This procedure provides more reliable and objective information that can be used to decide about the benefits of ongoing medication use. Unfortunately, many physicians do not gather objective feedback and rely on anecdotal reports to base medication decision on.

"How often do most ADHD children need to take medication?"

Because the effects of stimulant medication generally wears off within 3-8 hours, two doses per day - one before school and one at mid-day - is quite common. Some children are able to get by with only a single administration per day, while some may require a third dose to help with after school activities and homework.

"Do children with ADHD need to take medication on weekends and over vacations?"

For children whose symptoms are relatively mild, medication during the school day may be all they require. Unfortunately, some children have more severe forms of the disorder and may require medication to be successful in settings outside of school. In part, this will also depend on the effectiveness of other treatments that have been implemented. It is very unfortunate that changes in the insurance industry often prevent children from getting access to psychosocial treatments that can be very helpful.

"For how long do children with ADHD need to take medication?"

The best answer to this question is that a child should take medication for only as long as it is helpful and necessary. For some children with ADHD, symptoms dissipate over time to the point where medication is no longer necessary. Many other children struggle with ADHD symptoms into adolescence and young adulthood, however, and may benefit from medication during many years of their development. Because the need for, and effectiveness of stimulant medication may change over time, most experts recommend that this issue be re-evaluated on an annual basis.

"What other kinds of medication are used to treat children with ADHD?"

Tricyclic Antidepressants are also used in treating individuals with ADHD and the effectiveness and safety of these compounds has also been studied fairly extensively. Medications in this class of compounds include Imipramine, Desipramine, Amitriptyline, Nortriptyline, and Clomipramine.

In some cases, physicians may also prescribe other anti-depressants to treat ADHD including fluoxetine (i.e. Prozac), and bupropion (i.e. Wellbutrin). Although there is some research evidence that these medications can be helpful in treating ADHD, few controlled studies on their efficacy have been conducted to date.

"Why would antidepressants be prescribed rather than stimulants?"

In most instances, stimulant medication (generally methylphenidate) will be the drug prescribed initially. If the initial stimulant prescribed does not help, it is quite possible that another stimulant will.

Antidepressants would generally be tried if:

• stimulant medication was not effective - before giving up on stimulants, physicians may try several different types;
• even though stimulant medication reduced ADHD symptoms, there were adverse side effects that prevent the child from taking it;
• there is a clear indication of a co-occurring mood or anxiety disorder in addition to ADHD - there is some evidence that when these additional difficulties are present, stimulant medication may be less effective than antidepressants.

"What about using dietary changes to help with ADHD?"

The idea that ADHD symptoms reflected allergic reactions to food additives was popularized by Dr. Ben Feingold, a pediatrician and allergist. Dr. Feingold speculated that reactions to certain types of food additives accounted for many cases of ADHD and that dietary modifications would help many of these children.

Unfortunately, the data to support such a claim is lacking. There are probably a small group of children who respond negatively to certain food additives, however, and who will be helped by dietary changes. The odds that an ADHD child’s symptoms can be successfully treated by dietary changes would appear to be quite small.

"What about the use of natural remedies to treat ADHD?"

Over the years, a number of natural remedies to treat ADHD have been proposed. To my knowledge, however, no controlled studies documenting the effectiveness of these remedies have been conducted. This is a real problem, because in many cases, the apparent benefits reported by individuals may represent nothing more than a placebo effect.

Does that mean that these treatments do not work? Not necessarily. It does mean, however, that compelling scientific evidence for their effectiveness has not yet been provided.