ADHD treatment

The two most effective treatments^[21] for ADHD are medication and psychotherapy. Medication, though generally not as helpful when used alone as it is when taken alongside therapy, can be useful in treating the symptoms of ADHD, such as attention problems and impulsivity. It’s important to note that medications cannot cure ADHD—rather, they can help manage the symptoms of the disorder. ADHD medications work by affecting two chemicals in the brain known to affect attention and impulsivity: dopamine and norepinephrine. The FDA has approved the use of several different medications for the treatment of ADHD:

• Stimulants: These are the most common medications used to treat ADHD in both children and adults. Methylphenidate (MPH) and amphetamines (AMP) are regulated drugs and are tightly controlled by the Drug Enforcement Administration (DEA), as they pose a risk for substance abuse.

There are short and long-acting versions of these medications. Some people with ADHD who take stimulants prefer longer-acting options because they cause fewer “ups and downs” throughout the day compared to short-acting stimulants.

• Nonstimulants: These medications are typically used only if a person does not respond well (or at all) to stimulants, or if they have other conditions that prevent them from taking stimulants.

Your healthcare provider may prescribe you medications that manage your brain-based functions, while therapy can help address coping strategies and ways to manage the problematic thoughts and behaviors that can result from ADHD. Typically, medication treatment is monitored closely by a provider who specializes in psychiatric disorders. The treatment of ADHD can vary slightly between children and adults.

ADHD medication

Your provider may prescribe the following medications for ADHD:

Cognitive behavioral therapy for ADHD

Cognitive behavioral therapy, or CBT, is the most common type of therapy to address the behavioral issues associated with ADHD. The goal of behavioral therapy is to reduce or eliminate unwanted behaviors while affirming and strengthening positive ones. For young children under the age of six, it is important to try behavioral therapy before starting medications because:

• Younger children experience more side effects from ADHD medications than do older children
• We do not yet know the long-term effects of using ADHD medications on young children
• Parent training through behavioral therapy can help parents learn the tools to assist their children through the challenges of ADHD

Treatment of ADHD in children

The American Academy of Pediatrics suggests that behavioral management be the first line of treatment for children younger than six who have received an ADHD diagnosis. The AAP recommends that medication and behavioral therapy be used in combination for children aged six and older. Parents must be involved in the treatment^[22] of their child’s ADHD. This may include medication, behavioral therapy, or both. Parents are also encouraged to participate in behavioral therapy to help them learn techniques to aid their children in facing the challenges of ADHD. People from other areas of a child’s life can get involved as well, such as coaches, teachers, or babysitters. A child’s treatment plan should include regular monitoring to ensure the child is getting the help they need as well as making the changes that will help ensure their future success. There are many actions a parent can take to help their child manage the symptoms of their ADHD. For example:

• Creating a routine and following the same daily schedule
• Setting a good example of organization and encouraging your child to practice their own methods of organization, such as putting their toys away after play
• Limiting choices so as to decrease the likelihood of your child feeling overwhelmed or overstimulated
• Limiting distractions during times of focus, such as turning off the television while your child is finishing their homework
• Being clear and specific when giving instructions to your child
• Helping your child learn how to plan tasks by showing them the method of breaking down large goals into smaller components
• Disciplining your child by removing privileges or using time-outs (rather than adding negative consequences, such as yelling or spanking)
• Creating positive opportunities for your child by encouraging them to participate in activities they enjoy or excel at
• Tracking positive behaviors using a goal chart or another rewards system
• Providing a healthy lifestyle for your child with the opportunity for plenty of sleep, healthy food, and adequate physical activity.

It is recommended that children six years and older use a combination of medication and behavioral therapy. Effective behavioral therapies include parent training, peer interventions that strengthen positive behaviors, behavioral interventions in the classroom setting, and organizational skills training. Medications can also help children better manage their ADHD symptoms. However, it is important to remember that medications can affect children in different ways and can have the potential to cause side effects, such as changes in appetite or sleep patterns. The FDA has approved certain medications to treat children even as young as six years old:

• Stimulants: 70–80% of children with ADHD show fewer symptoms with the use of tightly controlled stimulant medications.
• Nonstimulants: These medications are longer-acting, but do not work as quickly as stimulants.

Treatment of ADHD in adults

Similar to children over the age of six, adults^[23] with ADHD benefit the most from a combination of medications and behavioral therapy. Cognitive behavioral therapy (CBT) has been shown to help adults with ADHD overcome the challenges associated with their disorder, such as time management problems, organizational struggles, and difficulties making and/or following through with plans. CBT can also help with regulating emotions and controlling impulsive behavior. CBT is also helpful for adults who have another pre-existing disorder, such as depression or generalized anxiety disorder. Studies have shown that in adults with ADHD, roughly half also have anxiety, and about one-third also has depression. Receiving therapy for these associated conditions has been shown to also help improve the symptoms of ADHD. There have not been any studies done to compare the effectiveness of CBT versus medication alone. Current research, however, shows that CBT is helpful regardless of whether or not a person is taking medication for their ADHD. CBT is known to be helpful in the long-term because it encourages the formation of positive behaviors and helps adults with ADHD learn the skills they need to reduce their unwanted symptoms.