Medication
In Australia, medication for ADHD is typically only prescribed for individuals over the age of 6 following a formal diagnosis. However, the decision to start medication depends on several factors, including the severity of symptoms, the individual’s overall health, and the response to other forms of treatment like behavioral therapy or educational support.
For younger children non-medication interventions such as behavioural therapy and environmental changes are often preferred, and medication is usually considered if these approaches are not effective.
It’s important for medication to be prescribed and monitored by regular follow-up appointments with a healthcare professional, often a pediatrician, psychiatrist, or GP with expertise in ADHD, to ensure safety and effectiveness.
The healthcare professional will typically start the patient on a low dose and gradually increase it to find the right balance between effectiveness and side effects. It might take time to find the right medication and dosage, so ongoing communication is key while they fine tune the treatment plan.
In all instances, parents should be involved in tracking progress and communicate any changes in behaviour, mood, or school performance. It is also recommended that parents inform the school that a new medication is being trialled and gather feedback from teachers, as their observations can provide valuable information to assist the practitioner to judge effectiveness.
Types of ADHD Medication
There are two primary types of ADHD medication: stimulant medications and non-stimulant medications.
Stimulant Medications
Stimulant medications are the most commonly prescribed medications for ADHD and are usually the first-line treatment. Stimulants are fast acting and the effect is felt within 30-90 minutes of the first dose.
Methylphenidate is the most well-known stimulant medication. It works by increasing neurotransmitters (dopamine and norepinephrine) in the brain, which helps improve concentration and reduce impulsivity and hyperactivity. Common medication names include Ritalin, Concerta and Daytrana.
Amphetamines are the second group of stimulant medications. These medications work similarly by boosting the levels of dopamine and norepinephrine in the brain. They tend to be slightly stronger and are often used if other stimulant medications are ineffective. Common medication names include Dexamphetamine, Adderall and Vyvanse.
Stimulants are generally considered safe when used appropriately, but their side effects mean they need to be monitored by healthcare professionals.
Side effects of stimulants may include:
- Decreased appetite (often resolves after a few weeks)
- Insomnia (often resolves after a few weeks)
- Mild stomach aches and headaches (often resolves after a few weeks)
- Slight Increase in heart rate and lift in blood pressure
- Used over long periods can slow down growth hormones
- Can cause complications for children with pre-existing heart conditions (needs cardiologist approval)
- Irritability or mood swings
- Potential for misuse
Non-Stimulant Medications
Non-Stimulant Medications may be prescribed if stimulants are not effective, cause unwanted side effects, or if there is a concern about misuse or dependency. They’re not as fast acting as stimulants and can take 2- 4 weeks for the drug to have full effect.
Atomoxetine
This medication works by increasing norepinephrine in the brain, and it’s commonly prescribed when stimulant medications are not suitable. The common medication name is Strattera.
Guanafacine
These are typically used when other medications haven’t worked. They’re alpha-2 agonists, which help regulate the brain’s attention and impulse control. These medications are usually prescribed for children who have problems with impulsivity and hyperactivity. Common medication names include Intuniv, Clonidine and Kapvay.
Side effects of non-stimulants may include:
- Sleep disturbances
- Stomach upset
- Decrease in appetite
- Dry mouth
- Nausea / vomiting
- Dizziness
- Problems urinating
- Sexual function
