ADHD

TABLE OF CONTENTS

Treatments

Non-drug

Prescription Drugs

Adderall XR (Mixed salts of a single-entity amphetamine product) Aptensio XR (Methylphenidate XR) Concerta (Methylphenidate XR) Focalin XR (Dexmethylphenidate) Intuniv (Guanfacine) Strattera (Atomoxetine)

Over-the-counter Drugs

What Leading Medical Organizations Recommend When Treating ADHD

WHAT TO TRY FIRST

After the diagnosis of ADHD is made according to professional criteria (DSM-IV), the American Academy of Pediatrics suggests:

Children age 6-11 years and adolescents age 12-18:  Any FDA-approved medication for ADHD with or without evidence based parent- and/or teacher-administered behavior/psychological therapy. Among medications, they feel that the evidence is stronger for stimulants (such as methylphenidate). Stimulant medications are started at a low dose which is gradually increased over 1 to 3 months with close monitoring by the physician.

Adults:  According to the National Institute for Health and Care Excellence - the organization that provides the British government with independent evidence-based advice on drugs and treatments:

"Drug treatment is the first-line treatment for adults with ADHD with either moderate or severe levels of impairment. Methylphenidate is the first-line drug. Psychological interventions without medication may be effective for some adults with moderate impairment, but there are insufficient data to support this recommendation."

WHAT ELSE TO TRY

Children age 6-11 years:  If the initial stimulant medication is ineffective at the maximum dose or has intolerable side effects, the Kaiser Permanente Care Management Institute recommends switching to a different stimulant, possibly adding a second stimulant or a different class of medication (such as guanfacine), or switching to atomoxetine. Consultation with a specialist is recommended.

Adults:  According to the National Institute for Health and Care Excellence:

"If methylphenidate is ineffective or unacceptable, atomoxetine can be tried. If there is residual impairment despite some benefit from drug treatment, or there is no response to drug treatment, cognitive-behavioral therapy may be considered."

SOURCES

American Academy of PediatricsADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011 Nov;128(5):1007-22
Kaiser Permanente Care Management Institute. Diagnosis and treatment of attention deficit hyperactivity disorder in school-age children and adolescents 2012 clinical practice guideline. Oakland (CA): Kaiser Permanente Care Management Institute; 2012 Mar.
National institute for Health and Care Excellence. Attention deficit hyperactivity disorder. Diagnosis and management of ADHD in children, young people and adults. 2008 Sep (reaffirmed 2013 Jul). NGC:007193