The Multi-Treatment Approach
There is no "quick fix" cure for ADHD, but there are ways to successfully manage its symptoms. Your child's treatment plan should be tailored to his or her specific needs, and may include:

• Behavioral management
• Counseling
• Medication

To be most effective, your child's treatment plan may combine two or all three of these approaches, and should involve you, school personnel, and health professionals working as a team.

Behavioral Management
The goal of any ADHD treatment program is to change ADHD behaviors and to help your child do better at home and school, and to help him or her interact more easily with friends and family. The key to behavior change is you working closely with your child. One way to do this is with behavior-management techniques. A qualified professional can help you design a program of these techniques to help you and your child identify undesirable behaviors and to replace them with more positive ones.

Your doctor can also help you develop clear and consistent guidelines for working with your child. This will let your child know what is expected from him or her and what consequences there are for different types of behaviors. To get your child to change undesirable behaviors, you can use rewards, such as stickers, treats, television, or game time. Rewards are not bribes to persuade a child to do well. They reinforce desired behaviors so that they become learned and replace undesired behaviors.

To help improve your child's self-esteem, the therapist or doctor can also help you create situations in which your child can succeed. Additionally, he or she can help you develop effective punishments, such as withdrawal of rewards or timeouts.

Counseling
Another ADHD treatment option involves counseling with qualified mental health professionals. Such counseling may include psychotherapy, social skills training, or parental training. Counseling can help the child (and parents) understand their feelings and change their behavior. It is especially helpful for coping with a child's low self-esteem, anxiety, depression, and stubborn behaviors. Support groups with other children can help your child learn to interact more effectively with others, develop relationships, and practice new behaviors. Counseling can also be helpful for you and your spouse. It can help you cope with your feelings about parenting a special-needs child, develop effective parenting strategies, and teach you ways to take better care of yourself.

Medication
Many children with ADHD are treated successfully with medication. Medication is especially helpful when it is used as one part of an overall treatment plan. ADHD medications cannot cure the disorder, but they can improve the symptoms so that the child with ADHD is able to function more easily at home, school, and with others.

Stimulants
Stimulants are the most commonly prescribed medications for children with ADHD. In fact, they are 75% to 95% effective in treating the symptoms of ADHD in children.

You may wonder how a medication called a "stimulant" can calm a child who is already hyperactive. These medications actually stimulate the action of the brain's chemical messengers (or neurotransmitters), making these messengers better able to control attention, impulse, and hyperactivity.

As a result, you may see an improvement in your child's:

• Overactivity
• Attention span
• Impulsivity
• Physical and verbal aggression
• School performance
• Relationships with peers, teachers, and parents

Different Types for Different Needs
Each child's need for medication and reactions to it are different. Some children may need larger doses than others to successfully manage their symptoms. Some children may only need to take medication before going to certain events, such as school or a social function. Other children may need to take medication more regularly. Fortunately, different varieties of stimulant medications are available.

Short-Acting Medications
These medications generally relieve symptoms for about 4 hours and are useful for children who only need medication from time to time or for a shorter time period.

Long-Acting Medications
These medications work to control symptoms for longer than 4 hours and can last throughout the school day without the need for a dose during the day.

Your doctor will start your child on the lowest possible dose, adjust the dose weekly, and closely monitor your child to determine if the medication is working or if the dosage should be changed.

Side Effects of Stimulant Medications
Like all medications, ADHD stimulants have some side effects. Most side effects are usually mild and temporary. They may include decreased appetite, stomach pain, weight loss, headache, and trouble sleeping. Other side effects that may be experienced with stimulant medications include nausea, vomiting, fever, dizziness, nervousness, tics, allergic reactions, increased blood pressure, and psychosis (abnormal thinking or hallucinations).

This is not a complete list of possible side effects. It is important to talk to your child's doctor to talk about any side effect your child develops.

Antidepressant Medications
When stimulant medications do not work or when your child is experiencing depression or anxiety in addition to ADHD, your doctor may prescribe other medications. Antidepressants are not approved by the Federal Drug Administration (FDA) for treating ADHD, but some doctors have found them useful. Stimulant medications and antidepressant medications can be taken at the same time. Like stimulants, antidepressants are believed to work on brain chemicals. But with antidepressants, the most dramatic improvement is usually in mood. In general, the children will be happier—less irritable, angry, anxious, or worried.

Children who are treated with antidepressants usually experience mild improvements in attention, impulse control, restlessness, and hyperactivity as well. Unlike stimulants, which are washed out of the body within a few hours, antidepressants must build up in the bloodstream over longer periods of time to work. Children usually take one pill in the morning and one in the evening, and their effectiveness lasts throughout the day. Your doctor will explain more to you about antidepressants and how they are used.

Other Medications
When children have other conditions besides ADHD and/or mood disorders, doctors may prescribe other medications. Like antidepressants, these medications are not approved by the FDA for treating ADHD, but some doctors have found them useful. Stimulant medications are usually more effective, but this drug may be prescribed when stimulants do not work or cannot be used.

It is important to know about the possible side effects, risks, benefits, and drug interactions of each medication. Talk to your child's doctor for more information.

Stimulant Medication—Schedule II Controlled Substance
Schedule II stimulants have special restrictions on them because people may abuse them and eventually become dependent on them. By law, you must see your doctor to get a new prescription for these medications every time they need to be refilled. Generally, stimulants should not be given to people with a history of drug dependence or alcoholism and should only be taken by the person for whom they are prescribed.