Treatment

Treatment for attention deficit hyperactivity disorder (ADHD) can help relieve the symptoms and make the condition much less of a problem in day-to-day life.

ADHD can be treated using medication or therapy, but a combination of both is often best.

Treatment is usually arranged by a specialist, such as a paediatrician or psychiatrist, although the condition may be monitored by your GP.

Medication

There are 5 types of medication licensed for the treatment of ADHD:

methylphenidate
dexamfetamine
lisdexamfetamine
atomoxetine
guanfacine

These medications are not a permanent cure for ADHD but may help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practise new skills.

Some medications need to be taken every day, but some can be taken just on school days. Treatment breaks are occasionally recommended to assess whether the medication is still needed.

If you were not diagnosed with ADHD until adulthood, your GP and specialist can discuss which medications and therapies are suitable for you.

If you or your child is prescribed one of these medications, you'll probably be given small doses at first, which may then be gradually increased. You or your child will need to see your GP for regular check-ups to ensure the treatment is working effectively and check for signs of any side effects or problems.

It's important to let your GP know about any side effects and talk to them if you feel you need to stop or change treatment.

Your specialist will discuss how long you should take your treatment but, in many cases, treatment is continued for as long as it is helping.

Methylphenidate

Methylphenidate is the most commonly used medication for ADHD. It belongs to a group of medicines called stimulants, which work by increasing activity in the brain, particularly in areas that play a part in controlling attention and behaviour.

Methylphenidate may be offered to adults, teenagers and children over the age of 5 with ADHD.

The medication can be taken as either immediate-release tablets (small doses taken 2 to 3 times a day) or as modified-release tablets (taken once a day in the morning, with the dose released throughout the day).

Common side effects of methylphenidate include:

a small increase in blood pressure and heart rate
loss of appetite, which can lead to weight loss or poor weight gain
trouble sleeping
headaches
stomach aches
mood swings

Lisdexamfetamine

Lisdexamfetamine is a similar medication to dexamfetamine and works in the same way.

It may be offered to teenagers and children over the age of 5 with ADHD if at least 6 weeks of treatment with methylphenidate has not helped. Adults may be offered lisdexamfetamine as the first-choice medication instead of methylphenidate.

Lisdexamfetamine comes in capsule form, taken once a day.

Common side effects of lisdexamfetamine include:

decreased appetite, which can lead to weight loss or poor weight gain
aggression
drowsiness
dizziness
headaches
diarrhoea
nausea and vomiting

Dexamfetamine

Dexamfetamine is similar to lisdexamfetamine and works in the same way. It may be offered to adults, teenagers and children over the age of 5 with ADHD.

Dexamfetamine is usually taken as a tablet once or twice a day, although an oral solution is also available.

Common side effects of dexamfetamine include:

decreased appetite
mood swings
agitation and aggression
dizziness
headaches
diarrhoea
nausea and vomiting

Atomoxetine

Atomoxetine works differently from other ADHD medications.

It's a selective noradrenaline reuptake inhibitor (SNRI), which means it increases the amount of a chemical in the brain called noradrenaline.

This chemical passes messages between brain cells, and increasing it can aid concentration and help control impulses.

Atomoxetine may be offered to adults, teenagers and children over the age of 5 if it's not possible to use methylphenidate or lisdexamfetamine. It's also licensed for use in adults if symptoms of ADHD are confirmed.

Atomoxetine comes in capsule form, usually taken once or twice a day.

Common side effects of atomoxetine include:

a small increase in blood pressure and heart rate
nausea and vomiting
stomach aches
trouble sleeping
dizziness
headaches
irritability

Atomoxetine has also been linked to some more serious side effects that are important to look out for, including suicidal thoughts and liver damage.

If either you or your child begin to feel depressed or suicidal while taking this medication, speak to your doctor.

Guanfacine

Guanfacine acts on part of the brain to improve attention, and it also reduces blood pressure.

It may be offered to teenagers and children over the age of 5 if it's not possible to use methylphenidate or lisdexamfetamine. Guanfacine should not be offered to adults with ADHD.

Guanfacine is usually taken as a tablet once a day, in the morning or evening.

Common side effects include:

tiredness or fatigue
headache
abdominal pain
dry mouth

Therapy

As well as taking medication, different therapies can be useful in treating ADHD in children, teenagers and adults. Therapy is also effective in treating additional problems, such as conduct or anxiety disorders, that may appear with ADHD.

Some of the therapies that may be used are outlined below.

Psychoeducation

Psychoeducation means you or your child will be encouraged to discuss ADHD and its effects. It can help children, teenagers and adults make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.

Behaviour therapy

Behaviour therapy provides support for carers of children with ADHD and may involve teachers as well as parents. Behaviour therapy usually involves behaviour management, which uses a system of rewards to encourage your child to try to control their ADHD.

If your child has ADHD, you can identify types of behaviour you want to encourage, such as sitting at the table to eat. Your child is then given some sort of small reward for good behaviour and has a privilege removed for poor behaviour.

For teachers, behaviour management involves learning how to plan and structure activities, and to praise and encourage children for even very small amounts of progress.

Parent training and education programmes

If your child has ADHD, specially tailored parent training and education programmes can help you learn specific ways of talking to your child, and playing and working with them to improve their attention and behaviour.

You may also be offered parent training before your child is formally diagnosed with ADHD.

These programmes are usually arranged in groups of around 10 to 12 parents. A programme usually consists of 10 to 16 meetings, lasting up to 2 hours each.

Being offered a parent training and education programme does not mean you have been a bad parent – it aims to teach parents and carers about behaviour management, while increasing confidence in your ability to help your child and improve your relationship.

Social skills training

Social skills training involves your child taking part in role-play situations and aims to teach them how to behave in social situations by learning how their behaviour affects others.

Cognitive behavioural therapy (CBT)

CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. A therapist would try to change how your child feels about a situation, which would in turn potentially change their behaviour.

CBT can be carried out with a therapist individually or in a group.

Other possible treatments

There are other ways of treating ADHD that some people with the condition find helpful, such as cutting out certain foods and taking supplements. However, there's no strong evidence these work, and they should not be attempted without medical advice.

Diet

People with ADHD should eat a healthy, balanced diet. Do not cut out foods before seeking medical advice.

Some people may notice a link between types of food and worsening ADHD symptoms. If this is the case, keep a diary of what you eat and drink, and what behaviour follows. Discuss this with your GP, who may refer you to a dietitian (a healthcare professional who specialises in nutrition).

Supplements

Some studies have suggested that supplements of omega-3 and omega-6 fatty acids may be beneficial for people with ADHD, although the evidence supporting this is very limited.

It's advisable to talk to your GP before using any supplements, because some can react unpredictably with medication or make it less effective.

You should also remember that some supplements should not be taken long term, as they can reach dangerous levels in your body.

Tips for parents

If you're the parent of a child with ADHD:

be sure your GP or specialist helps you understand the difference between ADHD and any other problems your child may have
think about who else needs to know about your child's ADHD, such as their school or nursery
find out the side effects of any medication your child takes and what you need to look out for
getting to know people at local support groups can stop you feeling isolated and unable to cope

For information on local support groups, contact Attention Deficit Disorder Information and Support Service (ADDISS) or call 020 8952 2800.