Should I Medicate My ADHD Child?

The decision to give your child ADHD medication is a difficult and personal one. By no means is it the only choice, but it's a decision that should be carefully considered before you accept or reject it as the right treatment method for your child.

Do we have to consider medication?

No. There are other options for parents to consider besides medication. When our child was first diagnosed with ADHD, the pediatric neurologist recommended that we first try Cognitive Behavior Therapy or CBT. CBT differs from traditional therapy in that it focuses on giving children ways to cope with the issues that bother them. The therapist will work with the child in their office and present them with different scenarios that expose the child to the issue they are trying to address. The child will also be given homework to do, with the intent of giving the child tools to cope with their issues. CBT doesn't remain open ended, although the therapist will ask for a dedicated commitment for a specific period of time.

While CBT helped our child with one of his co-existing conditions caused by ADHD, in his case, generalized anxiety. It did not address the main symptoms that were causing his social and academic difficulties, his impulsiveness and lack of focus. When he began to have more problems interacting with his friends and continuing to get good grades, we knew it was time to try other options.

Which medication works best?

Unfortunately, there is no one-size-fits-all medication for ADHD. Each child responds differently to different prescriptions, and it may take some time to determine which one works the best for them. The introduction of these medications is a trial and error process, so it is necessary to keep a close eye on the child to look for potential side effects.

The main medications that your doctor will prescribe include stimulants such as Concerta, Adderall, Ritalin and Focalin, or non-stimulants like Strattera. We tried three different medications before we settled on Concerta extended release for our son. The extended release medications that are available today make it much easier for school age ADHD children to take medication without having to make multiple day visits to the school nurse. We give one tablet earlier in the morning to our son and he is set for the day. It may also take time to find the right dosage as well, as small jumps in milligrams can make substantial behavioral differences.

Should I expect any Side Effects?

As with any stimulant based medication the doctor will want to make sure that your child is free of any heart related problems before he/she starts the medication. A typically healthy child should not have to be tested, but our son had been experiencing chest pains (related to Asthma) so it was necessary to have him see a pediatric cardiologist and to have an EKG and stress test to clear him before we began the medication.

Once on the medication you will want to watch for any side effects specific to the brand of medication your child is on. Some common side effects are decreased appetite, trouble sleeping and decreased growth rate in the first year of taking the medication. Rarer side effects can include aggression or depression. All symptoms should of course be reported to your doctor who can determine if the medication should be stopped or changed.

Do the benefits outweigh the side effects?

Each case is of course unique, but for our son the difference in his behavior was startling. We purposefully did not inform two of his teachers that he had started the medication. Both came back, unsolicited, to ask what we had done to our son, that he was a different child in class. He paid attention in class, had an easier time with his friends, and the three-hour marathon homework sessions of me cajoling, threatening and yelling became a thing of the past.

And while our success story is a happy one it did not come without its problems to overcome. Our son had difficulty sleeping at first. He wouldn't eat anything during the day and at 9 at night would become voraciously hungry. In the very beginning, he would have rebound effects coming off his medication at night and become extremely hyperactive as the medication wore off.

We stuck with it and figured out how to make it work. He began taking Melatonin at night to counteract the effects of the stimulants, and sleeps better because of it. We keep a jar of peanut butter and jelly at the ready at night for when his appetite returns, and have warned parents at sleepovers to do the same. And the rebound effects rarely appear any more as his body has adjusted to the medication.

As I look at my son as he sits quietly at the kitchen table doing his homework without my direction, or see his beaming face as he reports a 99 on a math test, or just have him come home from the bus having had a good day, I know the decision to have him take the medication has proven worth it. For the others of you out there, I say hang on, help is out there, in whatever form is right for you.