Signs ADHD Medications Are Not Working for Your Child

What are some signs that Concerta, Adderall, Ritalin, or another medication might not be working? Understanding how to tell and what steps to take next can help your child get the support they need to function at their best in their environment.

Medications for attention-deficit/hyperactivity disorder (ADHD) can be very effective for children. These medications can make it easier for kids to pay attention in school, maintain friendships, and navigate life.

Sometimes it's hard to find the right medicine and the right dosage with the fewest side effects. However, it's usually possible to find a program that works with some careful adjusting.

Signs ADHD Medications Are Not Work for Your Child

In order to determine if your child's medication is effective, it is important to first determine what the drug is intended to do. ADHD medications are often prescribed to help kids manage impulsive behaviors, balance energy levels, improve attention, and regulate emotions.

Some signs that your child's ADHD medication might not be working include:

• Intolerable side effects: You might notice that medication helps your child with attention and behavior, but it may result in side effects that your child cannot tolerate. Such side effects can vary, but may include changes in appetite, stomach upset, nausea, or problems sleeping.
• No change in symptoms: ADHD medications affect people differently. Some medicines may quickly result in changes in behavior, attention, and energy levels, while some might take longer to have an effect. However, if your child doesn't seem to be experiencing adequate relief, it is essential to talk to their doctor.
• Returning or worsening symptoms: In other cases, you might find that a medication works for a while but then seems to lose efficacy over time. If your child's symptoms seem to be returning or worsening, talk to their doctor about other medications that your child can try.

Types of ADHD Medications

There are different medication choices for ADHD. Most are stimulants, but that is not your only option. Non-stimulants can also be used.

Stimulants

The most commonly prescribed ADHD medications are stimulants. They may be methylphenidate-based, such as:

• Ritalin and Ritalin LA (methylphenidate)
• Focalin and Focalin XR (dexmethylphenidate)
• Concerta (methylphenidate), an extended-release tablet that can be taken once daily
• Jornay PM (methylphenidate), which is given at bedtime so the clinical effects begin in the morning
• Daytrana (methylphenidate), a transdermal patch worn for nine hours and then removed

Stimulants may also be amphetamine-based, such as:

• Adderall and Adderall XR (dextroamphetamine and amphetamine), mixed amphetamine salts
• Dexedrine and Dexedrine Spansules (dextroamphetamine)
• Vyvanse (lisdexamfetamine), which is taken once daily
• Mydayis (dextroamphetamine and amphetamine), an extended-release form that can also be taken once daily
• Dyanavel XR (amphetamine), a once-daily extended-release medication available as an oral suspension or tablet for children age six and up

These stimulants are thought to work by increasing levels of a neurotransmitter, or chemical messenger, in the brain called dopamine. Dopamine is associated with motivation and attention, among other things. For many people with ADHD, stimulant medications boost concentration and the ability to focus while at the same time curbing hyperactive and impulsive behaviors.

Non-Stimulant Medications

Non-stimulant medications are typically considered when stimulants can't be used. This could be due to medication side effects, for example. They might also be considered if stimulants are not providing sufficient relief.

A non-stimulant medication called Strattera (atomoxetine) is sometimes a good option for a child who isn't tolerating a stimulant. Some doctors also prescribe Strattera along with a stimulant, making it possible to lower the dose of the stimulant drug enough that it no longer causes side effects.

Other medications used to treat ADHD include non-stimulants Catapres (clonidine), Tenex (guanfacine), and Qelbree (viloxazine). These can be effective for impulsivity, hyperactivity, and sleep disturbances.

When Medication Doesn't Work

When a medication doesn't work or causes intolerable side effects, the options are usually to:

• Adjust the dose, either up or down
• Switch to another medication

For example, suppose Adderall isn't relieving a child's symptoms or is causing unwanted side effects. In that case, lowering their dosage or having them try one of the other stimulant medications may solve the problem.

However, sometimes a child doesn't respond to two or three different stimulant medications and continues to do poorly. It may be that the ADHD diagnosis is wrong and that something else is causing the symptoms the child is experiencing.

In this case, the AAP advises pediatricians to evaluate the child's diagnosis. It is also recommended to have the child tested for a coexisting condition such as depression, bipolar disorder, or a learning disability or behavioral problem.

What Parents Can Do

If you have a child with ADHD, putting various medications and dosages to the test to find what will work for them can be frustrating. Don't hesitate to ask your pediatrician any questions you might have about effectiveness and timing. Sometimes adjusting when the doses are taken can make a big difference.

There are also non-medication strategies that can help kids better manage their behavior. These options are often used alongside medications, including behavior therapy, parent training, and school interventions.