By Hedy Marks
Reviewed by Patricia Quinn, MD
Many children with ADHD have other conditions, such as anxiety, depression, and conduct disorder. They may be taking medications for that, as well as ADHD.
Doctors typically start patients on one medication at a time. They will then monitor your child to see how they respond to the medication and manage any side effects that may occur. Then they can add another medication if the first choice is not effective, or to address symptoms of another disorder.
After the other health problem is stable, then the ADHD medicine can be added, notes psychiatrist Alexander Strauss, MD. "The goal of ADHD medical treatment is to get an improvement of symptoms with the lowest dose and fewest side effects," Strauss says.
Is the Medication Working?
If the ADHD medicine is working and dosed correctly, you should notice a rapid improvement in your child's behavior, says psychiatry professor Steven Cuffe, MD, of the University of Florida College of Medicine in Jacksonville.
Your child may be more focused and better able to stay on task. You may also see improvements in his relationships, and he may be more tolerant.
If you're not seeing those changes, let your doctor know. The same goes for any other medications they're taking: If you're not seeing results, talk to your doctor.
5 Tips to Manage the Medications
- Keep a medication diary. Write down all the medications your child takes, how much they take, when they take it, and any side effects. Review the diary with your child's doctor at follow-up appointments.
- Create a medicine schedule. With the help of your child's doctor, create a schedule that shows when to take each drug. List the time, medication, and dose. Ask your doctor if it's OK for your child to take all the medicines at one time and at the same time each day.
- Use a pill organizer. Organizers can help ensure medicines are taken daily. But keep the original prescription bottles so that you can refer back to the name of the medicine, how to take it, and the number of refills available.
- Set an alarm. If your child has to take her medications at different times, set the alarm on your phone to remind you when it’s time to take a particular medication.
- Give medicine with food. Unless your child's doctor says otherwise, give the medicine with food to minimize stomachache. If your child doesn’t like the way the medication tastes, try giving it with yogurt or applesauce.
Overcoming Side Effects
The most common side effects associated with ADHD medicines have to do with eating and sleep. Long-acting stimulants, in particular, may hamper their appetite.
"To overcome this, try to get calories in kids before school, after school, at dinner, and with a nighttime snack," Strauss says. "Feed your child a hearty breakfast in the morning and high-calorie snacks such as ice cream and milkshakes in the afternoon."
Another option is to try a short-acting stimulant, which lasts about 3-4 hours, instead of a long-acting stimulant. Once the medicine wears off, you may be able to get your child to eat.
If your child develops sleep problems while taking medication, your doctor may recommend lowering the dose or switching the time of day that your child takes their medicine.
For example, some parents find it works well to give their child a long-acting stimulant earlier in the morning. (Wake them up, give them the medicine, and then let them go back to sleep for an hour.) By the time it's bedtime, the medicine is out of their system and it may be easier for them to fall asleep.
Of course, it's also important for your child to have good sleep habits, such as sticking to a regular bedtime and not watching TV or using computers or phones in the bedroom.
If Your Child Doesn't Want to Take the Medication
Many kids don't like the way medications make them feel, so they don't want to take them even if it is helping them.
Listen to their concerns. Tell them that you understand. Point out the differences you see, such as if they're doing better in school, at home, and with their relationships.
If they still don't want to take the medicine, talk to your child's doctor about adjusting or changing the medicine. There are now many different formulations of medication available to treat the symptoms of ADHD. Depending on the issue your child is having, he can be switched to a skin patch, sprinkles, or a liquid form of these medications rather than a pill.