There is no cure for attention deficit hyperactivity disorder (ADHD), but treatment can reduce your symptoms and make the condition much less of a problem in day-to-day life. ADHD can be treated using medications or therapy, but it is widely agreed that a combination of both forms of treatment is the best way to treat it.
The different ways of treating ADHD, and how they can be used for children, teenagers and adults, are outlined below. Treatment will usually be arranged by a specialist, such as a psychiatrist (an expert in mental and emotional health), although your condition may be monitored by your GP.
Medication
Medications for ADHD produce a short-lived improvement after each dose, but they are not a permanent cure. They create a short period when someone who has ADHD can:
- concentrate better
- be less impulsive
- feel calmer
- learn and practise new skills
There are three types of medication for ADHD:
- methylphenidate
- dexamfetamine
- atomoxetine
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.
Medications for ADHD are controlled drugs, which means their availability and use are more closely controlled than other prescription medicines. 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.
You or your child will need to return to your GP for regular check-ups to ensure that the treatment is still working effectively. If you or your child has shown an improvement and the condition appears stable, your GP may recommend a break from treatment, for example over a weekend or during school holidays. These breaks help to assess how you or your child can manage without the medicine.
Methylphenidate
Methylphenidate comes in a number of different brands and is one of the most commonly used medications for ADHD in the UK. Methylphenidate is known as a psychostimulant or central nervous system (CNS) stimulant. It is not completely clear how it works, but it is thought that it stimulates a part of the brain that changes mental and behavioural reactions.
Methylphenidate can be used by teenagers and children with ADHD who are 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 (an eye condition that affects vision)
- 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 (a condition that causes involuntary movements or sounds)
- if you or your child has epilepsy (a condition that causes fits) - 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, usually in the morning, and they release the dose throughout the day).
Your GP and specialist may recommend a modified release tablet if you or your child need the treatment to last into the evening. It may also be convenient for children who may not be able to take multiple doses at school. However, the doses of methylphenidate in modified release tablets may be larger, and may not be suitable for young children.
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 that they are growing properly)
- trouble sleeping
- dry mouth
- 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 the 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 - if you are still having fits the medicine may need to be stopped
- if you or your child has kidney problems
Dexamfetamine is usually taken as a daily tablet, and may have side effects that are 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 to 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 who have been 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 that 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 very 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 tablet form that you or your child takes once or twice a day. The tablets 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 you or your child has a tic or Tourette's syndrome.
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
- painful urination
- irritability
If you or your child needs to be prescribed a medication for ADHD, your GP and specialist will take several factors into account before recommending a treatment.
These factors will include:
- any other conditions that you or your child may have
- the side effects of each treatment
- whether or not the 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 any additional problems, such as conduct or anxiety disorders, that may appear with ADHD.
The 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 their 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 who are 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 that you or your child will be encouraged to discuss your ADHD and how it affects you. It can help children, teenagers and adults to make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.
See the Health A-Z topic about Psychotherapy for more information on this type of treatment.
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 that 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 an alternative form of therapy based on the idea that your problems are often created by you. It is not the situation itself that is causing problems, but how you think about it and how you react to it. A CBT therapist would try and change how your child feels about a situation, which would in turn change their behaviour.
See the Health A-Z topic about CBT for more information on this type of therapy.
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 certain supplements. However, there is no medical evidence that 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 certain foods without medical advice.
Some people may notice a link between certain types of food and worsening ADHD symptoms. For example, sugar and caffeine are often blamed for aggravating hyperactivity, and some people may 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).
If there is a link to certain types of food, your GP may consider advising that you eliminate this type of food. But 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, always 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. See Live Well: fitness for more information on getting active, and how much activity you and your child should be doing.
