Attention deficit hyperactivity disorder (ADHD) - Treatment 

Treating ADHD 

Reporting side effects

The Yellow Card Scheme allows you to report suspected side effects from medicine you are taking. It is run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA). See the Yellow Card Scheme website for more information.

Monitoring

If you or your child are prescribed medication for ADHD, you will be monitored depending on your individual circumstances.

Monitoring may include:

  • checking blood pressure and heart rate
  • children and young people having their height measured
  • children and young people having their weight measured
  • adults having their body mass index (BMI) measured

There is no cure for attention deficit hyperactivity disorder (ADHD), but treatment can alleviate your symptoms and make the condition much less of a problem in day-to-day life. ADHD can be treated using medication or therapy, but it is widely agreed a combination of both is the best way to treat it.

Treatment will usually be arranged by a specialist, such as a paediatrician or psychiatrist (an expert in mental and emotional health), although your condition may be monitored by your GP. 

Medication

There are three types of medication for ADHD:

Medications for ADHD are not a permanent cure. Methylphenidate- and dexamfetamine-based medications give a period of treatment during each day (between four and 12 hours depending on the preparation). Atomoxetine usually gives a longer period of treatment.

Medications help someone who has ADHD to:

  • concentrate better
  • be less impulsive
  • feel calmer
  • learn and practise new skills

In the UK, all three of these medications are licensed for use in children and teenagers. Atomoxetine is licensed for use in adults who were diagnosed with ADHD as children. However, there are no medications currently licensed for treating newly diagnosed adults, or for use specifically in adults.

If you have been diagnosed with adult ADHD, your GP and specialist can discuss which medications and therapies may be suitable for you.

Methylphenidate and dexamfetamine are controlled drugs, which means their availability and use are more closely controlled than other prescription medicines. With all ADHD medications, if you or your child is prescribed one of these treatments, you will probably be given small dosages at first, which may then be gradually increased.

Medication is most effective if used every day. Treatment breaks are not normally recommended apart from in specific situations.

You or your child will need to see your GP for regular check-ups to ensure the treatment is working effectively. Your specialist will discuss how long you should take your treatment. Generally, children with ADHD will need to continue treatment at least until after GCSE examinations.

Methylphenidate

Methylphenidate comes in a number of different brands and is the most commonly used medication for ADHD. Methylphenidate is known as a psychostimulant or central nervous system (CNS) stimulant. It is not completely clear how it works, but it is thought it stimulates a part of the brain that changes mental and behavioural reactions.

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

Methylphenidate cannot be taken:

  • by women who are pregnant or breastfeeding
  • if you or your child has glaucoma
  • if you or your child has severe depression

Methylphenidate should be used with caution:

  • if you or your child has a tic (a repeated involuntary movement or sound)
  • if you or your child has Tourette's syndrome 
  • if you or your child has epilepsy – if the frequency of the fits increases the medicine may need to be stopped 

Methylphenidate 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) as this will cover the whole school day or last into the evening. Modified-release capsules can be opened and sprinkled on food so are suitable for young children who may not be able to swallow tablets.

Methylphenidate can cause side effects, which may include:

  • a small increase in blood pressure and heart rate
  • loss of appetite, which can lead to weight loss (if your child is prescribed methylphenidate, your GP will monitor their weight to ensure they are growing properly)
  • trouble sleeping
  • headaches
  • stomach aches
  • mood swings

There are ways to ease these side effects. For example, loss of appetite may be avoided by taking the medication with a meal or snack. Teenagers and adults should avoid drinking alcohol during treatment because this can make side effects worse.

Dexamfetamine

Dexamfetamine works in the same way as methylphenidate. It is also classed as a psychostimulant or CNS stimulant, and may be particularly effective in controlling hyperactivity.

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

Dexamfetamine cannot be taken:

Dexamfetamine should be used with caution if you or your child has epilepsy.

Dexamfetamine is usually taken as a daily tablet once or twice a day and may have side effects similar to those of methylphenidate.

Atomoxetine

Atomoxetine works differently from methylphenidate and dexamfetamine.

Atomoxetine is known as a selective noradrenaline uptake inhibitor (it increases the amount of a chemical in the brain called noradrenaline). This chemical passes messages between brain cells, so by increasing the amount the atomoxetine aids concentration and helps control impulses.

Atomoxetine can be used by teenagers and children over 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 cannot be taken:

  • by women who are pregnant or breastfeeding
  • if you or your child has glaucoma

Like other medications, the use of atomoxetine must be closely monitored by your GP and specialist.

Some studies have shown a small number of children and young people who take atomoxetine are more likely to think about suicide. If either you or your child begin to feel depressed or suicidal while taking this medication, see your GP to ask about switching to a different medication.

Also, in rare cases, there is evidence that atomoxetine can cause liver damage. Arrange to see your GP regularly if you or your child is taking this medication.

Atomoxetine comes in capsule form you or your child takes once or twice a day. Capsules are long-acting, so your child will not need to take them at school. It may be prescribed as an alternative to methylphenidate or dexamfetamine if these are ineffective or cause adverse effects.

Atomoxetine can cause side effects, which may include:

  • a small increase in blood pressure and heart rate
  • nausea (feeling sick)
  • waking early in the morning
  • dizziness
  • stomach aches
  • irritability

If you or your child needs medication for ADHD, your GP and specialist will take several factors into account before recommending a treatment.

These will include:

  • any other conditions you or your child may have
  • side effects of each treatment
  • whether or not dosage times interfere with school or work

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.

Therapies outlined below can be carried out with the help of a number of healthcare professionals, including:

  • counsellors – experts trained to provide talking therapies that aim to help people cope better with their life and mental health condition
  • psychiatrists – qualified medical doctors who have done further training in treating mental health conditions
  • psychologists – healthcare professionals who specialise in the assessment and treatment of mental health conditions
  • social workers – experts often used to bridge the gap between mental health services and the wider social service provision, and provide advice on a variety of practical issues

Psychotherapy

Psychotherapy is a type of talking therapy, which 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.

Read more information about psychotherapy.

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 and penalties to encourage your child to try and 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 a small penalty 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, 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 officially 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 look after your child and improving the relationship between you and your child. 

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.

Read more information about cognitive behavioural therapy (CBT)

Other methods of treatment

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 medical evidence these methods 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 and caffeine are often blamed for aggravating hyperactivity, and some people feel they have intolerances to wheat or dairy products that 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).

However, do not change your (or your child's) diet without medical advice.

Supplements

Some people consider certain supplements, such as omega 3 fatty acid, to be beneficial in people with ADHD. However, there is no medical evidence to support this. If you do wish to try using a supplement, talk to your GP first, as some can react unpredictably with other medication or make it less effective.

Also remember that supplements should not be taken long-term, as they can build up to dangerous levels in your body.

Exercise

People with ADHD should take regular exercise. Read about health and fitness for more information on getting active, and how much activity you and your child should be doing.

Page last reviewed: 29/05/2012

Next review due: 29/05/2014

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Comments

The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

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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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 side effects of any medication your child takes
  • 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
  • See ADHD – Lifestyle for more practical tips on living with ADHD

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