Attention Deficit Disorder, whether with or without hyperactivity, is a complex disorder that requires multimodal management involving a healthy lifestyle, a psychoeducational and psychotherapeutic approach, the implementation of a treatment strategy and finally taking adapted medications.
Specialists can actually prescribe medication to treat ADHD. This practice, studied in depth, is now used for more than forty years and is really effective. In two-thirds of the cases, medication specific to ADHD significantly improves the daily life of the hyperactive child as a whole: behavior, schooling, etc.
The role of drugs for ADHD: why?
With great difficulty in controlling attention, emotion, gesture and behavior, it is worth remembering that attention deficit disorder with or without hyperactivity is primarily a neurological disorder. When he comes to cripple its victim, the regulation of or brain chemicals causing his symptoms becomes necessary, hence the use of drugs is necessary.
The drug for ADHD has the overall role of boosting dopamine and / or norepinephrine, neurotransmitters playing an important role in the cognition, mood and attention of a person. It reduces the symptoms of the disorder to improve the function of the brain and subsequently, to allow the child to reach its full potential.
ADHD medications do not treat it to cure it. In fact, drugs prescribed as part of an attention deficit disorder are used for “correction” purposes. Like a pair of glasses that are used to correct vision, these medications are prescribed to correct the lack of attention, agitation, impulsivity and hypersensitivity. More concretely, they will act on the brain to:
- Improve concentration
- Regulate and manage emotions
- Reinforce the attention paid to each task;
- Strengthen self-control and mastery of gestures and behavior.
Which drug for ADHD to choose?
The choice of medication depends on several factors: the severity of symptoms, the consequences of the disorder on the quality of life of the patient and the expected effects. This task is up to the medical specialist who will prescribe drugs on a case by case basis. Depending on the patient’s profile, he can prescribe three types of treatment:
- Psychostimulants based on methylphenidate;
- Psychostimulants based on amphetamines;
Note that psychostimulants are allowed because scientifically proven to be very effective in alleviating the symptoms of ADHD. At a therapeutic dose, improvement in concentration and attention is noticeable only hours after taking.
Psychostimulants based on methylphenidate
Methylphenidate stimulants do not affect the production of dopamine: they do not increase it, they do not inhibit it either. The role of this psychostimulant substance is actually to “correct” the effects of dopamine on the cortex. Its purpose is to awaken the child and subsequently to promote the child’s attention abilities. Among the most well-known methylphenidate-based drugs are:
- Ritalin: On the market since the 1960s, reviews on this drug are controversial because of which it is rarely prescribed so far. Its effects are also quite limited, because they fade about three hours after taking.
- Concerta: In the form of an insoluble pill, it is the first long-lasting ADHD drug. Its effects can last up to 8 hours which makes it ideal for sustained cognitive activities. The problem is that studies have shown that it is much more effective at the beginning of the afternoon, at which time it is recommended, than in the morning when most of the learning is done in class.
- Biphentin: it is also a long-term medication. Its effects only fade 8 or 10 hours after taking, but like the Concerta, it can be taken in the morning. Another advantage, this drug is in the form of capsule containing granules easily dissolvable in water or other liquid food (juice, compote, yogurt …).
Several scientific studies have proven the effectiveness of amphetamines, especially mixed salts, in reducing symptoms of ADHD. Because of the side effects they can cause, however, amphetamine-based psychostimulants are usually prescribed only when there are no convincing results with those based on methylphenidate. Among the stimulants derived from this substance are:
- Adderall: a long-lasting medication that can last up to 12 hours.
- Vyvanse: very long-lasting medication, the effects of which can last up to 14 hours. It is mainly prescribed to adolescents and adults.
- Dexamphetamine: Delivered as a sustained-release capsule, this drug stimulates the brain to maintain alertness. Depending on the dose prescribed and taken, its effect may vary between 10 to 12 hours.
The main role of nonstimulant drugs is to correct the effects of norepinephrine in the brain. As a reminder, this neurotransmitter plays a key role in the process of learning (and therefore concentration), memorization (and therefore attention) and vigilance (and therefore awakening). Non-stimulant drugs used to treat ADHD include:
- Strattera: Often prescribed to replace psychostimulants when the side effects of these are poorly supported by the patient, this drug works for 24 hours in a row, after a response time of 2 to 4 weeks. In addition to boosting the attention, it can also reduce anxiety and undeniable advantage, its catch can be interrupted during non-school periods (weekends, holidays, etc.)
- Atomoxetine: the best-known non-stimulant, this medicine is recommended to the patient in need of sustained attention. After a response time of about two weeks indeed, Atomoxetine inhibits the reuptake of norepinephrine which improves attention for nearly 24 hours. You can buy this product on RXShopMD.com.
- Intuniv: Designed primarilyto treat high blood pressure, this new drug can be used as a supplement or as a main treatment for ADHD. Drug in second intention after the psychostimulants, with long lasting effect of 24 hours (thus only one catch per day), it is addressed especially to the hyperactive children from 6 to 12 years old.
Drug for ADHD: what dose and how often?
Only the medical specialist can define, from the clinical responses obtained after a few days and a few weeks after the start of treatment, the appropriate dose for the patient. Again, it will act on a case-by-case basis, because a dose prescribed to one may be too high or not effective for the other.
The dose is to be adjusted gradually. At the beginning of the treatment, the doctor will prescribe the lowest possible dose and increase the dosage until the minimum dose providing the maximum clinical response is reached. The choice of the final dosage should also take into account the number of adverse effects caused by the drug and their degree of severity.
What about the duration of treatment?
The duration of treatment will depend on the drug and the patient’s profile. Depending on the severity of the symptoms, certain medications should be taken regularly and daily without any interruption. Others, in particular non-stimulants, can be stopped during periods when cognitive activities are rare: during weekends, during holidays, etc.
It is rare that a drug for ADHD is taken for life, but it is not excluded. If the symptoms persist into adulthood and disrupt the patient’s functioning, treatment can and should continue. In any case, it is always advisable to stick to the opinion of the attending physician!