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Attention Deficit Hyperactivity Disorder (ADHD) is a disorder of inattention, impulsivity, and hyperreactivity. ADHD is managed with a combination of behavioural, psychological and medication interventions. 

Behavioural Management

Behavioural management may not be effective in immediately reducing ADHD symptoms, but it is a critical part of ADHD treatment as it can lead to a significant improvement in a child’s functioning. Part of this behavioural management is parent training.  There are many programs available to help you learn more about ADHD and give you specific, positive ways to respond to unwanted behaviours.  There are many tools as a parent to help your child with ADHD, but first and foremost make sure you take care of yourself too.   

Medications for ADHD

Though it may seem counter-intuitive, the treatment for ADHD is a stimulant medication.  One of the hypotheses about the cause of ADHD is that there is a lack of dopamine in certain parts of the brain.  Stimulant medicines increase the amount of dopamine and norepinephrine in the parts of the brain that are responsible for sustaining attention and reducing hyperactivity and impulsivity. 

Medications are generally not started until a child is at least 6 years of age.  Your physician will generally choose between amphetamine-type medicines or methylphenidate.  These medications have a long track record of safety in treating ADHD.  You can also see positive effects of the medication relatively quickly.  Side effects are generally mild and can be resolved with adjustments of dosages or timing.  Most common side effects include weight loss, sleep disturbances, and emotional lability.  

Non-stimulant medications are used as second-line treatments if parents do not want to treat their children with stimulants, if children have side effects to stimulants, or if there is a family history of addiction or abusing stimulants.  They are generally less effective than stimulant medications.  Some examples of non-stimulants include atomoxetine, clonidine, or guanfacine.  

Other Interventions

Some parents choose to use complementary or alternative therapies which include things like dietary supplements, fatty acid supplements, high dose vitamins, and diet changes. Others might choose more intensive treatments such as chelation therapy. Current medical evidence suggests that there is no observable benefit to any of these treatments.  Some treatments like chelation and high dose vitamins have potential for serious adverse consequences and worsened health outcomes.  Please discuss any complementary or alternative therapies with your child’s doctor. 

This post was co-authored by Suzanne Black, MD BSc, Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

References

Feldman, H.; Reiff, M. Attention Deficit-Hyperactivity Disorder in Children and Adolescents. The new England journal of medicine, 370;9. Febrary 27, 2014.