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A Comprehensive Guide To ADHD Medication Types For Kids

For parents and carers of children with ADHD, the decision to explore medication options can be both daunting and crucial.
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A Comprehensive Guide To ADHD Medication Types For Kids

31/05/2024
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For parents and carers of children with ADHD, the decision to explore medication options can be both daunting and crucial.

It’s a decision accompanied by a multitude of questions, concerns, and hopes for the child’s well-being. On one hand, there’s the desire to alleviate their child’s symptoms and help them thrive in various aspects of life, from school to social interactions. On the other hand, there’s the understandable apprehension about the potential side effects and long-term impacts of medication.

Parents may find themselves grappling with conflicting advice, navigating the maze of available options, and weighing the benefits against the risks. They want what’s best for their child, of course; but they may feel overwhelmed by the complexities of ADHD treatment.

In this comprehensive guide, we aim to provide clarity and guidance on parent support for children with ADHD, offering insights into the different types of ADHD medications for kids, their benefits, potential side effects, and expert considerations.

With knowledge and understanding, parents can make informed decisions, and identify the right time to seek an ADHD assessment for children.

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What Are the Best ADHD Medications For Kids?

When it comes to selecting and assessing the best ADHD medication types for kids, medical consensus and evidence-based research should form the basis.

While there’s no one-size-fits-all answer, several options have demonstrated effectiveness in managing ADHD symptoms and improving functional outcomes for kids.

It’s important to consider factors such as the child’s age, specific symptoms, medical history, and individual response to medication.

Stimulants

Stimulant medications are among the most commonly prescribed and effective treatments for ADHD in children. They work by increasing the levels of neurotransmitters such as dopamine and norepinephrine in the brain, which play key roles in attention, impulse control, and executive functions.

There are two main types of stimulant medications: methylphenidate-based and amphetamine-based.

Methylphenidate-based stimulants

These medications are typically the first-line treatment for ADHD due to their proven efficacy and safety profile. Methylphenidate-based stimulants are available in various formulations, including immediate-release and extended-release, allowing for flexibility in dosing and duration of action.

Amphetamine-based stimulants

These medications also effectively increase neurotransmitter levels in the brain, but may have slightly different mechanisms of action compared to methylphenidate-based stimulants. Amphetamine-based stimulants are often prescribed when methylphenidate-based medications are not providing sufficient symptom relief, or are associated with intolerable side effects.

In clinical practice, healthcare providers may prescribe different stimulant medications based on factors such as:

  • The child’s response to previous treatments
  • Presence of comorbid conditions (e.g., anxiety, tic disorders)
  • Individual preferences.

For example, a child who finds it hard swallowing pills may benefit from a patch or liquid formulation, while another child may respond better to a long-acting medication to maintain symptom control throughout a long day at school.

It’s important to keep a close eye on children who have been prescribed stimulant medications. Certain side effects, such as decreased appetite, difficulty sleeping, and mood changes can sometimes occur.

Healthcare providers typically adjust the dosage and formulation as needed to achieve optimal symptom management with minimal side effects.

Non-Stimulants

Non-stimulant medications are another option for treating ADHD in children, particularly those who do not respond well to or are unable to tolerate stimulant medications. They work by targeting different neurotransmitter systems in the brain, such as norepinephrine or alpha-2 adrenergic receptors.

Atomoxetine

Clinically known as a ‘selective norepinephrine reuptake inhibitor’ (SNRI), atomoxetine helps increase levels of norepinephrine in the brain. It is typically prescribed as a second-line treatment for ADHD, particularly in children with comorbid conditions such as anxiety. Atomoxetine may be a preferred option for children who do not tolerate stimulant medications, due to medical reasons or concerns about side effects.

Guanfacine and Clonidine

These medications are referred to as ‘alpha-2 adrenergic agonists’, meaning they work by targeting specific receptors in the brain to regulate attention and impulse control. Guanfacine and clonidine are often used as adjunctive (additional) treatments to stimulant medications, or as standalone options for children with ADHD and comorbid conditions such as aggression or sleep disturbances.

Like stimulant medications, non-stimulants can (but do not necessarily) lead to side effects that need to be monitored. These may include sedation / lethargy, gastrointestinal symptoms, and changes in blood pressure.

For that reason, healthcare providers will carefully titrate the dosage and monitor the child’s response to ensure effective symptom management while minimising any adverse effects.

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How Is ADHD Medication Dosed in the UK?

In the UK, dosing of ADHD medication for children is typically based on guidelines established by organisations such as the National Institute for Health and Care Excellence (NICE) and the British Association for Psychopharmacology (BAP). These guidelines provide recommendations for starting doses, titration schedules, and maximum daily doses.

  • For stimulant medications, dosing is often initiated at a low dose and gradually increased based on the child’s response and tolerability. The goal is to find the lowest effective dose that provides symptom relief without causing significant side effects. Healthcare providers may adjust the dose and formulation (e.g., immediate-release vs extended-release) based on factors such as the child’s age, weight, and individual pharmacokinetics (or the movement of medication in an individual’s body).
  • Non-stimulant medications follow a similar dosing approach, with initial dosing based on weight and age and subsequent adjustments made based on clinical response. These medications may require longer titration periods compared to stimulants to achieve optimal efficacy.

ADHD specialists closely monitor children while titrating medication doses to assess both therapeutic response and potential side effects. Follow-up appointments are scheduled to evaluate the child’s progress, adjust dosing as needed, and address any concerns or questions.

It’s worth caregivers exploring resources on parent support for children with ADHD, including dosing schedules, potential side effects to watch for, and when to contact their healthcare provider.

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Is ADHD Medication For Kids Necessary?

Determining whether ADHD medication is necessary for a child depends on a number of factors, including the severity of symptoms, the impact on daily functioning, and the child’s individual needs and circumstances.

Let’s explore more closely what this might look like:

Scenario 1

A child exhibits significant ADHD symptoms that interfere with their academic performance, social relationships, and overall quality of life. Despite implementing various non-pharmacological interventions such as behaviour therapy, educational accommodations, and parental support, the child continues to struggle with attention, impulsivity, and hyperactivity to a degree that significantly impairs their ability to function in daily activities. In this case, medication may be considered necessary to provide symptom relief and improve the child’s functional outcomes.

Scenario 2

A child demonstrates mild to moderate ADHD symptoms that do not severely impact their academic or social functioning. The child receives support from teachers, parents, and other caregivers through behaviour management strategies, coaching, structured routines, lifestyle adjustments, and academic accommodations. While the child may still experience occasional challenges related to ADHD symptoms, they are able to cope effectively and participate in daily activities without significant impairment. In this situation, medication may not be deemed necessary, and non-pharmacological interventions may continue to be the primary approach.

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Are There Any Side Effects Associated With ADHD Medications For Children?

ADHD medications – like any medication – can have potential side effects. It’s crucial for parents and caregivers to be aware of these effects and to discuss them with healthcare providers when considering treatment options for their children.

More Common Side Effects:

Stimulant Medications:

  1. Insomnia: Stimulant medications can sometimes disrupt sleep patterns, leading to difficulty falling asleep or staying asleep.
  2. Decreased Appetite: Children may experience a temporary decrease in appetite, which can lead to weight loss or slower weight gain.
  3. Mood Changes: Some children may experience mood swings, irritability, or emotional sensitivity while taking stimulant medications.
  4. Increased Heart Rate/Blood Pressure: Stimulant medications can elevate heart rate and blood pressure in some children, although these effects are usually mild and temporary.

Non-Stimulant Medications:

  1. Gastrointestinal Issues: Non-stimulant medications may occasionally cause gastrointestinal side effects such as nausea, stomach upset, or constipation.
  2. Fatigue: Some children may feel tired or lethargic when taking non-stimulant medications, although this effect is less common than with stimulant medications.
  3. Headaches: Headaches are a potential side effect of certain non-stimulant medications, although they are usually mild and transient.

Less Common Side Effects:

  1. Allergic Reactions: Rarely, children may experience allergic reactions to ADHD medications, which can manifest as skin rashes, hives, or difficulty breathing.
  2. Psychiatric Symptoms: In some cases, stimulant medications may exacerbate existing psychiatric conditions or trigger new symptoms such as anxiety, agitation, or hallucinations.
  3. Cardiovascular Effects: Though extremely rare, stimulant medications have been associated with more serious cardiovascular effects such as arrhythmias or sudden cardiac events, particularly in children with pre-existing heart conditions.
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Should I Seek ADHD Medication For My Child?

Deciding whether to pursue medication as part of your child’s ADHD treatment plan is a significant decision, and one that should be made in consultation with healthcare professionals. Medication can be an effective tool for managing ADHD symptoms – but it’s not the only option, and it may not be appropriate for every child.

The key things to keep in mind are:

  • The individual child’s needs and situation
  • Severity of symptoms
  • Impact on daily life
  • The potential benefits
  • Integration with a holistic, whole-person approach

Open communication with healthcare providers, including therapists and psychiatrists, can help ensure that you make an informed decision that aligns with your child’s best interests. If you’d like to discuss any of the points we’ve raised further, don’t hesitate to contact us today, or book an online assessment now.

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