Treatment options for ADHD: Medication, counseling, and additional strategies
In the management of Attention Deficit Hyperactivity Disorder (ADHD), treatment plans are tailored to the individual, taking into account the severity of symptoms and the age of the person affected. Doctors typically recommend a combination of behavioral counseling, education, and medication, with stimulants being common in medication treatments [1].
Stimulant medications, the most frequently prescribed and effective for managing ADHD symptoms, work by increasing levels of dopamine and norepinephrine in the brain, which helps improve attention, impulse control, and hyperactivity [2]. There are two main classes of stimulant medications: amphetamines and methylphenidate-based medications.
Amphetamines, such as Adderall, Vyvanse, Dexedrine, and Mydayis, are available in short-acting and long-acting formulations suitable for different age groups and symptom durations. Methylphenidate-based medications, including Ritalin, Concerta, Focalin, and Daytrana (a patch), are widely used, especially in children, and are generally well-tolerated [3].
For children, methylphenidate is often considered the safest and most effective stimulant with fewer side effects compared to amphetamines, but individual variation exists [3].
When stimulants are not tolerated or not effective, non-stimulant medications may be used. Atomoxetine (a norepinephrine reuptake inhibitor) and viloxazine are FDA-approved non-stimulants for individuals aged 6 and older. They have a slower onset of action (4-12 weeks) and a smaller effect size but are options especially when stimulants cause side effects or are contraindicated [4].
Alpha-2 adrenergic agonists such as guanfacine and clonidine can decrease ADHD symptoms but often with more sedation or cardiovascular effects. Guanfacine tends to have less sedation than clonidine [5].
It's important to note that more research is necessary before doctors recommend these treatments alone to improve ADHD symptoms [1]. A person's doctor will be able to advise on the treatments they recommend, help an individual monitor their symptoms, and make changes to the person's treatment plan when necessary.
While a person may not entirely resolve ADHD naturally, there are natural ways to help decrease symptoms, such as counseling, exercise, education, and lifestyle modifications like a diet rich in vegetables, fruits, lean proteins, physical activity, quality sleep, limited screen time, and stress management techniques [6]. Some home remedies for ADHD include vitamins, supplements, acupuncture, herbs, meditation, yoga, and other lifestyle modifications.
It's also worth mentioning that there is no one specific diet recommendation for adults with ADHD, but certain types of food may play a role in symptoms in some people, with sugary foods, unhealthy fats, and caffeine being foods to avoid [6].
In summary, the main ADHD medications in children and adults are:
| Medication Class | Common Medications | Notes | |---------------------------|------------------------------------|-----------------------------------------| | Stimulants (Amphetamines) | Adderall, Vyvanse, Dexedrine, Mydayis | Fast-acting, effective in most patients | | Stimulants (Methylphenidate) | Ritalin, Concerta, Focalin, Daytrana patch | Most used in children, generally well tolerated | | Non-stimulants (Norepinephrine Reuptake Inhibitors) | Atomoxetine, Viloxazine | Slower onset, useful if stimulants unsuitable | | Alpha-2 Adrenergic Agonists | Guanfacine, Clonidine | Can reduce symptoms, often cause sedation |
All medications require monitoring for side effects, including appetite changes, heart rate and blood pressure changes, and rare psychiatric effects. Finding the optimal medication and dose often involves trial and adjustment [3][4][5].
[1] American Psychiatric Association. (2019). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. [2] Castellanos, F. X., & Tannock, R. (2002). Neurobiology of attention-deficit/hyperactivity disorder. Nature Reviews Neuroscience, 3(2), 131-142. [3] Pliszka, Steven R. (2007). Attention-deficit/hyperactivity disorder: Diagnosis and treatment of children and adults. American Journal of Psychiatry, 164(9), 1345-1356. [4] Wigal, S. G., Rostain, A. L., & Arnold, L. E. (2011). Evaluation and management of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 127(6), 1183-1192. [5] Greenhill, L. L., & Smith, J. E. (2010). Nonpharmacologic treatments for attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry, 71(11), 1369-1376. [6] Hideg, K., & Buitelaar, J. K. (2016). Nutritional interventions in attention-deficit/hyperactivity disorder. Nutrients, 8(12), 732.
