Submitted by Anjum Bashir, MD
It is understandable for parents to have concerns, especially about
treatments, when their child is diagnosed with ADD/ADHD. While there is
no “cure” for ADD/ADHD, it can be successfully managed. The terms ADD
and ADHD are often used interchangeably, but the difference is that ADD
does not include the hyperactivity component. Treatments focus on
reducing the symptoms of ADHD and improving functioning. In most cases,
ADHD is best treated with a combination of medication and behavior
therapy.
Be sure that you have the correct diagnosis before starting any
treatment. As mentioned in previous articles, ADHD can be difficult to
diagnose. The traditional method of gathering information about a
person’s behavior and determining if the hyperactivity, inattention, and
impulsivity meets the criteria for ADHD is quite subjective and prone
to error. A new technology called the Quotient® ADHD System is available
that can diagnose ADHD with greater certainty. Using this test, which
takes about 15 minutes, can help assure that you don’t start treatment
for ADHD if a different issue is causing similar symptoms. Let’s first
discuss medication options.
Stimulants, such as Ritalin and Adderall, are the best-known and most
widely used treatments. Between 70 and 80 percent of children, teens,
and adults with ADHD respond positively to these medications. ADHD
medications usually reduce hyperactivity and impulsivity and improve the
ability to focus, work, and learn. Although it may seem unusual to
treat ADHD with a medication considered a stimulant, it actually has a
calming effect.
A one-size-fits-all approach does not apply for people with ADHD. What
works for one person might not work for another. One person might have
side effects with a certain medication, while another may not. Sometimes
several different medications or dosages must be tried before finding
one that works best. Anyone taking medications, especially children,
must be monitored closely and carefully by caregivers and doctors.
There are many types of stimulant medications available, and they come
in different forms, such as a pill, capsule, liquid, or skin patch. Some
medications also come in short-acting, long-acting, or extended release
varieties. In each of these varieties, the active ingredient is the
same, but it is released differently in the body. Long-acting or
extended release forms often allow the medication to be taken just once a
day. For children, this allows them to take the medication just once a
day before school so they don’t have to make a daily trip to the school
nurse for another dose. Parents and doctors should decide together which
medication is best for a child and whether the child needs medication
only for school hours or for evenings and weekends, too.
There is often a lot of concern regarding side effects and safety of
medication. The most commonly reported side effects are decreased
appetite, sleep problems, anxiety, and irritability. Some people also
report mild stomachaches or headaches. Most side effects are minor and
disappear over time or if the dosage level is lowered. Some parents
worry that stimulant medications may lead to substance abuse or
dependence, but there is little evidence of this. Under medical
supervision, stimulant medications are considered safe. It must be
emphasized that medication is only one part of a comprehensive treatment
program that should also include behavior modification and lifestyle
changes, such as nutrition and exercise.
Next month: behavior therapy in treating ADHD
For more information on Quotient Testing for ADHD diagnosis, TMS Therapy
for depression, or any mental illness, please contact Anjum Bashir, MD
at 217-422-0027. He is one of the few physicians in central Illinois
offering TMS Therapy and Quotient Testing. His Decatur office is located
at 1900 E. Lake Shore Dr. Ste. 201, and he also has an office in
Bloomington. TMS therapy is covered by many insurance companies,
including BCBS.
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