Common ADHD Medications & Treatments for Children

For most children, stimulant medications are a safe and effective way to relieve attention-deficit/hyperactivity disorder (ADHD) symptoms. As glasses help people focus their eyes to see, these medications help children with ADHD focus their thoughts better and ignore distractions. This makes them more able to pay attention and control their behavior.

Stimulants may be used alone or combined with behavior therapy to treat children with ADHD.

Studies show that about 80% of children with ADHD who are treated with stimulants improve a great deal once the right medication and dose are determined.

Two forms of stimulants are available:

• Immediate-release (short-acting) medications usually are taken every 4 hours, when needed. They are the cheapest of the medications. Extended-release medications usually are taken once in the morning.

• Extended-release (intermediate-acting and long-acting) medications are usually taken once in the morning. Children who take extended-release forms of stimulants can avoid taking medication at school or after school. It is important not to chew or crush extended-release capsules or tablets, unless it is labeled as a chewable form. However, three are extended-release capsules that are made up of beads can be opened and sprinkled onto food for children who have difficulties swallowing tablets or capsules.

Non-stimulant ADHD medication can be tried when stimulant medications don't work or cause bothersome side effects.

Products are mentioned for informational purposes only and do not imply an endorsement by the American Academy of Pediatrics. Your doctor or pharmacist can proside you with important safety information for the products listed.

Which ADHD medication is best for my child?

It may take some time to find the best medication, dosage, and schedule for your child. Be patient with the process. Your child may need to try different types of stimulants or other medication. Some children respond to one type of stimulant but not another.

• What dosage? The amount of medication (dosage) that your child needs also may need to be adjusted. The dosage is not based solely on his weight. Your pediatrician will vary the dosage over time to get the best results and control possible side effects.

• When to give it? The medication schedule also may be adjusted depending on the target ­outcome. For example, if the goal is to get relief from symptoms mostly at school, your child may take the medication only on school days.

• Is it working? It is important for your child to have regular medical checkups to monitor how well the medication is working and check for possible side effects.
  

Is there a shortage of Adderall?

In 2022, the U.S. Food & Drug Administration announced a shortage of immediate release formulation of amphetamine mixed salts. These are often referred to by the brand name Adderall or Adderall IR. Amphetamine mixed salts, including Adderall, are FDA-approved for the treatment of ADHD and narcolepsy.

The shortage of Adderall and some other ADHD medications has continued.Talk with your pediatrician about alternative therapies available, such as the extended-release version of amphetamine mixed salts. They can advise which may work best for your child until the shortage eases and discuss other supports like behavior therapy.

What side effects can stimulants cause?

Side effects occur sometimes. These tend to happen early in treatment and are usually mild and short-lived, but in rare cases they can be prolonged or more severe.

The most common side effects include:

• Decreased appetite/weight loss

• Sleep problems
  

• Social withdrawal

Some less common side effects include:

• Rebound effect (increased activity or a bad mood as the medication wears off)

• Transient muscle movements or sounds called tics

• Minor growth delay
  

The same sleep problems do not exist for atomoxetine, but initially it may make your child sleepy or upset her stomach. There have been very rare cases of atomoxetine needing to be stopped because it was causing liver damage. Rarely atomoxetine increased thoughts of suicide. Guanfacine and clonidine can cause drowsiness, fatigue, or a decrease in blood pressure.

Most side effects can be relieved by:

• Changing the medication dosage

• Adjusting the schedule of medication

• Using a different stimulant or trying a non-stimulant

Monitoring the effects of your child's medication

Close contact with your pediatrician is needed until you find the best medication and dose for your child. After that, periodic monitoring by your doctor is important to maintain the best effects.

To monitor the effects of the medication, your pediatrician will probably have you and your child's teachers fill out behavior rating scales, observe changes in your child's target goals, notice any side effects, and monitor your child's height, weight, pulse and blood pressure.

Stimulants, atomoxetine, and guanfacine may not be an option for children who are taking certain other medications or who have some medical conditions, such as some forms of congenital heart disease.

Are children getting high on stimulant medications?

When taken as directed by a doctor, there is no evidence that children are getting high on stimulant drugs such as methylphenidate and amphetamine. At therapeutic doses, these drugs also do not sedate or tranquilize children and do not increase the risk of addiction.

Stimulants are classified as Schedule II drugs by the US Drug Enforcement Administration. This is because there is abuse potential of this class of medication. If your child is on this medication, it is always best to supervise the use of the medication closely. Atomoxetine and guanfacine are not Schedule II drugs because they don't have abuse potential, even in adults.

Are stimulant medications gateway drugs leading to illegal drug or alcohol abuse?

People with ADHD are naturally impulsive and tend to take risks. But patients with ADHD who are taking stimulants are not at a greater risk and actually may be at a lower risk of using other drugs. Children and teenagers who have ADHD and also have coexisting conditions may be at ­higher risk for drug and alcohol abuse, regardless of the medication used. See "ADHD and Substance Use Disorder: The Link Parents Need to Know" for more information.

More information

• Understanding ADHD: Information for Parents
  

• Behavior Therapy for Children with ADHD
  

• ADHD and Substance Abuse: The Link Parents Need to Know

• Treatment & Target Outcomes for Children with ADHD
  

• All About ADHD Medication (Understood.org)