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The treatment of ADHD

Use the links below to learn more about a particular area of treatment.

Treatment options

ADHD can respond well to treatment. In the UK, both the National Institute for Health and Clinical Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) recommend ADHD be treated.1,3

The precise treatment that the child will be offered will depend on their particular needs.

However, treatment is to include:

1.Advice and behavioural therapy
Advice, support and behavioural therapy for parents and/or the child and/or teachers.

This includes specific training on how to manage the child's behaviour most effectively and to promote ways of bringing out the best in them.3

There are several behavioural techniques
Techniques may include:

  • Identifying and focusing on particular problem times or situations such as mealtimes, getting ready for school or doing homework
  • Planning in advance what to do in response to the child's behaviour and responding consistently
  • Developing techniques to improve the child's listening; for example, using
  • eye-to-eye contact, talking about one thing at a time.
  • Using "time out" and other sanctions

Social skills training, counselling and remedial teaching

ADHD commonly occurs together with other conditions. As part of their treatment, the child may be offered:

  • Training in social skills to help build relationships and avoid aggressive behaviour
  • Counselling to improve self-esteem
  • Remedial teaching to help them "catch up" at school

2. Medication

The medicines approved in the UK for treatment of ADHD are:

  • Methylphenidate14-16
  • Dexamfetamine17
  • Atomoxetine18
  • Lisdexamfetamine19

Methylphenidate, dexamfetamine and atomoxetine
Methylphenidate and dexamfetamine belong to a group of medicines called stimulants. Atomoxetine acts in a slightly different way and is not classed as a stimulant.Different treatment options suit different children.

Long-acting medicines make school-time dosing unnecessary
The effect of methylphenidate lasts only for a few hours, so two to three daily doses are recommended.16 Longer acting formulations of methylphenidate are also available in the UK: one formulation has a 12-hour action, designed to mimic a three times daily regime, and makes school-time and early evening dosing unnecessary;14 other formulations have an 8-hour action designed to mimic a twice daily regime making school-time dosing unnecessary.15

Benefits for child and school
For the child, long-acting medicines can avoid the stigma of having to take medication at school. For the school, not having to dispense medication can be an advantage.20 However, once-daily dosing may reduce dose flexibility.

Complementary and alternative therapies
Various complementary and alternative therapies have been tried in ADHD, including Chinese herbal medicines, chiropractic intervention and electromyography.3 There is little evidence that they are effective in treating ADHD.3

The most suitable drug is always recommended
Medicines for ADHD are always prescribed and supervised by a doctor, who will recommend the most suitable drug for the child. Factors they will take into account when deciding which drug to choose include:

  • Likely effectiveness in the child's particular case
  • Possible side effects (see Treatment expectations for more about this)
  • Convenience and acceptability to the child

Some children need both medication and behavioural therapy
The treatment programme prescribed will depend on the child and the severity of their symptoms. Some children will respond to behavioural therapy alone, whilst others will need a combination of behavioural therapy and medication.

Treatment expectations

It is important to understand the potential benefits and limitations of medical treatment for ADHD.

  • Treatment can greatly improve the symptoms of the child's ADHD, but cannot cure it completely.
  • The child's doctor will be able to discuss the best treatment based on their individual needs

While treatment is effective, it can also cause side effects.

Side effects

For a full list of possible side effects please speak to a health professional.It may take some time to find the best dose of drug treatment to use for the child. The specialist may prescribe a low dose to begin with, then increase it, aiming to achieve symptom relief while minimising.

During the early stages of treatment, you may be asked to help monitor the child's symptoms using forms provided to you, and to look out for side effects.

Length of treatment

The length of time for which the child will receive treatment for ADHD is not fixed in advance.

Treatment for ADHD may need to continue for a number of years. Some people take medication for ADHD into adulthood.3

The doctor may recommend that the child stops their medication every so often to see how they get on without it (sometimes known as a "medication/treatment holiday"). Stopping treatment should be carried out only under the supervision of the specialist in charge of the child's care.

 

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Resources

Visit our resource centre for useful information and helpful activities for parents, teachers and teenagers living with ADHD.

 

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