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.

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 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

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 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 working.

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) and Tenex (guanfacine). 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, 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.

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.

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 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.

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.