The treatment of ADHD
Use these links below to learn more about a particular area of your child's treatment.
ADHD often responds well to treatment. In the UK, both the National Institute for Health and Clinical Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) recommend ADHD should be treated.2,3
The precise treatment that your child will be offered will depend on their particular needs.
However, treatment is likely to include:
1. Advice, support and behavioural therapy for parents and/or the child and/or teachers.
This includes specific training on how to manage your child's behaviour most effectively and to promote ways of bringing out the best in them.3
Techniques may include:
- Identifying and focussing on particular problem times or situations such as mealtimes, getting ready for school or doing homework
- Planning in advance what to do in response to your child's behaviour and responding consistently
- Developing techniques to improve your child's listening; for example, using eye-to-eye contact, talking about one thing at a time and focussing on what to do rather than what not to do
- Using behaviour contracts and rewards for achieving agreed goals
- Using "time out" and other sanctions
ADHD commonly occurs together with other conditions. As part of their treatment, your child may be offered:
- Training in social skills to help in building relationships and avoid aggressive behaviour
- Counselling to improve self-esteem
- Remedial teaching to help them "catch up" at school
See the Top 10 hints and tips section for more recommendations about behavioural approaches to help you cope with your child's ADHD.
The treatment recommended for your child will depend upon their age and the severity of their symptoms. Some children will require behavioural treatments only while others may require behavioural treatment and medication to control their symptoms adequately .
The medicines approved in the UK for treatment of ADHD are:
Methylphenidate and dexamfetamine belong to a group of medicines called stimulants. Atomoxetine acts in a slightly different way and is not classed as a stimulant.17 Different treatment options suit different children.
The effect of methylphenidate lasts only for a few hours, so two to three daily doses are recommended.14,15 Long acting formulations of methylphenidate are available in the UK: one formulation has a 12 hour action, designed to mimic a three times daily regime, and makes school-time and early evening dosing unnecessary;12 other formulations have an 8 hour action designed to mimic a twice daily regime making school-time dosing unnecessary 13
For the child, long-acting medicines can avoid the stigma of having to take medication at school. For the school, not having to dispense medication can be an advantage.18 However, once-daily dosing may reduce dose flexibility.
Various complementary and alternative therapies have been tried in ADHD, including Chinese herbal medicines, chiropractic intervention and electromyography.3 There is little evidence that they are effective
in treating ADHD.3
Medicines for ADHD are always prescribed and supervised by a doctor, who will recommend the most suitable drug for your child. Factors they will take into account when deciding which drug to choose include:
- Likely effectiveness in your child's particular case
- Possible side effects (see Treatment expectations for more about this)
- The convenience and acceptability to your child
In most cases it is recommended that a combination of both medication and advice, support and behavioural therapy is the best way to manage the full range of problems experienced by those with ADHD.3 However, the extent to which this is possible will vary from region to region based on local resources and expertise.
It is important to understand the potential benefits and limitations of your child's medical treatment.
It may take some time to find the best dose of drug treatment to use for your child. The specialist may prescribe a low dose to begin with, then increase it, aiming to achieve symptom relief while minimising side effects.
- Treatment can greatly improve the symptoms of your child's ADHD, but cannot cure it completely
- Your child's doctor will be able to discuss the best treatment for your child based on their individual needs.
During the early stages of treatment, you may be asked to help monitor your child's symptoms using forms provided to you, and to look out for side effects.
For a full list of possible side effects please speak to a health professional
Some treatments are taken once daily, while others need to be taken two or three times a day. You may need to encourage or prompt your child to remember their medication.
You and your child will need to attend the clinic for regular follow up visits. The doctor will want to monitor how well the treatment is working and whether there have been any problems. Your child's blood pressure, pulse, height and weight should be checked regularly.
Length of treatment
The length of time for which your child will receive treatment for ADHD is not fixed in advance.
Treatment for ADHD may need to continue for a number of years.
The doctor may recommend that your child stops their medication every so often to see how they get on without it (sometimes known as a "medication/treatment holiday"). Stopping treatment should be carried out only under the supervision of the specialist in charge of your child's care.