There are several treatment options available to help improve the symptoms of Attention Deficit Hyperactivity Disorder. Since there is no prescription medicine that can "cure" for ADHD, the various medical interventions seek to improve symptoms. The most commonly used medicines are stimulants, such as Ritalin, Dexedrine, Cylert, and ADDerall. Stimulants have been around for about 50 years. Overall, they work very well. Ritalin and Dexedrine are moderately beneficial, or very beneficial, for about 70% to 75% of those who try them.
Stimulants work by increasing both blood flow and the levels of Dopamine in the brain, especially the frontal lobes where the brain's Executive Functions take place. They also increase the inhibitory systems of the brain by enhancing Serotonin and Norepinepherine levels. They do not work by having some mystical "opposite effect" on children.
There is an unbelievable amount of research done on children and Ritalin, less with Dexedrine, ADDerall, and Cylert. We have heard that Ritalin is the most widely studied medication prescribed to children in the world, and we would not dispute that claim. It seems that every doctoral candidate writing his dissertation for psychology does something with Ritalin.
Stimulants, whether Ritalin or the amphetamines such as Dexedrine or ADDerall, all have benefits for children and adults with Attention Deficit Hyperactivity Disorder. Stimulants will increase the brain's ability to inhibit itself. This allows the brain to focus on the right thing at the right time, and to be less distracted, and less impulsive. Stimulants increase the "signal to noise ratio" in the brain.
They will also increase both gross motor co-ordination and fine motor control. For several years the sales brochure for Ritalin simply had pictures of children's handwriting before Ritalin, and with 10 mg of Ritalin in their system. The changes were dramatic, and physicians wrote a lot of prescriptions for Ritalin. Ritalin may be "over-prescribed" in America, it may not be. But if it is "over-prescribed" it is because it actually works! If it didn't work, sometimes dramatically, it wouldn't be "over-prescribed."
Of course, as with any prescription medication, there are potential side-effects that can be serious. So please consult with your physician and monitor the use of these medications very closely.
Are we great advocates for the use of stimulant medications? We have seen these medications help literally hundreds of our patients, and since we have always asked the physicians that we have worked with to be very conservative in prescribing the medications we have seen very few problems over the past fifteen or more years. However, even with that said, we would prefer that patients at least try the nutritional medicines like Attend and Extress, or EEG Biofeedback training first. However, there is a time and a place for the use of stimulant medications. And we want you to have accurate information about them.
You can get more information on the treatment of attention deficit hyperactivity disorder, including specific medications, at the ADHD Information Library.
Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library's family of seven web sites, including attention deficit hyperactivity disorder, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.
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