ADHD

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, or excessive activity and impulsivity, which are otherwise not appropriate for a person’s age. Some individuals with ADHD also display difficulty regulating emotions or problems with executive function. For a diagnosis, the symptoms should appear before a person is twelve years old, be present for more than six months, and cause problems in at least two settings (such as school, home, or recreational activities). In children, problems paying attention may result in poor school performance. Additionally, there is an association with other mental disorders and substance misuse. Although it causes impairment, particularly in modern society, many people with ADHD can have sustained attention for tasks they find interesting or rewarding (known as hyperfocus).

An estimated 8.4 percent of children and 2.5 percent of adults have ADHD. ADHD is often first identified in school-aged children when it leads to disruption in the classroom or problems with schoolwork. It can also affect adults. It is more common among boys than girls.

ADHD Drugs

Selecting the “best” ADHD medication can be a lengthy trial-and-error process of dosage and timing that is often related to a patient’s history, genetics, experienced side effects, and unique metabolism. ADHD medication is also often accompanied by behavioral therapy and other non-pharmacological treatments.

The most popular ADHD medications among ADDitude readers include (in alphabetical order):

  • Adderall XR (amphetamine)
  • Concerta (methylphenidate)
  • Dexedrine (amphetamine)
  • Evekeo (amphetamine)
  • Focalin XR (dexmethylphenidate)
  • Quillivant XR (methylphenidate)
  • Ritalin (methylphenidate)
  • Strattera (atomoxetine hydrochloride)
  • Vyvanse (lisdexamfetamine dimesylate)

Many parents and adults with ADHD remain confused about the distinctions and similarities between these and other treatment choices for ADHD. Our ADHD medication chart offers a side-by-side comparison of the most popular stimulants and non stimulants in the treatment of ADHD.

Symptoms and Diagnosis

Many ADHD symptoms, such as high activity levels, difficulty remaining still for long periods of time and limited attention spans, are common to young children in general. The difference in children with ADHD is that their hyperactivity and inattention are noticeably greater than expected for their age and cause distress and/or problems functioning at home, at school or with friends.
ADHD is diagnosed as one of three types: inattentive type, hyperactive/impulsive type or combined type. A diagnosis is based on the symptoms that have occurred over the past six months.

Inattentive type – six (or five for people over 17 years) of the following symptoms occur frequently:

  • Doesn’t pay close attention to details or makes careless mistakes in school or job tasks.
  • Has problems staying focused on tasks or activities, such as during lectures, conversations or long reading.
  • Does not seem to listen when spoken to (i.e., seems to be elsewhere).
  • Does not follow through on instructions and doesn’t complete schoolwork, chores or job duties (may start tasks but quickly loses focus).
  • Has problems organizing tasks and work (for instance, does not manage time well; has messy, disorganized work; misses deadlines).
  • Avoids or dislikes tasks that require sustained mental effort, such as preparing reports and completing forms.
  • Often loses things needed for tasks or daily life, such as school papers, books, keys, wallet, cell phone and eyeglasses.
  • Is easily distracted.
  • Forgets daily tasks, such as doing chores and running errands. Older teens and adults may forget to return phone calls, pay bills and keep appointments.

Hyperactive/impulsive type – six (or five for people over 17 years) of the following symptoms occur frequently:

  • Fidgets with or taps hands or feet, or squirms in seat.
  • Not able to stay seated (in classroom, workplace).
  • Runs about or climbs where it is inappropriate.
  • Unable to play or do leisure activities quietly.
  • Always “on the go,” as if driven by a motor.
  • Talks too much.
  • Blurts out an answer before a question has been finished (for instance may finish people’s sentences, can’t wait to speak in conversations).
  • Has difficulty waiting for his or her turn, such as while waiting in line.
    Interrupts or intrudes on others (for instance, cuts into conversations, games or activities, or starts using other people’s things without permission). Older teens and adults may take over what others are doing.

There is no lab test to diagnose ADHD. Diagnosis involves gathering information from parents, teachers and others, filling out checklists and having a medical evaluation (including vision and hearing screening) to rule out other medical problems. The symptoms are not the result of a person being defiant or hostile or unable to understand a task or instructions.

ADHD Side Effect

stimulant medications can be very effective in reducing symptoms of ADHD, but some kids do experience uncomfortable or harmful side effects. When side effects become a problem, we try to change the dosage, the release formula, or the type of medication your child is taking. The goal is to determine what will give him the most benefit, with the least side effects.
The key problems to be on the lookout for:

  • Sleep problems
  • Decreased appetite
  • Delayed growth
  • Headaches and stomachaches
  • Rebound (irritability when the medication wears off)
  • Tics
  • Moodiness and irritability

To get an accurate picture of side effects, we need to establish your child’s baseline before he starts taking the medication. For instance, some kids with ADHD have a hard time falling asleep to begin with. Some kids with ADHD are very picky eaters, to begin with.

Identifying existing problems helps us avoid blaming the medicine for problems that were already there.