Stimulant and nonstimulant medications

Medication is often an important part of treatment for a child with ADHD. However, it can be a difficult decision to make as a parent.

To make the best choice, you and your child’s doctor should work together to decide if medication is a good option. If so, ask the doctor whether your child needs medication during school hours only, or on evenings and weekends as well. You and the doctor should also determine what type of medication might be best. The two main types of ADHD medications are stimulants and nonstimulants.

Central nervous system stimulants

Central nervous system (CNS) stimulants are the most commonly prescribed class of ADHD drugs. These drugs work by increasing the amounts of the brain chemicals called dopamine and norepinephrine. The effect improves your child’s concentration and helps them focus better.

Common CNS stimulants used to treat ADHD include:

• amphetamine-based stimulants (Adderall, Dexedrine, Dextrostat)
• dextromethamphetamine (Desoxyn)
• dextromethylphenidate (Focalin)
• methylphenidate (Concerta, Daytrana, Metadate, Ritalin)

Nonstimulant medications

Your child’s doctor may consider nonstimulant medications when stimulants haven’t worked or have caused side effects that your child finds hard to handle.

Certain nonstimulant medications work by increasing levels of norepinephrine in your child’s brain. Norepinephrine is thought to help with attention and memory. These nonstimulant treatments include:

• atomoxetine (Strattera)
• antidepressants like nortriptyline (Pamelor)

Other nonstimulant medications can also help with ADHD. It isn’t fully known how these medications help with ADHD, but there is some evidence that they help certain chemicals work better in the part of the brain involved with attention and memory. These other nonstimulants include:

• guanfacine (Intuniv)
• clonidine (Kapvay)

Side effects of stimulants and nonstimulants

The more common side effects of stimulants and nonstimulants are pretty similar, although they tend to be stronger for stimulants. These side effects can include:

• headache
• trouble sleeping
• stomach upset
• nervousness
• irritability
• weight loss
• dry mouth

The more serious side effects of these drug types are rarer. For stimulants, the serious side effects in children can include:

• hallucinations (seeing or hearing things that aren’t there)
• increased blood pressure
• allergic reaction
• suicidal thoughts or actions

For nonstimulants, the serious side effects in children can include:

• seizures
• suicidal thoughts or actions  

Therapeutic ADHD treatments

Several therapy options can help children with ADHD. Talk to your doctor about whether one or more of these options would be a good choice for your child.

Psychotherapy

Psychotherapy can be useful in getting your child to open up about their feelings of coping with ADHD. ADHD can cause your child to have problems with peers and authority figures. Psychotherapy can help children better handle these relationships.

In psychotherapy, a child may also be able to explore their behavior patterns and learn how to make good choices in the future. And family therapy can be a great way to help figure out how best to work through disruptive behaviors.

Behavior therapy

The goal of behavior therapy (BT) is to teach a child how to monitor their behaviors and then change those behaviors appropriately. You and your child, and perhaps the child’s teacher, will work together. You’ll develop strategies for how your child behaves in response to certain situations. These strategies often involve some sort of direct feedback to help the child learn suitable behaviors. For instance, a token reward system could be devised to support positive behaviors.

Social skills training

Social skills training can sometimes be useful if a child shows serious issues dealing with social environments. As with BT, the goal of social skills training is to teach the child new and more appropriate behaviors. This helps a child with ADHD play and work better with others. A therapist may try to teach behaviors such as:

• waiting their turn
• sharing toys
• asking for help
• dealing with teasing

Support groups

Support groups are great for helping parents of children with ADHD connect with others who may share similar experiences and concerns. Support groups typically meet regularly to allow relationships and support networks to be built. Knowing you’re not alone in dealing with ADHD can be a huge relief for many parents.

Support groups can also be a great resource for ideas and strategies for coping with your child’s ADHD, especially if your child was recently diagnosed. Ask your doctor how to find support groups in your area.

Parenting skills training

Parenting skills training gives you tools and techniques for understanding and managing your child’s behaviors. Some techniques may include the following:

Immediate rewards: Try using a point system or other means of immediate rewards for good behavior or work.

Timeouts: Use a timeout when your child becomes too unruly or out of control. For some children, being pulled out of a stressful or overstimulating situation can help them learn how to react more appropriately the next time a similar situation comes up.

Togetherness: Find time together every week to share a pleasurable or relaxing activity. During this time together, you can look for opportunities to point out what your child does well and praise their strengths and abilities.

Striving for success: Structure situations in a way that allows your child to find success. For instance, you might allow them to have only one or two playmates at a time so they don’t get overstimulated.

Stress management: Use methods such as meditation, relaxation techniques, and exercise to help manage stress.

Behavioral interventions for home and school

One of the biggest concerns for parents of children with ADHD is their child’s success in school. A lot of that success depends on how organized they are. Being organized is a skill that many children with ADHD struggle with. Simple steps such as these below can be an immense help.

Build a schedule

Set the same routine every day. Try to make sure that waking up, bedtime, homework, and even playtime are done at consistent times. Post the schedule in a visible place. If a change must be made, make it as far in advance as possible.

Organize everyday items

Make sure that clothing, backpacks, school supplies, and play items all have a designated, clearly marked space.

Use homework and notebook organizers

Stress the importance of writing down assignments and bringing home anything needed to complete homework.

Ask about using a computer in class

For some children with ADHD, handwriting is another obstacle to success. If necessary, see if their teacher will allow for computer use in the classroom.

Use positive reinforcement

Children with ADHD often receive criticism from authority figures. Then they start to expect it. If they get only negative feedback without ever hearing positive things about themselves, they’ll start to think of themselves as bad.

To boost your child’s self-esteem and reinforce appropriate behavior, use positive reinforcement. If your child follows the rules and behaves well, give small rewards and praise. This lets them know what behavior you prefer, while letting them know that they can be good. 

Talk with your doctor

Effective treatment for a child’s ADHD often includes several approaches. These can include medication and one or more types of therapy, as well as behavioral measures that you can put into practice as a parent. Getting proper treatment can help your child manage their ADHD symptoms and feel better about themselves.

To learn more about what treatment might work best for your child, talk with your child’s doctor. Some of your questions might include:

• Would medication, therapy, or both help my child?
• Would you recommend a stimulant or a nonstimulant medication or my child?
• What side effects from the medication should I watch for?