When ADHD Medications Are Not Working for Your Child

Medications for treating symptoms of attention deficit hyperactivity disorder (ADHD) can be very effective for children, making it easier for them to pay attention in school, maintain friendships, and navigate life. But sometimes, it's hard to find the right medicine and the right dosage, with the fewest side effects. With some careful adjusting, however, it's usually possible to find a program that works.

ADHD Medications

There are different medication choices for ADHD. Most medications are stimulants, but that is not your only option.

Stimulants

The most commonly prescribed ADHD are stimulants. They may be methylphenidate-based: (Ritalin IR and LA), Focalin (dexmethylphenidate IR & XR), Concerta, and others (once daily) and Jornay (given at bedtime, clinical effects begin in the morning). There is also the transdermal patch Daytrana, which is worn for nine hours of the day and then removed.

Stimulants may also be amphetamine-based: Adderall (mixed amphetamine salts - IR & XR), Dexedrine (IR & ER), Vyvanse (lisdexamfetamine - once daily), and Mydayis (also once daily).

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

When a medication doesn't work or causes intolerable side effects, the options are usually to adjust the dose, either up or down, or switch to another medication. For example, if Adderall isn't relieving a child's symptoms or is making them cry a lot, then lowering their dosage or having them try one of the other stimulant medications may solve the problem.

Non-Stimulant Medications

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 alternative medications used to treat ADHD include the medications Catapres (clonidine) and Tenex (guanfacine). These can be effective for impulsivity, hyperactivity, and sleep disturbances.

When Medication Doesn't Work

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.

A Word From Verywell

If you have a child with ADHD, putting various medications and dosages to the test to find what will work for him 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).

Let the doctor know about any side effects you believe are associated with your child's treatment. Don't be afraid to push for changes. There are many options available.