ADHD Treatment & Management

Recommended treatment for ADHD depends on age. For children aged 4-5 years, the American Academy of Pediatrics recommends trying behavior therapy first, before trying medication, whereas for children aged 6 and above, it recommends a combination of behavior therapy and medication. For adults, treatment and management options include medications, psychotherapy, and coaching. Education promoting understanding of ADHD is important for individuals with ADHD regardless of age.

Medications

ADHD medications are important intervention for ADHD and are well studied in research. Approximately 75% of children and adolescents will have noticeable improvement on one or more of the medications used for ADHD.

These medications reduce ADHD symptoms by affecting the availability of neurotransmitters, which are chemical messengers that brain cells use to communicate with each other, resulting in better communication within and between different areas of the brain. The common neurotransmitters that are targeted by ADHD medications include dopamine and norepinephrine.

The two main categories of medications that have US Food and Drug Administration (FDA) approvals are stimulants and nonstimulants.

Stimulants are first-line medications for ADHD because of their effectiveness. They can be divided into two types, amphetamine (examples: Adderall, Vyvanse) and methylphenidate (examples: Ritalin, Concerta). The two types of stimulants work in slightly different ways, and one may work better for an individual than another in terms of symptom reduction and side effects.
Nonstimulants are second-line medications for ADHD and may be considered if your child does not respond sufficiently to stimulants. They may also be considered if your child has medical conditions that contraindicate the use of stimulants or have intolerable side effects with them. A nonstimulant may be used together with stimulant medications to improve the management of ADHD symptoms.
- Examples of nonstimulants for ADHD are atomoxetine (Strattera), viloxazine (Qelbree), clonidine (Kapvay, Catapres), and guanfacine (Intuniv, Tenex). Clonidine and guanfacine belong to a class of medications called alpha-2 adrenergic agonists, which may also help with sleep, aggression, behavioral dysregulation, and tics.

To learn more, see Quick Guide to ADHD Medications (pdf).

Therapy

Behavior therapy is the first-line treatment for young children under 6 years of age. It helps children with ADHD to develop positive behaviors and self-control. Parents engage in training sessions with a therapist to learn techniques that help their children be successful at home and at school by reinforcing positive behaviors. Behavioral therapy involving parents also strength the relationship between parents and their children.

For older children aged 8-10 years or above, they can also engage in behavioral therapy themselves to learn new behaviors, eliminate problem behaviors, and handle strong emotions.

In the classroom, teachers can use behavior therapy to manage behavioral issues.

To learn more,

Behavior Therapy for Young Children with ADHD
Behavior Therapy for Younger and Older Children with ADHD
Finding a Therapist - Behavior therapy for young children with ADHD

For adolescents and adults, psychotherapy such as cognitive-behavioral therapy can be helpful for coping with psychological distress resulting from the challenges with living with ADHD, such as issues with self-esteem, negative thoughts, anxiety, depression, and interpersonal difficulties. Therapists may also help individuals with ADHD to develop coping skills and practical strategies to overcome their unique challenges.

Education

Education plays a crucial role in an individual's journey living with a mental health condition. Having a good understanding of one's condition empowers an individual to develop awareness of their symptoms as well as strategies that help them cope with associated challenges. Here are some recommended resources for learning about ADHD.

CHADD’s National Resource Center on ADHD provides comprehensive information on ADHD for different audiences including individuals with ADHD (adults and teens), parents, educators, and professionals.

CDC's Attention-Deficit / Hyperactivity Disorder (ADHD) site includes information on symptoms, diagnosis, treatment, data, research, and free resources.

Understood's ADHD site provides articles, podcasts, and videos on topics related to ADHD, such as tips and strategies, medications, personal stories.