ADHD: Should my child take medicine for ADHD?

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the facts

Your options

Have your child take medicine for ADHD.
Don't have your child take medicine. Instead, use counseling, behavior therapy, or social skills training to help manage your child's symptoms.

Key points to remember

If your child's symptoms are mild, then counseling, behavior therapy, or social skills training may be enough to improve your child's behavior.
If your child's symptoms are moderate to severe and are causing problems at home, in school, and with family members and friends, your doctor may recommend medicine.
Medicine can't cure ADHD or solve all of your child's behavior problems. Behavioral therapies and extra support at home and in school can help your child succeed and feel better about himself or herself.
Medicines can help, but they may have side effects and risks.
If your child needs medicine, help your child not feel ashamed about taking it. ADHD is a medical condition, not a character flaw or weakness.

FAQs

What is ADHD?

ADHD (attention deficit hyperactivity disorder) affects a child's behavior and ability to pay attention. ADHD symptoms are noticed early in a child's life and continue into adulthood.

Children with ADHD tend to be:

Inattentive . They are easily distracted and find it hard to focus on any one task.
Impulsive . They act before thinking about the cause and effect of their actions. They may talk or laugh too loud or get more angry than the situation calls for. They may not share or be able to wait for their turn.
Hyperactive . They can't sit still for even a short time. They may squirm, fidget, or run around at the wrong times.

It may be hard to know if your child has ADHD or is just misbehaving. It's normal for a child to be inattentive, impulsive, or hyperactive from time to time. But if these behaviors continue or become worse, they may be signs of ADHD.

The exact cause of ADHD is not clear, but it tends to run in families.

Some medical problems have symptoms that look like ADHD, so it's important that your child gets the right diagnosis. Your doctor may do some tests and ask you and your child questions to help rule out other problems, such as depression or an anxiety disorder. Sometimes the symptoms of bipolar disorder and ADHD can be confused.

The symptoms of ADHD can also be confused with a learning disability. A psychologist can do some tests to see if your child is having trouble learning how to read, write, or do math problems.

There is no cure for ADHD. But treatment can help manage your child's symptoms.

What are the risks of not treating your child for ADHD?

Without treatment, your child is more likely to:

Do poorly in school or at work.
Be rejected by his or her peers.
Have relationship problems with family members and friends.
Have low self-esteem.
Be depressed.
Lack social skills.

What medicines can your child take for ADHD?

Stimulant medicines are most often used to treat moderate to severe symptoms of ADHD. These medicines affect the way your child's brain controls impulses, behavior, and attention.

Stimulant medicines are sorted into two groups:

Amphetamines, such as Adderall and Dexedrine. These are approved by the U.S. Food and Drug Administration for children age 3 and older.
Methylphenidate, such as Concerta, Daytrana, Focalin, Metadate CD, and Ritalin. It is approved for children age 6 and older. It is often prescribed first because it has fewer side effects than other medicines and it works well to control behavior.

If these medicines don't help, your doctor may suggest other medicines to treat ADHD. These include:

Atomoxetine , such as Strattera. It's a nonstimulant medicine approved for ADHD.
Antihypertensives , including clonidine (such as Catapres) and guanfacine (such as Tenex). These medicines are used to treat high blood pressure, but they also help ADHD sometimes.
Antidepressants, including bupropion (such as Wellbutrin).

How well do these medicines work?

Stimulant medicines are the most effective treatment for ADHD. They work fast and can improve ADHD symptoms in about 75 to 80 out of 100 children who take them. This means that they don't improve symptoms in about 20 to 25 out of 100 children who take them.¹

Studies have shown that children who take stimulant medicines:²

Are calmer.
Are more attentive, focused, and organized.
Interrupt less often.
Have better relationships with family members and friends.

Studies have also shown that:

The nonstimulant medicine atomoxetine can control ADHD symptoms in children and adults.³
The antihypertensive medicine clonidine combined with a stimulant medicine can reduce aggressive and disruptive behavior.⁴

Even though medicine can help reduce your child's symptoms, it can't solve all of your child's behavior problems. Your child may also benefit from counseling, behavior therapy, or social skills training.

What can you expect if your child takes medicine for ADHD?

Your child will take pills every day for as long as he or she needs them. It's important that your child takes the medicine as prescribed and keeps taking it so it has time to work.

If you don't see any improvement in your child's behavior, talk to your doctor. Your child may need to try several different medicines to find one that works for him or her.

You'll need to closely watch your child after he or she begins to take the medicine. The medicine may cause side effects, but they will usually go away within the first few weeks. If they don't, your doctor may need to lower the dose.

What are the side effects of these medicines?

Common side effects include:

Loss of appetite.
Headaches.
Upset stomach.
Sleep problems or drowsiness.

There is also a chance that your child's growth may be slowed. A study found that children who take stimulant medicine grow almost 0.5 in. (1.3 cm) a year slower than children who don't take medicine. More studies are needed to see whether children taking these medicines might catch up over time.^5, ⁶

What are risks of these medicines?

Studies show that when used for only a short time, medicines for ADHD are safe and can help improve your child's behavior and quality of life. But there are some risks. And the effects of using these medicines over the long term haven't been studied. You'll need to weigh the benefits of your child taking medicine with the possible risks.

FDA advisories

There is a small chance that a child may think about suicide when he or she takes atomoxetine or an antidepressant. The FDA doesn't recommend that people stop using these medicines, but instead to watch for warning signs of suicide.

Studies by the FDA have found that:

Less than 1 out of 100 children who used atomoxetine thought about suicide, while more than 99 out of 100 didn't.⁷ For more information, see the FDA advisory on atomoxetine.
About 4 out of 100 children who used an antidepressant thought about suicide, while 96 out of 100 didn't.⁸ For more information, see the FDA advisory on antidepressants.

All medicines approved for ADHD come with an FDA warning about possible heart-related or mental health problems. There have been reports of sudden death in patients who have heart problems or heart defects. And there have been reports of stroke or heart attack in adults with certain risk factors. Be sure to tell your doctor if your child has any heart problems, heart defects, or mental health problems or if there is a family history of these problems.

The FDA has issued an advisory about atomoxetine and the risks of liver injury, orthostatic hypotension, and syncope. Call your doctor if you have nausea or belly pain. Also, call your doctor if you feel dizzy or lightheaded or if your skin is yellowing.

What other treatments are available?

If your child's symptoms are mild, then treatments other than medicine may be enough to help your child improve his or her behavior. Behavioral therapies and extra support at home and in school can help your child be successful and feel better about himself or herself.

These treatments work for some children:

Behavior therapy can help your child understand why he or she acts a certain way. And it can help your child find positive ways to deal with problems by changing the way he or she thinks and behaves. Behavior therapy encourages good behavior through praise or rewards. It discourages bad behavior through time-outs or loss of privileges.
Social skills training can help your child be less aggressive and impulsive, manage anger, and behave in a more socially acceptable way. It uses specific steps and goals, such as helping your child learn how to listen and engage in conversation or be part of a new group.
Counseling , including family therapy, allows your child and the entire family to express fears and concerns, recognize problem behaviors, and learn new ways of getting along.

Why might your doctor recommend medicine to treat your child's ADHD?

Your doctor may suggest that your child take medicine if:

Your child's symptoms are moderate to severe and are causing problems at home, in school, and with family members and friends.
Your child's symptoms haven't improved with counseling or behavioral therapies alone.

2. Compare your options

	Have your child take medicine for ADHD	Don't have your child take medicine
What is usually involved?	Your child takes pills every day for as long as he or she needs them. Your child may also see a counselor or get behavior therapy or social skills training.	Your child sees a counselor or gets behavior therapy or social skills training.
What are the benefits?	Medicines for ADHD can help your child to: Be more calm, attentive, focused, and organized. Be less aggressive and disruptive. Have better relationships with family members and friends.	If your child's symptoms are mild, then counseling, behavior therapy, or social skills training may be enough to improve your child's behavior. If your child's symptoms don't improve with counseling or behavioral therapies, you can decide later to try medicine. Your child can avoid the side effects of the medicine. You don't have to pay for medicine.
What are the risks and side effects?	Possible side effects include: Loss of appetite. Headaches. Upset stomach. Sleep problems or drowsiness. Slowed growth. Heart and mental health problems. There is a small chance that your child may think about suicide while taking nonstimulant or antidepressant medicines.	Without treatment, your child is more likely to: Do poorly in school or at work. Be rejected by his or her peers. Have relationship problems with family members and friends. Have low self-esteem. Be depressed. Lack social skills.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

If you need more information, see the topic Attention Deficit Hyperactivity Disorder (ADHD).

Personal stories about taking medicine for ADHD

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

" We thought that our son had a learning disability. He seemed "spacey" at times. When he was little, he couldn't pay attention long enough for me to read an entire book to him. As he got older, he did poorly on standardized tests at school. A psychiatrist finally diagnosed him with ADHD and suggested that medication might be helpful. We are thinking it over and will probably try it. Our son is old enough to help us with the decision too. I'm sure he would be happy to have some help staying on task at school and with his homework. "

— Parents of Michael, age 11

" We thought our son was just a little more energetic than other kids. Then he started preschool. We got a call from the teacher on his second day there. Turns out he was a lot more "energetic" than the other kids. We have been working with his doctor and with the preschool teacher for several months on different ways to get him to sit still and stay on task. He's made some progress, but he is still a handful. We are trying to hold off on trying medication until he is around age 6. We realize that he may always need more than just a little extra attention in order to succeed in school. "

— Parents of Carlos, age 4

" Our daughter Ann Marie doesn't have many friends at school. Her impulsive behavior is so out of control that none of the other kids want to play with her. It is hard for us, because we know what a warm and fun-loving child she is. When our doctor suggested that she might benefit from medications, we were happy to have an option that might make it easier for her to get along with her classmates. "

— Parents of Ann Marie, age 6

" We aren't sure what our daughter's problem is—ADHD, learning disability, depression, or some combination of things. It's a little frustrating that it seems to be taking so long to figure it out, but we like our doctor and she has done a good job of helping us understand why there are no quick and easy answers. Our daughter isn't hyper like a lot of kids with ADHD, but she can't seem to pay attention in class and she's not doing well in school. We work with her most nights at home to help her focus on her homework, and we do not want to put her on any medication at this point. However, if her grades still aren't up at the end of this quarter, we may consider trying medication to help her focus. "

— Parents of Emily, age 7

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons for your child to take medicine for ADHD

Reasons for your child not to take medicine

My child wants to try medicine.

My child doesn't want to try medicine.

More important

Equally important

More important

My child's ADHD isn't improving with counseling alone.

I want my child to continue counseling, without medicine, at least for a while.

More important

Equally important

More important

I'm worried that ADHD is affecting my child's schoolwork and relationships with friends and family.

My child's schoolwork and relationships with friends and family don't seem to be affected.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having my child take medicine

NOT having my child take medicine

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Can medicine cure ADHD?

Yes
No
I'm not sure

That's right. Medicine can't cure ADHD or solve all of your child's behavior problems.

2. Do ADHD medicines have side effects?

Yes
No
I'm not sure

That's right. Medicines can help, but they have side effects and risks.

3. Are there other ways to treat ADHD that don't involve taking medicine?

Yes
No
I'm not sure

That's right. If your child's symptoms are mild, then counseling, behavior therapy, or social skills training may be enough to improve your child's behavior.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

References

Citations

Schweitzer JB ,et al. (2001). Attention-deficit/hyperactivity disorder. Medical Clinics of North America, 85(3): 757–777.
American Academy of Child and Adolescent Psychiatry (2002). Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. Journal of the American Academy of Child and Adolescent Psychiatry, 41(2, Suppl): 26S–49S.
Greydanus DE, et al. (2003). Attention-deficit/hyperactivity disorder in children and adolescents: Interventions for a complex costly clinical conundrum. Pediatric Clinics of North America, 50(5): 1049–1092.
Hazell LH, Stuart JE (2003). A randomized controlled trial of clonidine added to psychostimulant medication for hyperactive and aggressive children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(8): 886–894.
MTA Cooperative Group (2004). National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: Changes in effectiveness and growth after the end of treatment. Pediatrics, 113(4): 762–769.
Jensen PS, et al. (2007). 3-year follow-up of the NIMH MTA Study. Journal of the American Academy of Child and Adolescent Psychiatry, 46(8): 989–1002.
U.S. Food and Drug Administration (2005). FDA issues public health advisory on Strattera (atomoxetine) for attention deficit disorder. FDA News P05-65. Available online: http://www.fda.gov/bbs/topics/NEWS/2005/NEW01237.html.
U.S. Food and Drug Administration (2007). Antidepressant Use in Children, Adolescents, and Adults. Available online: http://www.fda.gov/cder/drug/antidepressants/default.htm.