective noradrenaline uptake inhibitor (SNRI), which means it increases the amount of a chemical in the brain called noradrenaline. This chemical passes messages between brain cells, and increasing the amount can aid concentration and help control impulses.

Atomoxetine can be used by teenagers and children over the age of six. It is also licensed for use in adults who are continuing treatment after taking the medication as a teenager. It is not licensed for use in adults newly diagnosed with ADHD, but your GP and specialist may prescribe it under their supervision.

Atomoxetine comes in capsule form, which you or your child usually take once or twice a day.

Common side effects of atomoxetine include:

  • a small increase in blood pressure and heart rate
  • nausea and vomiting
  • stomach aches
  • trouble sleeping
  • dizziness
  • headaches
  • irritability

Atomoxetine has also been linked to some more serious side effects that it's important to look out for, including suicidal thoughts and liver damage.

If either you or your child begin to feel depressed or suicidal while taking this medication, speak to your doctor.

Therapy

As well as taking medication, different therapies can be useful in treating ADHD in children, teenagers and adults. Therapy is also effective in treating additional problems, such as conduct or anxiety disorders, that may appear with ADHD.

Some of the therapies that may be used are outlined below.

Psychoeducation

Psychoeducation means you or your child will be encouraged to discuss ADHD and how it affects you. It can help children, teenagers and adults make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.

Behaviour therapy

Behaviour therapy provides support for carers of children with ADHD, and may involve teachers as well as parents. Behaviour therapy usually involves behaviour management, which uses a system of rewards to encourage your child to try to control their ADHD.

If your child has ADHD, you can identify types of behaviour you want to encourage, such as sitting at the table to eat. Your child is then given some sort of small reward for good behaviour, and removal of a privilege for poor behaviour. For teachers, behaviour management involves learning how to plan and structure activities, and to praise and encourage children for even very small amounts of progress.

Parent training and education programmes

If your child has ADHD, specially tailored parent training and education programmes can help you learn specific ways of talking to your child, and playing and working with them to improve their attention and behaviour. You may also be offered parent training before your child is formally diagnosed with ADHD.

These programmes are usually arranged in groups and can last several weeks. They aim to teach parents and carers about behaviour management (see above), while increasing your confidence in your ability to help your child, as well as improving your relationship. 

Social skills training

Social skills training involves your child taking part in role play situations, and aims to teach them how to behave in social situations by learning how their behaviour affects others.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave. A CBT therapist would try and change how your child feels about a situation, which would in turn potentially change their behaviour.

CBT can be carried out with a therapist individually or in a group.

Other possible treatments

There are other ways of treating ADHD that some people with the condition find helpful, such as cutting out certain foods and taking supplements. However, there is no strong evidence these work, and they should not be attempted without medical advice.

Diet

People with ADHD should eat a healthy, balanced diet. Do not cut out foods without medical advice.

Some people may notice a link between types of food and worsening ADHD symptoms. For example, sugar, food colourings and additives, and caffeine are often blamed for aggravating hyperactivity, and some people believe they have intolerances to wheat or dairy products, which may add to their symptoms.

If this is the case, keep a diary of what you eat and drink, and what behaviour this causes. Discuss this with your GP, who may refer you to a dietitian (a healthcare professional who specialises in nutrition).

Do not change your (or your child's) diet without medical advice.

Supplements

Some studies have suggested that supplements of omega-3 and omega-6 fatty acids may be beneficial in people with ADHD, although the evidence supporting this is very limited.

It's advisable to talk to your GP before using any supplements, because some can react unpredictably with medication or make it less effective.

You should also remember that some supplements should not be taken long term, as they can reach dangerous levels in your body.

Page last reviewed: 15/05/2014

Next review due: 15/05/2016

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Comments

The 5 comments posted are personal views. Any information they give has not been checked and may not be accurate.

sarahjones88 said on 06 July 2014

I thank God because a friend of my husband pointed us to some ADHD express Focus Method for ADHD kids and certainly we thought it wouldn't work but turns out that it in fact works!!
It is featured by Harvard Doctors and apparently Cornell doctors too.
I mean, we've seen progress with our kid and seems to be more focused and thoughtful of things. We're so excited! I hope that's not all to it.

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007daddy said on 14 October 2013

One size doesn't ft all....
I'm a parent who has a 7 year old who has (ADHD) - these types of conditions are never clear cut when you involve mental health. All these type of conditions overlap - from aspergers to autism.

We knew from the first few days that our little boy wasn't right (the birth was traumatic and we feel that this had a part to play in his condition now); whether for a limited time he had lack of oxygen or something else, I bet if you did a study of traumatic births - you'd see a high percentage of behavourial issues...

Each child is a unique personality but unless you're a parent of a child with ADHD symptoms - you simply are a passenger when it comes to commenting.. Only those with children with these type of issues know the difficulties for the child, their family and heartache involved for all.

All I can say is that you will never find that 'norm' - all you can do is manage the situation the best you can. You may be lucky and your childs' symptoms may not be too extreme so they can live a normal life, or you may be unlucky and have a constant piano on your back trying to help your child, protect them and ensuring they live a happy and content life.

My only advice would be - seek medical help, don't get fobbed off and try to stay positive. I'm sure most parents who have an ADHD child probably separate over time as it can destroy you if you it.

Consultants and doctors should spend time in the homes of families with ADHD - an hour session can't evaluate the problem and it's simply a snapshot...

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xclairex said on 13 October 2013

My son is 7 yrs old and today we have had one of his worst episodes ever. He has seen a psychologist once only and is due to see a pediatrician a wk on Monday. Today however he ran away having no reason to do so just exploded in a fit of anger & sat in the middle of the road. I called the hospital to be told to call the police then for them to come out only to advise I call nhs 24. We waited 3 or more hrs to be called by a doctor on call. By this time he was exhausted and agitated again. She advised to let him sleep & call again tomorrow if he worsens again.
I want to know why I had such an awful job finding the correct person to call when I was in such an awful predicament.. my son didn't understand why he did what he did & couldn't understand why he had to wait so long for nothing to be done. Help xx

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dawngorgeoussuccess said on 28 August 2013

I am surprised we would even consider giving medication to children and young people that would increase the possibility of suicidal thoughts. I am actually quite disturbed by this.

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norca said on 06 November 2012

I have taken treatment for ADHD in the past but now I wish I hadn't. I generally took Ritalin which contains methylphenidate, and my compulsive behavior escalated over time to the extent that I started to misuse these drugs. I feel very bad about this but life goes on and since I stopped doing this over a year ago now I didn't really have any negative side effects. Hope it stays this way.

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