There is a world of difference between treating a child with an antibiotic for strep throat and prescribing a stimulant to treat ADHD. Choosing to medicate is a deeply personal decision for parents and their children.
Any seasoned practitioner should welcome a collaborative approach and an ongoing dialogue to address any questions or concerns. In my professional experience of over four decades, treating ADHD with medication can be done safely and effectively under the right conditions.
With a comprehensive evaluation and careful, ongoing monitoring, medication can unlock so much untapped potential in people with ADHD. To begin the dialogue, I discuss the possible side effects with the family and introduce the concept of a
Medication Trials: What to Expect
Fortunately, ADHD medications become pharmacologically active very rapidly, unlike anti-depressants. In some cases, effects can be seen within the first day of treatment. In most cases, a medication trial takes as little as two weeks. During this time, parents can see the benefits and side effects in real time to then make a truly informed decision about treating with medication. In approximately 70-80% of cases, there will be significant improvement, and rarely will side effects result in discontinuation of the medication. Each person’s biochemistry will determine the effectiveness of a medication. Currently, there are about 30 stimulant medications, which are Ritalin or Adderall based, and a handful of non-stimulants for ADHD approved by the Federal Drug Administration. As a general rule, both of these products have similar modes of working in the brain and comparable efficacy when adjusted for differences in dosing.
During a proposed trial, parents observe their child and are provided with feedback from teachers and professionals who work with their child. Families can also use a medication log to track behaviors and side effects during the trial period. Parents can use this information to determine whether they want to continue.
In this age of anxiety, deciding on a treatment plan for a child with ADHD can be quite stressful. A medication trial is one way to help plan. It gives parents the information they need to determine whether the medication will have a positive impact on their child as well as a choice about whether to proceed.
Any child with ADHD taking medication should also have a support plan at school that details accommodations for an integrated team approach.
Alternatives to Medication
In my clinical experience, combining medication with appropriate education accommodations and executive function coaching can be very effective. On the other hand, there are several other interventions that may be considered before or during a medication trial:
Determining what’s best for your family may take some trial and error, but with sound guidance and an open mind, everyone can find the right kind of intervention.
~Jim Varga, M.D., F.A.A.P., is a board-certified physician specializing in developmental pediatrics and the evaluation and treatment of children and teens with learning differences.
For more information about ADHD and interventions, visit CHADD.