Caring for Kids…at Billings Clinic

ADHD Part 2

Last week I defined ADHD and talked about some non-medical interventions that can be helpful for children with this common behavior disorder.  If you are worried your child has ADHD and the non-medical interventions have not been helpful, it’s time to speak with a healthcare provider.  At our office we have a packet of information that needs to be filled out by both parents and school teachers.  Once this is complete you then meet with a pediatrician to go over the paperwork.

Oftentimes ADHD screening tools also screen for other conditions like anxiety, depression and oppositional defiant disorder.  If it is determined your child does meet the diagnosis for ADHD, your child’s doctor will discuss treatment options with you.  Medications are highly effective but can also produce a lot of anxiety for parents.  In our society we are comfortable treating asthma, pneumonia, high blood pressure, etc. with medications but parents are much more uncomfortable talking about treatments for anything considered a brain disorder. For many children, the benefits of medications outweigh the risks. I’ve seen countless times when children who were failing school, becoming socially isolated, and losing more and more confidence every day blossom overnight into confident children finally reaching their potential.

The most common medications are stimulants (Concerta, Adderall, Ritalin, Focalin, Vyvanse to name a few).  They can be dosed with long acting forms usually only taken once or occasionally twice a day.  The short acting forms are taken usually 2-3 times per day.  A few children are on a combination of both.  All of these medicines wear off by the end of the day.  There is no “build up” effect so you can see results almost immediately and make dose adjustments very quickly.  These medicines can be stopped immediately, no weaning is necessary.    In as little as two weeks we can see amazing results: glowing reports from teachers, families enjoying dinner time together, 15 minutes of homework not two hours, improved self-esteem, and less fights at home.

As with any medications there are side effects.  Most of them are the same has a strong cup of coffee, including stomachaches especially if taken on empty stomachs, loss of appetite and trouble sleeping.  Making sure kids eat a good breakfast can help with stomachaches.  Most kids don’t eat much lunch while taking these medicines so will need large, high protein snacks either after school or before bed.  Weight should be monitored at the physician’s office.  Making sure children are on the lowest effective dose can help with sleep issues as well as sticking with a good sleep schedule.  (See previous sleep blog)  Some kids can experience some emotionality, crying more easily or being more sensitive than normal.  This often gets better overtime.  And of course any questions or concerns should be discussed with your doctor.

Children often start treatment in elementary school but ADHD can be diagnosed at any age, even as an adult.  Not every child will continue to need treatment into adulthood.  Some outgrow symptoms by Junior High or High School and others will continue to need it for college and beyond.  Treating symptoms in teenagers becomes important for reasons beyond school.  Teenagers with untreated ADHD are impulsive and more likely to be in car accidents, participate in risky behaviors, abuse drugs and/or alcohol, and commit suicide.  In addition there is a strong genetic component to ADHD.  I hear over and over that parents realize they themselves have a lot of the same symptoms seen in their children.  So if you personally feel you have ADHD symptoms that are interfering with work or home-life I would encourage you to discuss your concerns with a healthcare professional.

Children with ADHD can be challenging for both parents and teachers but with patience, understanding, and occasional medical therapy these children can thrive and succeed.

Kathryn Lysinger, MD

I am a part-time pediatrician and full-time mom of 5 year old Jacob and 3 year old Lauren. After several years away in the “big city” my husband Jeri and I are excited to be back home in Montana. When not working I love to travel, cook and can’t wait to get the entire family back on the slopes in my hometown Red Lodge, MT.

1 comment on “ADHD Part 2
  1. Sara says:

    My son is on Adderall for his ADHD it has saved our family. Before his diagnosis we couldn’t have him home for more than 3 days without needing a break. Now he is a much happier child because he can focus and can stay out of trouble.

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