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There is no cure for Attention Deficit Hyperactivity Disorder (ADHD). Therapy aims to reduce the symptoms to allow for normal learning and growth of the child.
Basic tenets of therapy include medication and counselling. Other parts of therapy include accommodating the child in regular classrooms and providing family and community support.
Medications used for ADHD are known as psychostimulants and nonstimulants like Atomoxetine. These come in oral forms like tablets, capsules, liquids and also in form of skin patches.
Stimulants include Methylphenidate (Brand names Ritalin, Concerta, Daytrana), Dextroamphetamine-amphetamine (Adderall) and Dextroamphetamine (Dexedrine, Dextrostat).
These stimulants improve the deranged balance of nerve messengers in the brain called neurotransmitters. They help to improve the major symptoms of hyperactivity-impulsivity and inattention.
ADHD medication may be short acting, where action lasts for around four hours, or long acting where action lasts between six and twelve hours.
Methylphenidate for example can be given as a patch that when applied over the hip much like a bandaid can deliver the medication into the body over nine hours.
Long acting preparations usually take time to begin their action but carry the advantage of less frequent dosing.
These stimulants however tend to lose their efficacy over time. In addition all children do not benefit at similar doses and the right dosing sometimes may take time.
Common side effects include weight loss and loss of appetite, sleep disturbances, irritability towards the end of action of the medication etc.
Some children may develop twitches or jerky movements as side effects and in some growth may be affected.
These side effects are not permanent and may be reversed after the drug is stopped.
There are some reports of sudden death in children and adolescents using psychostimulants. This risk is raised in those with underlying heart disease or heart defect.
Furthermore, Methylphenidate and Dexamphetamine cannot be taken by pregnant women, children or persons with glaucoma, hyperthyroidism (overactive thyroid) and severe depression.
Nonstimulant medication for ADHD includes Atomoxetine. It is chosen when stimulant drugs are ineffective or cause side effects.
This drug needs to be taken once or twice daily and also reduces anxiety.
Side effects include loss of appetite and weight, nausea and sleepiness. Rare side effects include liver problems, depression and suicidal thoughts.
Children who do not respond to these medications are prescribed other drugs. These include antidepressants and Clonidine (actually a high blood pressure medication).
All medications used in ADHD should be kept out of the child’s reach and administered only under adult supervision.
Apart from medications, children with ADHD often benefit from counselling and behavioural therapy.
This may be imparted by a trained psychologist, psychiatrist, mental health care professional or social worker. These include –
Behavioural therapy is team effort and needs to be coordinated.
Other alternative calming therapies include yoga and meditation.
There is no solid evidence that certain foods if banished from diet or added (like vitamin supplements, herbal medications, essential fatty acids etc.) help in reducing symptoms of ADHD. However ADHD children need to be given a healthy balanced diet. It is advisable not to remove anything from the child’s diet without medical advice.
Regular exercise is also recommended in persons with ADHD. Over years the symptoms of ADHD lessen considerably but may never completely go away.