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| |    Medications for ADHD by Robert Needlman, M.D., F.A.A.P. reviewed by Laura Jana, M.D., F.A.A.P. The medications most often used to treat ADHD belong to a group called stimulants. You might wonder why we give a stimulant to a child who is already hyperactive. The reason is because these medications stimulate the parts of the brain that are responsible for paying attention, following rules, and thinking before acting. Stimulating these areas causes you to become more watchful and more aware of the consequences of your actions, and therefore less impulsive. The two most time-tested stimulant medications are methylphenidate (brand name Ritalin) and dextroamphetamine (brand name Dexedrine or Dextrostat). A third, pemoline (Cylert) is not used often because it can cause serious liver damage in rare cases. Newer stimulants are variations on the older ones: A mixture of different forms of amphetamine, closely related to dextroamphetamine, is sold under the brand name of Adderall. There are also two new formulations of methylphenidate (brand names Metadate and Concerta) that are supposed to be longer-acting. Many school-age children hate having to go to the school nurse or the front office in the middle of the day to take their medication. For them, the once-a-day option is particularly attractive. How well do stimulants work? Many studies show that either one of the two main stimulants (methylphenidate or dextroamphetamine) will help about 7 out of 10 children with ADHD. Again, about 70 percent of children who don't respond well to the first stimulant tried will respond well to the other. There is no good way to tell which medication a child is going to respond to best. A "good response" means a very noticeable improvement in activity level, attention, and impulse control. Most children do best when medication is combined with nonmedical behavioral and educational therapy Click here to join the discussion on ADHD and Attention Problems. Stimulants do not make children smarter. But they can help a child complete his work, follow rules more consistently, and get by with less friction at home and in school. In older children, they might also improve sports performance (because of better concentration) and driving safety. Stimulants do not treat the other problems that sometimes accompany ADHD, such as learning disabilities, depression, or serious rule breaking, but they often help somewhat with oppositional behavior. Other medications In addition to the stimulants, there are many other medications that can be used to treat ADHD. But none of them has been researched nearly as much as the stimulants. So many children have taken Ritalin, for instance, that we can be pretty confident that we know all of its side effects. The same cannot be said for the newer ADHD medications, however. These medications can be very helpful for children who don't respond well to stimulants. But it only makes sense to try these once you've tried and rejected the stimulants.
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