Why treat ADHD with medication

This month is ADHD awareness month and there is still a lot of stigma and misunderstanding about treatments for ADHD. Research shows that an estimated one third of children with this significant and treatable condition go untreated. Yet many adults who finally seek medical treatment for ADHD say it’s the best thing for them and has totally changed their life- they wish they had it sooner. Medications don’t cure ADHD but they help reduce the symptoms.  In the same way wearing glasses helps someone with a vision impairment or blood pressure medication helps someone who is hypertensive ADHD medication helps a person with a different neurochemistry to concentrate, follow instructions and make safer choices. So what are the treatments for ADHD?

When someone is diagnosed with attention-deficit/hyperactivity disorder (ADHD) the first line treatment is usually stimulant medication. People with ADHD have brains which produce less of certain neurotransmitters including dopamine and norepinephrine. This results in difficulty concentrating, increased impulsivity, hyperactivity and other executive functioning challenges like difficulty planning and regulating emotions.   Medications work to correct this imbalance- but every ADHD brain is different, and it can be a process of trial and error to find the right medication to help an individual.

Stimulants are the most common type of prescription medication to treat ADHD. Stimulants don’t work by increasing your stimulation. Rather, they work by increasing levels of certain chemicals (neurotransmitters) in the brain called dopamine and norepinephrine. These neurotransmitters play important roles in your ability to pay attention, think and stay motivated. Studies have shown that approximately 80% of children with ADHD have fewer symptoms after finding the correct stimulant medication and dosage.

How does it help:

Several researchers have found the benefits of taking medications for ADHD include:

• Better quality of life for families of the child with ADHD
• Better relationships with others
• Better behaviour in the classroom and better outcomes in the workplace
• 32% Reduced risk of accidents and injuries
• Better educational outcomes for children who start medication early ( 6 years old)
• 38-58% Less motor vehicle accident
• 32-41% reduced risk of criminality
• Reduced risk of suicide

What are the side effects?

• Reduced appetite
• Stomach aches
• headaches
• Sleep disturbances
• Increased anxiety

These side effects can be counteracted by changing doses and timing the dose after breakfast or lunchtime. The side effects also stop as soon as the medication is stopped and do not cause long term differences. There also be a combination of medications that work together to get the perfect balance for the individual brain. A psychiatrist or paediatrician is the best person to discuss these options with.

Other treatments:

Deciding what treatment option to use for someone with ADHD isn’t easy. Medication isn’t the only option, as there are data that speech therapy, occupational therapy behavioural treatments that can help children with ADHD learn different skills are also effective. An occupational therapist can help a child work on sensory regulation and organisation skills, while a psychologist may help with managing emotions and risk taking behaviour. A speech pathologist can help with a  communication skills so they understand instructions, can self-advocate and use visuals to help them learn and stay on task.  Recent studies indicate that a combination approach is the best. In other words, medication in combination with therapy  helps people with ADHD to get more out of therapy and school supports and develop lifelong healthy habits. When prescribed correctly by a medical doctor who understands and commonly treats these issues, the downsides of medication do not outweigh the positives in most cases.

Written by Calla Dolton Speech Pathologist

References and further reading:

https://www.health.harvard.edu/blog/adhd-medication-for-kids-is-it-safe-does-it-help-201603049235

https://my.clevelandclinic.org/health/treatments/11766-adhd-medication

Chang Z, Ghirardi L, Quinn PD, Asherson P, D’Onofrio BM, Larsson H. Risks and Benefits of Attention-Deficit/Hyperactivity Disorder Medication on Behavioral and Neuropsychiatric Outcomes: A Qualitative Review of Pharmacoepidemiology Studies Using Linked Prescription Databases. Biol Psychiatry. 2019 Sep 1;86(5):335-343. doi: 10.1016/j.biopsych.2019.04.009. Epub 2019 Apr 17. PMID: 31155139; PMCID: PMC6697582.

https://www.medicalnewstoday.com/articles/long-term-effects-of-adhd-medication#side-effects